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. 2017 Apr;27(4):1013-1023.
doi: 10.1007/s11695-016-2415-6.

The Short-Term Effect of Weight Loss Surgery on Volumetric Breast Density and Fibroglandular Volume

Nasreen A Vohra  1 , Swapnil D Kachare  2   3 , Paul Vos  4 , Bruce F Schroeder  5 , Olga Schuth  2   6 , Dylan Suttle  7 , Timothy L Fitzgerald  2 , Jan H Wong  2 , Kathryn M Verbanac  2
Affiliations

The Short-Term Effect of Weight Loss Surgery on Volumetric Breast Density and Fibroglandular Volume

Nasreen A Vohra et al. Obes Surg. 2017 Apr.

Abstract

Purpose: 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.

Materials and methods: Fibroglandular volume, breast volume, and their ratio, the VBD, were calculated from mammograms before and after WLS by using Volpara™ automated software.

Results: For 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.

Conclusions: 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.

Keywords: Breast Volume; Breast cancer; Breast density; Diabetes; Fibroglandular volume; Obesity; Volumetric breast density; Weight loss surgery.

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Conflict of interest statement

Conflict of Interest

Nasreen A. Vohra, Swapnil D. Kachare, Paul Vos, Olga Schuth, Dylan Suttle, Timothy L. Fitzgerald, Jan. H. Wong, and Kathryn M. Verbanac declare no conflict of interest.

Bruce F. Schroeder is an investor and advisor for Volpara Healthcare Solutions and a paid consultant for GE Healthcare.

Funding

None.

Ethical Statement and Consent Statement

All procedures for this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This retrospective study was approved by the Institutional Review Board at East Carolina University (ID no. UMCIRB 13-001289) and was in compliance with the Health Information Portability and Accountability Act. For this type of study, formal consent is not required.

Figures

Fig. 1
Fig. 1
Study population
Fig. 2
Fig. 2
Difference in fibroglandular volume (FGV, top panel) and volumetric breast density (VBD, bottom panel) before and after weight loss surgery in the a entire study population, b premenopausal women, c perimenopausal women, and d postmenopausal women. N number of patients in each group. Bold line within the box plot indicates median
Fig. 3
Fig. 3
Difference in fibroglandular volume (FGV, top panel) and volumetric breast density (VBD, bottom panel) before and after weight loss surgery in a non-diabetics, b diabetics who became non-diabetics, and c diabetics who stayed diabetic. N number of patients in each group. Bold line within the box plot indicates median
Fig. 4
Fig. 4
a Matrix showing Volpara density grades (VDG) pre and post weight loss surgery. Shaded bold boxes indicate the number of patients with unchanged VDG pre and post weight loss surgery. b Volumetric breast density (VBD) pre and post weight loss surgery in patients who had an unchanged BI-RADS density score of 2 for the pre and post weight loss surgery mammogram
See this image and copyright information in PMC

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