Top

Published in:

01-10-2017 | Clinical trial

Mammographic breast density decreases after bariatric surgery

Authors: Austin D. Williams, Alycia So, Marie Synnestvedt, Colleen M. Tewksbury, Despina Kontos, Meng-Kang Hsiehm, Lauren Pantalone, Emily F. Conant, Mitchell Schnall, Kristoffel Dumon, Noel Williams, Julia Tchou

Published in: Breast Cancer Research and Treatment | Issue 3/2017

Abstract

Purpose

Breast density (BD), an important risk factor for breast cancer, can change over time in some women, but the underlying mechanism is unclear. Very little is known about the impact of surgical weight loss on BD. Our hypothesis is that weight loss after bariatric surgery is associated with a significant and favorable change in mammographic BD.

Methods

We identified 1097 women 40 years of age or older who underwent gastric bypass or sleeve gastrectomy at our institution from 2010 to 2014. Women who did not have either pre- and post-bariatric surgery mammograms performed at our institution were excluded; 110 had both mammograms and comprised the cohort. Breast density was determined both qualitatively, using reported BI-RADS density, and quantitatively, using the Laboratory for Individualized Breast Radiodensity Assessment.

Results

Qualitative BI-RADS density, quantitative breast area, and percent BD significantly decreased in post-bariatric surgery mammograms (p = 0.009, <0.001, and <0.001, respectively).

Conclusions

Our retrospective study demonstrated that surgical weight loss was associated with a significant decrease in breast density. Additional studies are warranted to validate our findings and elucidate the molecular mechanisms underlying breast density change after weight loss surgery.

Available only for authorised users

Boyd NF, Byng JW, Jong RA, Fishell EK, Little LE, Miller AB, Lockwood GA, Tritchler DL, Yaffe MJ (1995) Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst 87(9):670–675CrossRef

Boyd NF, Lockwood GA, Byng JW, Tritchler DL, Yaffe MJ (1998) Mammographic densities and breast cancer risk. Cancer Epidemiol Biomark Prev 7(12):1133–1144

Byrne C, Schairer C, Wolfe J, Parekh N, Salane M, Brinton LA, Hoover R, Haile R (1995) Mammographic features and breast cancer risk: effects with time, age, and menopause status. J Natl Cancer Inst 87(21):1622–1629CrossRef

Warner E, Lockwood G, Tritchler D, Boyd NF (1992) The risk of breast cancer associated with mammographic parenchymal patterns: a meta-analysis of the published literature to examine the effect of method of classification. Cancer Detect Prev 16(1):67–72PubMed

D’orsi C, Bassett L, Berg W, Feig S, Jackson V, Kopans D (2003) Breast imaging reporting and data system: ACR BI-RADS-mammography. American College of Radiology (ACR), Reston

Figueroa JD, Pfeiffer RM, Patel DA, Linville L, Brinton LA, Gierach GL, Yang XR, Papathomas D, Visscher D, Mies C, Degnim AC, Anderson WF, Hewitt S, Khodr ZG, Clare SE, Storniolo AM, Sherman ME (2014) Terminal duct lobular unit involution of the normal breast: implications for breast cancer etiology. J Natl Cancer Inst. doi:10.1093/jnci/dju286 CrossRefPubMedPubMedCentral

Shepherd JA, Kerlikowske K, Ma L, Duewer F, Fan B, Wang J, Malkov S, Vittinghoff E, Cummings SR (2011) Volume of mammographic density and risk of breast cancer. Cancer Epidemiol Biomark Prev 20(7):1473–1482. doi:10.1158/1055-9965.EPI-10-1150 CrossRef

Heine JJ, Cao K, Rollison DE (2011) Calibrated measures for breast density estimation. Acad Radiol 18(5):547–555. doi:10.1016/j.acra.2010.12.007 CrossRefPubMedPubMedCentral

Kerlikowske K, Ichikawa L, Miglioretti DL, Buist DS, Vacek PM, Smith-Bindman R, Yankaskas B, Carney PA, Ballard-Barbash R, Institutes National, National Institutes of Health Breast Cancer Surveillance C (2007) Longitudinal measurement of clinical mammographic breast density to improve estimation of breast cancer risk. J Natl Cancer Inst 99(5):386–395. doi:10.1093/jnci/djk066 CrossRefPubMed

10.

Martinez JA, Chalasani P, Thomson CA, Roe D, Altbach M, Galons JP, Stopeck A, Thompson PA, Villa-Guillen DE, Chow HH (2016) Phase II study of metformin for reduction of obesity-associated breast cancer risk: a randomized controlled trial protocol. BMC Cancer 16:500. doi:10.1186/s12885-016-2551-3 CrossRefPubMedPubMedCentral

11.

Brisson J, Morrison AS, Kopans DB, Sadowsky NL, Kalisher L, Twaddle JA, Meyer JE, Henschke CI, Cole P (1984) Height and weight, mammographic features of breast tissue, and breast cancer risk. Am J Epidemiol 119(3):371–381CrossRef

12.

Reeves KW, Stone RA, Modugno F, Ness RB, Vogel VG, Weissfeld JL, Habel LA, Sternfeld B, Cauley JA (2009) Longitudinal association of anthropometry with mammographic breast density in the Study of Women’s Health Across the Nation. Int J Cancer 124(5):1169–1177. doi:10.1002/ijc.23996 CrossRefPubMedPubMedCentral

13.

Boyd NF, Greenberg C, Lockwood G, Little L, Martin L, Byng J, Yaffe M, Tritchler D (1997) Effects at two years of a low-fat, high-carbohydrate diet on radiologic features of the breast: results from a randomized trial. Canadian Diet and Breast Cancer Prevention Study Group. J Natl Cancer Inst 89(7):488–496CrossRef

14.

Wanders JO, Bakker MF, Veldhuis WB, Peeters PH, van Gils CH (2015) The effect of weight change on changes in breast density measures over menopause in a breast cancer screening cohort. Breast Cancer Res 17:74. doi:10.1186/s13058-015-0583-2 CrossRefPubMedPubMedCentral

15.

Shah M, Simha V, Garg A (2006) Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab 91(11):4223–4231. doi:10.1210/jc.2006-0557 CrossRefPubMed

16.

Weber M, Muller MK, Bucher T, Wildi S, Dindo D, Horber F, Hauser R, Clavien PA (2004) Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg 240(6):975–982 discussion 982–973 CrossRef

17.

Keller BM, Chen J, Daye D, Conant EF, Kontos D (2015) Preliminary evaluation of the publicly available Laboratory for Breast Radiodensity Assessment (LIBRA) software tool: comparison of fully automated area and volumetric density measures in a case-control study with digital mammography. Breast Cancer Res 17:117. doi:10.1186/s13058-015-0626-8 CrossRefPubMedPubMedCentral

18.

Keller BM, Nathan DL, Wang Y, Zheng Y, Gee JC, Conant EF, Kontos D (2012) Estimation of breast percent density in raw and processed full field digital mammography images via adaptive fuzzy c-means clustering and support vector machine segmentation. Med Phys 39(8):4903–4917. doi:10.1118/1.4736530 CrossRefPubMedPubMedCentral

19.

Analytics CfBICa (2014) The Laboratory for individualized breast radiodensity assessment

20.

Radimer KL, Ballard-Barbash R, Miller JS, Fay MP, Schatzkin A, Troiano R, Kreger BE, Splansky GL (2004) Weight change and the risk of late-onset breast cancer in the original Framingham cohort. Nutr Cancer 49(1):7–13. doi:10.1207/s15327914nc4901_2 CrossRefPubMed

21.

Parker ED, Folsom AR (2003) Intentional weight loss and incidence of obesity-related cancers: the Iowa Women’s Health Study. Int J Obes Relat Metab Disord 27(12):1447–1452. doi:10.1038/sj.ijo.0802437 CrossRefPubMed

22.

Goodwin PJ, Chlebowski RT (2016) Obesity and Cancer: insights for Clinicians. J Clin Oncol 34(35):4197–4202. doi:10.1200/JCO.2016.70.5327 CrossRefPubMedPubMedCentral

23.

van den Brandt PA, Schulpen M (2017) Mediterranean diet adherence and risk of postmenopausal breast cancer: results of a cohort study and meta-analysis. Int J Cancer 140(10):2220–2231. doi:10.1002/ijc.30654 CrossRefPubMed

24.

Himpens J, Dapri G, Cadiere GB (2006) A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 16(11):1450–1456. doi:10.1381/096089206778869933 CrossRefPubMed

25.

Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S, Larsson B, Narbro K, Sjostrom CD, Sullivan M, Wedel H, Swedish Obese Subjects Study Scientific G (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351(26):2683–2693. doi:10.1056/NEJMoa035622 CrossRefPubMed

26.

Adams TD, Stroup AM, Gress RE, Adams KF, Calle EE, Smith SC, Halverson RC, Simper SC, Hopkins PN, Hunt SC (2009) Cancer incidence and mortality after gastric bypass surgery. Obesity (Silver Spring) 17(4):796–802. doi:10.1038/oby.2008.610 CrossRef

27.

Sjostrom L, Gummesson A, Sjostrom CD, Narbro K, Peltonen M, Wedel H, Bengtsson C, Bouchard C, Carlsson B, Dahlgren S, Jacobson P, Karason K, Karlsson J, Larsson B, Lindroos AK, Lonroth H, Naslund I, Olbers T, Stenlof K, Torgerson J, Carlsson LM, Swedish Obese Subjects S (2009) Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol 10(7):653–662. doi:10.1016/S1470-2045(09)70159-7 CrossRefPubMed

28.

Vohra NA, Kachare SD, Vos P, Schroeder BF, Schuth O, Suttle D, Fitzgerald TL, Wong JH, Verbanac KM (2016) The short-term effect of weight loss surgery on volumetric breast density and fibroglandular volume. Obes Surg. doi:10.1007/s11695-016-2415-6 CrossRefPubMedCentral

29.

Mokhtari TE, Rosas US, Downey JR, Miyake KK, Ikeda DM, Morton JM (2017) Mammography before and after bariatric surgery. Surg Obes Relat Dis 13(3):451–456. doi:10.1016/j.soard.2016.10.021 CrossRefPubMed

30.

Sprague BL, Conant EF, Onega T, Garcia MP, Beaber EF, Herschorn SD, Lehman CD, Tosteson AN, Lacson R, Schnall MD, Kontos D, Haas JS, Weaver DL, Barlow WE, Consortium P (2016) Variation in mammographic breast density assessments among radiologists in clinical practice: a multicenter observational study. Ann Intern Med 165(7):457–464. doi:10.7326/M15-2934 CrossRefPubMedPubMedCentral

Title: Mammographic breast density decreases after bariatric surgery
Authors: Austin D. Williams
Alycia So
Marie Synnestvedt
Colleen M. Tewksbury
Despina Kontos
Meng-Kang Hsiehm
Lauren Pantalone
Emily F. Conant
Mitchell Schnall
Kristoffel Dumon
Noel Williams
Julia Tchou
Publication date: 01-10-2017
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2017
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-017-4361-y

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2017

Prognostic values of cancer associated macrophage-like cells (CAML) enumeration in metastatic breast cancer

A randomized phase II trial of ridaforolimus, dalotuzumab, and exemestane compared with ridaforolimus and exemestane in patients with advanced breast cancer

A pilot study of cabergoline for the treatment of metastatic breast cancer

Impact of the 21-gene recurrence score on outcome in patients with invasive lobular carcinoma of the breast

New FTY720-docetaxel nanoparticle therapy overcomes FTY720-induced lymphopenia and inhibits metastatic breast tumour growth

Risk of mortality of node-negative, ER/PR/HER2 breast cancer subtypes in T1, T2, and T3 tumors

Keynote webinar | Spotlight on antibody–drug conjugates in cancer