{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T08:08:09Z","timestamp":1785312489311,"version":"3.55.0"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["88887.901362\/2023\u201000"],"award-info":[{"award-number":["88887.901362\/2023\u201000"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The association between periodontitis and breast cancer (BC) risk has been reported, but with considerable variability in effect estimates across studies. This meta\u2010epidemiological study aimed to systematically evaluate how methodological characteristics of primary studies influence these reported effect estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cohort and case\u2010control studies were searched in electronic databases up to February 2025. Study quality was assessed using the Newcastle\u2013Ottawa Scale. Meta\u2010analyses were conducted to estimate risk measures (relative risk [RR] and 95% confidence intervals [CI]). Meta\u2010regression and subgroup analyses were performed to investigate potential variability in effect estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 19 included studies, although the overall pooled estimate indicated a 19% higher risk of BC in women with periodontitis compared with those without periodontitis (RR\u00a0=\u00a01.19; 95%CI, 1.05\u20131.34), meta\u2010epidemiological analyses showed attenuated estimates in prospective vs. case\u2010control studies (RR\u00a0=\u00a01.05\u00a0vs. 1.54), high\u2010 vs. moderate\u2010quality studies (RR\u00a0=\u00a01.09\u00a0vs. 2.10), and adjusted vs. unadjusted analyses (RR\u00a0=\u00a01.07\u00a0vs. 1.48) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although a small association between periodontitis and BC risk was observed, its magnitude appears to be overestimated in lower\u2010quality, case\u2010control, and inadequately adjusted studies. These findings underscore the importance of methodological rigor in the interpretation of the evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain language summary<\/jats:title>\n                    <jats:p>This meta\u2010epidemiological study, based on a systematic and rigorous literature search, confirmed a modest association between periodontitis and increased breast cancer risk. The strength of this association appears to be inflated by methodological limitations in the primary studies, particularly in case\u2010control designs and in studies with limited adjustment for confounding factors. These findings emphasize the need for high\u2010quality prospective studies to more accurately characterize this relationship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.70171","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:37:52Z","timestamp":1785310672000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Periodontitis and breast cancer risk: A systematic review with meta\u2010epidemiological analysis"],"prefix":"10.1002","author":[{"given":"Rhayssa Kuhn","family":"Peitoxo","sequence":"first","affiliation":[{"name":"Department of Stomatology\u2010Periodontics Federal University of Santa Maria  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catiusse Crestani","family":"Del Agnese","sequence":"additional","affiliation":[{"name":"Department of Stomatology\u2010Periodontics Federal University of Santa 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