众所周知，肥胖和乳腺密度与绝经后女性乳腺癌相关。减肥手术可以有效治疗病态肥胖、持续减轻体重，可能减少癌症发生。不过，减肥手术对于女性乳腺密度的影响尚不明确。
年7月16日，全国乳腺中心联盟（原美国乳腺疾病学会）《乳腺杂志》在线发表美国弗吉尼亚大学医疗中心的研究报告，对减肥手术后的女性乳腺密度变化进行了定性和定量分析。
该研究对～年接受减肥手术、手术前后进行乳腺钼靶检查的例女性患者体重指数变化、乳腺钼靶与手术相隔时间、美国放射学学会乳腺成像报告数据系统（BI-RADS）定性评分进行回顾分析。通过沃尔帕拉密度自动化软件，对其中有定量数据的82例女性乳房体积密度、纤维腺体积、乳房总体积进行计算。对术前和术后数值之差进行评定。
结果，手术时中位年龄50.0岁，术前乳腺钼靶检查与手术相隔中位8.8个月，手术与术后乳腺钼靶检查相隔中位62.3个月。
研究期间，体重指数显著减少（中位46.0比35.4，P0.）。术前与术后乳腺钼靶检查相比，乳腺密度定性评分相似。
82例女性获得沃尔帕拉密度数据，虽然这些患者的乳房体积密度增加，但是减肥手术后纤维腺体积和乳房总体积都显著减少。
因此，该研究结果表明，减肥手术引起体重减轻后，乳房体积密度增加、纤维腺体积和乳房总体积减少。乳腺密度定性评分相似，表明BI-RADS与沃尔帕拉密度测量存在差异。故有必要开展进一步研究，确定乳腺密度成分的不同变化可能如何影响乳腺癌发生风险。
BreastJ.Jul16.[Epubaheadofprint]
Theimpactofbariatricsurgeryonqualitativeandquantitativebreastdensity.
TarynE.Hassinger,J.HunterMehaffey,AnneT.Knisely,BenjaminN.Contrella,DavidR.Brenin,AnnekeT.Schroen,BruceD.Schirmer,PeterT.Hallowell,JenniferA.Harvey,ShaynaL.Showalter.
UniversityofVirginiaHealthSystem,Charlottesville,Virginia,USA.
BACKGROUND:Obesityandbreastdensityareassociatedwithbreastcancerinpostmenopausalwomen.Bariatricsurgeryeffectivelytreatsmorbidobesity,withsustainableweightlossandreductionsincancerincidence.Weevaluatedchangesinqualitativeandquantitativedensity;hypothesizingbreastdensitywouldincreasefollowingbariatricsurgery.
METHODS:Womenundergoingbariatricsurgeryfromtowereidentified,excludingpatientswithoutamammogramperformedbothbeforeandaftersurgery.Changesinbodymassindex(BMI),timebetweenmammogramsandsurgery,andAmericanCollegeofRadiologyBreastImagingReportingandDataSystem(BI-RADS)scoreswereassessed.VolparaDensityautomatedsoftwarecalculatedvolumetricbreastdensity(VBD),fibroglandularvolume(FGV),andtotalbreastvolumeforthe82womenwithdigitaldataavailable.Differencesbetweenpre-andpostsurgeryvalueswereassessed.
RESULTS:Onehundredeightywomenwereincluded.Medianageatsurgerywas50.0years,with8.8monthsbetweenpresurgerymammogramandsurgeryand62.3monthsbetweensurgeryandpostsurgerymammogram.MedianBMIsignificantlydecreasedoverthestudyperiod(46.0vs35.4kg/m2;P0.).NochangeinBI-RADSscoreswasseenbetweenthepre-andpostsurgerymammograms.Eighty-twowomenhadVolparaDensitydataavailable.WhileVBDincreasedinthesepatients,FGVandtotalbreastvolumebothdecreasedfollowingbariatricsurgery.
CONCLUSIONS:IncreasedVBD,decreasedFGV,anddecreasedtotalbreastvolumewereseenfollowingbariatricsurgery-inducedweightloss.Therewasnodifferenceinqualitativebreastdensity,highlightingthediscrepancybetweenBI-RADSandVolparaDensitymeasurements.Furtherinvestigationwillberequiredtodeterminehowdifferentialchangesin
