Vohra Nasreen A, Kachare Swapnil D, Vos Paul, Schroeder Bruce F, Schuth Olga, Suttle Dylan, Fitzgerald Timothy L, Wong Jan H, Verbanac Kathryn M
Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC, 27834, USA.
Vidant Medical Center, Greenville, NC, 27834, USA.
Obes Surg. 2017 Apr;27(4):1013-1023. doi: 10.1007/s11695-016-2415-6.
Obesity and breast density are both associated with an increased risk of breast cancer and are potentially modifiable. Weight loss surgery (WLS) causes a significant reduction in the amount of body fat and a decrease in breast cancer risk. The effect of WLS on breast density and its components has not been documented. Here, we analyze the impact of WLS on volumetric breast density (VBD) and on each of its components (fibroglandular volume and breast volume) by using three-dimensional methods.
Fibroglandular volume, breast volume, and their ratio, the VBD, were calculated from mammograms before and after WLS by using Volpara™ automated software.
For the 80 women included, average body mass index decreased from 46.0 ± 7.22 to 33.7 ± 7.06 kg/m. Mammograms were performed on average 11.6 ± 9.4 months before and 10.1 ± 7 months after WLS. There was a significant reduction in average breast volume (39.4 % decrease) and average fibroglandular volume (15.5 % decrease), and thus, the average VBD increased from 5.15 to 7.87 % (p < 1 × 10) after WLS. When stratified by menopausal status and diabetic status, VBD increased significantly in all groups but only perimenopausal and postmenopausal women and non-diabetics experienced a significant reduction in fibroglandular volume.
Breast volume and fibroglandular volume decreased, and VBD increased following WLS, with the most significant change observed in postmenopausal women and non-diabetics. Further studies are warranted to determine how physical and biological alterations in breast density components after WLS may impact breast cancer risk.
肥胖和乳腺密度均与乳腺癌风险增加相关，且都具有潜在的可调节性。减肥手术（WLS）可使体脂量显著减少，并降低乳腺癌风险。WLS对乳腺密度及其组成部分的影响尚无文献记载。在此，我们采用三维方法分析WLS对乳腺体积密度（VBD）及其各组成部分（纤维腺体体积和乳房体积）的影响。
使用Volpara™自动化软件，根据WLS前后的乳房X线照片计算纤维腺体体积、乳房体积及其比值VBD。
纳入的80名女性中，平均体重指数从46.0±7.22降至33.7±7.06kg/m²。乳房X线照片平均在WLS前11.6±9.4个月及术后10.1±7个月进行。平均乳房体积显著减少（减少39.4%），平均纤维腺体体积减少（减少15.5%），因此，WLS后平均VBD从5.15%增至7.87%（p<1×10⁻⁴）。按绝经状态和糖尿病状态分层时，所有组的VBD均显著增加，但只有围绝经期和绝经后女性以及非糖尿病患者的纤维腺体体积显著减少。
WLS后乳房体积和纤维腺体体积减少，VBD增加，绝经后女性和非糖尿病患者的变化最为显著。有必要进一步研究以确定WLS后乳腺密度组成部分的生理和生物学改变如何影响乳腺癌风险。
