Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.
Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia, USA.
Breast J. 2019 Nov;25(6):1198-1205. doi: 10.1111/tbj.13430. Epub 2019 Jul 16.
Obesity and breast density are associated with breast cancer in postmenopausal women. Bariatric surgery effectively treats morbid obesity, with sustainable weight loss and reductions in cancer incidence. We evaluated changes in qualitative and quantitative density; hypothesizing breast density would increase following bariatric surgery.
Women undergoing bariatric surgery from 1990 to 2015 were identified, excluding patients without a mammogram performed both before and after surgery. Changes in body mass index (BMI), time between mammograms and surgery, and American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) scores were assessed. VolparaDensity™ automated software calculated volumetric breast density (VBD), fibroglandular volume (FGV), and total breast volume for the 82 women with digital data available. Differences between pre- and postsurgery values were assessed.
One hundred eighty women were included. Median age at surgery was 50.0 years, with 8.8 months between presurgery mammogram and surgery and 62.3 months between surgery and postsurgery mammogram. Median BMI significantly decreased over the study period (46.0 vs 35.4 kg/m ; P < 0.001). No change in BI-RADS scores was seen between the pre- and postsurgery mammograms. Eighty-two women had VolparaDensity™ data available. While VBD increased in these patients, FGV and total breast volume both decreased following bariatric surgery.
Increased VBD, decreased FGV, and decreased total breast volume were seen following bariatric surgery-induced weight loss. There was no difference in qualitative breast density, highlighting the discrepancy between BI-RADS and VolparaDensity™ measurements. Further investigation will be required to determine how differential changes in components of breast density may affect breast cancer risk.
肥胖和乳腺密度与绝经后妇女的乳腺癌有关。减重手术可以有效地治疗病态肥胖，可持续减轻体重并降低癌症发病率。我们评估了定性和定量密度的变化；假设减重手术后乳腺密度会增加。
从 1990 年至 2015 年期间，确定接受减重手术的女性患者，但不包括手术前后均未进行乳房 X 光检查的患者。评估体重指数（BMI）、乳房 X 光检查与手术之间的时间以及美国放射学院乳腺成像报告和数据系统（BI-RADS）评分的变化。对于 82 名具有数字数据的女性，使用 VolparaDensity™自动软件计算体积乳腺密度（VBD）、纤维腺体体积（FGV）和总乳房体积。评估手术前后值之间的差异。
共纳入 180 名女性。手术时的中位年龄为 50.0 岁，术前乳房 X 光检查与手术之间的时间为 8.8 个月，手术与术后乳房 X 光检查之间的时间为 62.3 个月。研究期间 BMI 显著降低（46.0 与 35.4 kg/m2；P<0.001）。术前和术后乳房 X 光检查之间的 BI-RADS 评分无变化。82 名女性有 VolparaDensity™数据。尽管这些患者的 VBD 增加，但减重手术后 FGV 和总乳房体积均减少。
减重手术后体重减轻会导致 VBD 增加、FGV 减少和总乳房体积减少。定性乳腺密度没有差异，突出了 BI-RADS 和 VolparaDensity™测量之间的差异。需要进一步研究以确定乳腺密度成分的差异变化如何影响乳腺癌风险。
