Tara E Mokhtari1, Ulysses S Rosas1, John R Downey2, Kanae K Miyake2, Debra M Ikeda2, John M Morton3. 1. Bariatric and Minimally Invasive Surgery, Stanford Hospital and Clinics, Palo Alto, CA. 2. Department of Radiology, Stanford Hospital and Clinics, Palo Alto, CA. 3. Bariatric and Minimally Invasive Surgery, Stanford Hospital and Clinics, Palo Alto, CA. Electronic address: morton@stanford.edu.
Abstract
BACKGROUND: Morbidly obese women are at increased risk for breast cancer, and the majority of surgical weight-loss patients are older than 40 years old. OBJECTIVE: The purpose of the present study was to determine the technical and interpretive changes in mammography following bariatric surgery. SETTING: Accredited Academic Hospital. METHODS: Two breast-imaging radiologists reviewed screening mammograms performed on 10 morbidly obese women undergoing bariatric surgery both pre- and postoperatively. American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) density, imaging quality measurements, compression force, breast thickness, pectoral nipple line (PNL) length, and x-ray beam kilovoltage (kVp) and miliamperes per second (mAs) were recorded. RESULTS: The average patient age was 56 years old, with mean age at menarche of 13 years old; 70% of patients were postmenopausal (average age 49 years at menopause) and 50% had a family history of breast cancer. There was a significant reduction in both BMI (-13.2 kg/m2, P<.01) and waist circumference (-32.0 cm, P<.01) following bariatric surgery. There was a significant reduction in breast thickness (-23.8 mm), reduction in PNL length (-1.9 cm), reduction in kVp (-1.2), and reduction in mAs (-16.7) even though there was no compression force change in pre- and postoperative mammograms detected. All breast densities were fatty or scattered though there were more scattered and fewer fatty images after surgery (P = .002). CONCLUSION: Morbidly obese women can undergo quality mammograms before and after bariatric surgery; however, weight loss after bariatric surgery leads to only slightly denser mammograms. Furthermore, weight loss reduces mammographic radiation doses.
BACKGROUND: Morbidly obesewomen are at increased risk for breast cancer, and the majority of surgical weight-losspatients are older than 40 years old. OBJECTIVE: The purpose of the present study was to determine the technical and interpretive changes in mammography following bariatric surgery. SETTING: Accredited Academic Hospital. METHODS: Two breast-imaging radiologists reviewed screening mammograms performed on 10 morbidly obesewomen undergoing bariatric surgery both pre- and postoperatively. American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) density, imaging quality measurements, compression force, breast thickness, pectoral nipple line (PNL) length, and x-ray beam kilovoltage (kVp) and miliamperes per second (mAs) were recorded. RESULTS: The average patient age was 56 years old, with mean age at menarche of 13 years old; 70% of patients were postmenopausal (average age 49 years at menopause) and 50% had a family history of breast cancer. There was a significant reduction in both BMI (-13.2 kg/m2, P<.01) and waist circumference (-32.0 cm, P<.01) following bariatric surgery. There was a significant reduction in breast thickness (-23.8 mm), reduction in PNL length (-1.9 cm), reduction in kVp (-1.2), and reduction in mAs (-16.7) even though there was no compression force change in pre- and postoperative mammograms detected. All breast densities were fatty or scattered though there were more scattered and fewer fatty images after surgery (P = .002). CONCLUSION: Morbidly obesewomen can undergo quality mammograms before and after bariatric surgery; however, weight loss after bariatric surgery leads to only slightly denser mammograms. Furthermore, weight loss reduces mammographic radiation doses.
Authors: Rafael Alvarez; Elika Ridelman; Natalie Rizk; Morgan S White; Chuan Zhou; Heang-Ping Chan; Oliver A Varban; Mark A Helvie; Randy J Seeley Journal: Surg Obes Relat Dis Date: 2018-08-01 Impact factor: 4.734
Authors: Natalia Partain; Ali Mokdad; Nancy Puzziferri; Jessica Porembka; Stephen Seiler; Alana Christie; Deborah Farr; Aeisha Rivers; A Marilyn Leitch; Rachel Wooldridge; James Huth; Roshni Rao Journal: BMC Med Imaging Date: 2018-05-09 Impact factor: 1.930