Department of Surgery, University of Michigan, Ann Arbor, Michigan.
Department of Surgery, University of Michigan, Ann Arbor, Michigan.
Surg Obes Relat Dis. 2018 Nov;14(11):1643-1651. doi: 10.1016/j.soard.2018.07.024. Epub 2018 Aug 1.
Mammographic breast density (BD) is an independent risk factor for breast cancer. The effects of bariatric surgery on BD are unknown.
To investigate BD changes after sleeve gastrectomy (SG).
University hospital, United States.
Fifty women with mammograms before and after SG performed from 2009 to 2015 were identified after excluding patients with a history of breast cancer, hormone replacement, and/or breast surgery. Patient age, menopausal status, co-morbidities, hemoglobin A1C, and body mass index were collected. Craniocaudal mammographic views before and after SG were interpreted by a blinded radiologist and analyzed by software to obtain breast imaging reporting and data system density categories, breast area, BD, and absolute dense breast area (ADA). Analyses were performed using χ, McNemar's test, t test, and linear regressions.
Radiologist interpretation revealed a significant increase in breast imaging reporting and data system B+C category (68% versus 54%; P = .0095) and BD (9.8 ± 7.4% versus 8.3 ± 6.4%; P = .0006) after SG. Software analyses showed a postoperative decrease in breast area (75,398.9 ± 22,941.2 versus 90,655.9 ± 25,621.0 pixels; P < .0001) and ADA (7287.1 ± 3951.3 versus 8204.6 ± 4769.9 pixels; P = .0314) with no significant change in BD. Reduction in ADA was accentuated in postmenopausal patients. Declining breast area was directly correlated with body mass index reduction (R = .4495; P < 0.0001). Changes in breast rather than whole body adiposity better explained ADA reduction. Neither diabetes status nor changes in hemoglobin A1C correlated with changes in ADA.
ADA decreases after SG, particularly in postmenopausal patients. Software-generated ADA may be more accurate than radiologist-estimated BD or breast imaging reporting and data system for capturing changes in dense breast tissue after SG.
乳腺密度（BD）是乳腺癌的独立危险因素。减重手术对 BD 的影响尚不清楚。
研究袖状胃切除术（SG）后 BD 的变化。
美国大学医院。
从 2009 年至 2015 年，对接受 SG 治疗的 50 例女性患者进行了研究，排除了有乳腺癌病史、激素替代治疗和/或乳房手术史的患者。收集患者年龄、绝经状态、合并症、糖化血红蛋白和体重指数。由一名盲法放射科医生对 SG 前后的头尾位乳腺 X 线片进行解读，并通过软件分析获得乳腺影像报告和数据系统（BI-RADS）密度分类、乳腺面积、BD 和绝对致密乳腺面积（ADA）。采用卡方检验、McNemar 检验、t 检验和线性回归进行分析。
放射科医生解读显示，SG 后 BI-RADS B+C 类（68%比 54%；P=0.0095）和 BD（9.8%比 8.3%；P=0.0006）显著增加。软件分析显示，SG 后乳腺面积（75398.9 比 90655.9 像素；P<0.0001）和 ADA（7287.1 比 8204.6 像素；P=0.0314）减少，但 BD 无显著变化。绝经后患者的 ADA 减少更明显。下降的乳腺面积与体重指数的降低呈直接相关（R=0.4495；P<0.0001）。与全身脂肪相比，乳腺脂肪的变化更好地解释了 ADA 的减少。糖尿病状态或糖化血红蛋白的变化与 ADA 的变化无关。
SG 后 ADA 减少，尤其是绝经后患者。与放射科医生估计的 BD 或 BI-RADS 相比，软件生成的 ADA 可能更能准确捕捉 SG 后致密乳腺组织的变化。
