Abstract
PurposeObesity 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.Materials and MethodsFibroglandular volume, breast volume, and their ratio, the VBD, were calculated from mammograms before and after WLS by using Volpara™ automated software.ResultsFor the 80 women included, average body mass index decreased from 46.0 ± 7.22 to 33.7 ± 7.06 kg/m2. 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 × 10−9) 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.ConclusionsBreast 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.
Highlights
Mammographic density is a term used to describe the proportion of radiopaque, fibroglandular/dense tissue on a mammogram
Breast volume and fibroglandular volume decreased, and volumetric breast density (VBD) increased following Weight loss surgery (WLS), with the most significant change observed in postmenopausal women and non-diabetics
The mean body mass index (BMI) at the time of the preoperative mammogram was 46.0 ± 7.22 kg/m2; this decreased to 33.7 ± 7.1 kg/m2 at the time of the postoperative mammogram
Summary
Mammographic density is a term used to describe the proportion of radiopaque, fibroglandular/dense tissue on a mammogram. In 1976, Wolfe first reported that breast cancer risk was associated with mammographic parenchymal patterns [1]. Initially this increased risk was attributed to a Bmasking bias^ stemming from difficulty in detecting a tumor against a radiodense background, further studies confirmed that a higher density in and of itself conferred additional risk [2]. Several studies have shown that reductions in mammographic density over time, for example, in response to endocrine therapies, are associated with a significant decrease in breast cancer risk [9,10,11,12,13,14,15]. Because density is a modifiable risk factor and can be targeted for cancer risk reduction, there is a great deal of interest in investigating the biologic and molecular mechanisms that link breast density to breast cancer risk
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