title: Mammography before and after bariatric surgery.
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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Bariatric and Minimally Invasive Surgery, Stanford Hospital and Clinics, Palo Alto, CA.
authors.forename: Tara E
authors.initials: TE
authors.lastname: Mokhtari
authors.affiliation: Bariatric and Minimally Invasive Surgery, Stanford Hospital and Clinics, Palo Alto, CA.
authors.forename: Ulysses S
authors.initials: US
authors.lastname: Rosas
authors.affiliation: Department of Radiology, Stanford Hospital and Clinics, Palo Alto, CA.
authors.forename: John R
authors.initials: JR
authors.lastname: Downey
authors.affiliation: Department of Radiology, Stanford Hospital and Clinics, Palo Alto, CA.
authors.forename: Kanae K
authors.initials: KK
authors.lastname: Miyake
authors.affiliation: Department of Radiology, Stanford Hospital and Clinics, Palo Alto, CA.
authors.forename: Debra M
authors.initials: DM
authors.lastname: Ikeda
authors.affiliation: Bariatric and Minimally Invasive Surgery, Stanford Hospital and Clinics, Palo Alto, CA. Electronic address: morton@stanford.edu.
authors.forename: John M
authors.initials: JM
authors.lastname: Morton
mesh_terms: D050110:Bariatric Surgery; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008327:Mammography / Q000592:standards*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D017698:Postmenopause / Q000502:physiology; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D055105:Waist Circumference; D015431:Weight Loss / Q000502:physiology
keywords: bariatric; breast; cancer; mammography; weight loss