Assessment of mammographic breast density after sleeve gastrectomy

Alvárez, Rafael; Ridelman, Elika; Rizk, Natalie N.; White, Morgan S.; Zhou, Chuan; Chan, Heang Ping; Varban, Oliver A.; Helvie, Mark A.; Seeley, Randy J.

doi:10.1016/j.soard.2018.07.024

Cited by 3 publications

(5 citation statements)

References 29 publications

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“…The results of the meta-analysis showed that after bariatric surgery, VBD increased (P = 0.001), while BI-RADS grade A decreased by 3.83% (183 vs. 176) (P = 0.38). However, methods for quantifying breast density from before to after bariatric surgery by other software all yielded positive results ( 15 , 17 ). This discrepancy in results was due to differences in breast density evaluation software and evaluation methods.…”

Section: Discussionmentioning

confidence: 99%

“…However, methods for quantifying breast density from before to after bariatric surgery by other software all yielded positive results (15,17). This discrepancy in results was due to differences in breast density evaluation software and evaluation methods.…”

Section: Discussionmentioning

confidence: 99%

“…The mean follow-up period was 3.5 years. All seven studies used the BI-RADS scale (6,(13)(14)(15)(16)(17)(18)(19). Four (13,15,17,19) used two density scoring methods and evaluation criteria (Table 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All seven studies used the BI-RADS scale (6,(13)(14)(15)(16)(17)(18)(19). Four (13,15,17,19) used two density scoring methods and evaluation criteria (Table 1). When we compared the BI-RADS scores before and after bariatric surgery (Table 2), we found the following changes: grade A: 183 vs. 176; grade B: 248 vs. 263; grade C: 94 vs. 89; and grade D: 1 vs. 4.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Effects of bariatric surgery on breast density in adult obese women: systematic review and meta-analysis

et al. 2023

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IntroductionBariatric surgery is one of the most effective methods for treating obesity. It can effectively reduce body weight and reduce the incidence of obesity-related breast cancer. However, there are different conclusions about how bariatric surgery changes breast density. The purpose of this study was to clarify the changes in breast density from before to after bariatric surgery.MethodsThe relevant literature was searched through PubMed and Embase to screen for studies. Meta-analysis was used to clarify the changes in breast density from before to after bariatric surgery.ResultsA total of seven studies were included in this systematic review and meta-analysis, including a total of 535 people. The average body mass index decreased from 45.3 kg/m2 before surgery to 34.4 kg/m2 after surgery. By the Breast Imaging Reporting and Data System score, the proportion of grade A breast density from before to after bariatric surgery decreased by 3.83% (183 vs. 176), grade B (248 vs. 263) increased by 6.05%, grade C (94 vs. 89) decreased by 5.32%, and grade D (1 vs. 4) increased by 300%. There was no significant change in breast density from before to after bariatric surgery (OR=1.27, 95% confidence interval (CI) [0.74, 2.20], P=0.38). By the Volpara density grade score, postoperative volumetric breast density increased (standardized mean difference = -0.68, 95% CI [-1.08, -0.27], P = 0.001).DiscussionsBreast density increased significantly after bariatric surgery, but this depended on the method of detecting breast density. Further randomized controlled studies are needed to validate our conclusions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Effects of bariatric surgery on breast density in adult obese women: systematic review and meta-analysis

et al. 2023

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“…Furthermore, reduced recurrence and mortality from cancer have been observed in bariatric surgery patients ( Aminian et al, 2022 ; Bruno and Berger, 2020 ; Zhang et al, 2020a ) although underlying mechanisms remain unclear. A major question remains regarding whether reductions in cancer risk and outcomes are associated with weight loss per se or are due to bariatric surgery-specific benefits, which are inherently challenging to delineate in patients ( Schauer et al, 2017 ; Alvarez et al, 2018 ). Taken together, additional prospective studies are necessary to determine if intentional weight loss through surgery offers significant promise as an approach that could be highly impactful for reducing cancer burden and potentially improving therapy ( Courcoulas, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Response to immune checkpoint blockade improved in pre-clinical model of breast cancer after bariatric surgery

Sipe

Chaib

Korba

et al. 2022

eLife

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Bariatric surgery is becoming more prevalent as a sustainable weight loss approach, with vertical sleeve gastrectomy (VSG) being the first line of surgical intervention. We and others have shown that obesity exacerbates tumor growth while diet-induced weight loss impairs obesity-driven progression. It remains unknown how bariatric surgery-induced weight loss impacts cancer progression or alters responses to therapy. Using a pre-clinical model of diet induced obesity followed by VSG or diet-induced weight loss, breast cancer progression and immune checkpoint blockade therapy was investigated. Weight loss by bariatric surgery or weight matched dietary intervention before tumor engraftment protected against obesity-exacerbated tumor progression. However, VSG was not as effective as dietary intervention in reducing tumor burden despite achieving a similar extent of weight and adiposity loss. Circulating leptin did not associate with changes in tumor burden, however circulating IL-6 was elevated in mice after VSG. Uniquely, tumors in mice that received VSG displayed elevated inflammation and immune checkpoint ligand PD-L1+ myeloid and non-immune cells. Further, mice that received VSG had reduced tumor T lymphocytes and markers of cytolysis suggesting an ineffective anti-tumor microenvironment. VSG-associated elevation of PD-L1 prompted us to next investigate the efficacy of immune checkpoint blockade in lean, obese, and formerly obese mice that lost weight by VSG or weight matched controls. While obese mice were resistant to immune checkpoint blockade, anti-PD-L1 potently impaired tumor progression after VSG through improved anti-tumor immunity. Thus, in formerly obese mice, surgical weight loss followed by immunotherapy reduced breast cancer burden. Last, we compared transcriptomic changes in adipose tissue after bariatric surgery from both patients and mouse models that revealed a conserved bariatric surgery associated weight loss signature (BSAS). Importantly, BSAS significantly associated with decreased tumor volume. Our findings demonstrate conserved impacts of obesity and bariatric surgery-induced weight loss pathways associated with breast cancer progression.

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Breast cancer chemoprevention: An update on current practice and opportunities for primary care physicians

Ball

Arévalo

Juarez

et al. 2019

Preventive Medicine

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Assessment of mammographic breast density after sleeve gastrectomy

Abstract: ADA decreases after SG, particularly in postmenopausal patients. Software-generated ADA may be more accurate than radiologist-estimated BD or breast imaging reporting and data system for capturing changes in dense breast tissue after SG.

Cited by 3 publications

References 29 publications

Effects of bariatric surgery on breast density in adult obese women: systematic review and meta-analysis

Effects of bariatric surgery on breast density in adult obese women: systematic review and meta-analysis

Response to immune checkpoint blockade improved in pre-clinical model of breast cancer after bariatric surgery

Breast cancer chemoprevention: An update on current practice and opportunities for primary care physicians

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