Table_2_Effects of bariatric surgery on breast density in adult obese women: systematic review and meta-analysis.docx

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.

引言：减重手术（Bariatric surgery）是治疗肥胖症最有效的手段之一，可有效降低体重并减少肥胖相关乳腺癌的发病率。然而，关于减重手术如何影响乳腺密度，目前学界尚未达成统一结论。本研究旨在明确减重手术前后乳腺密度的变化情况。

方法：本研究通过PubMed和Embase数据库检索相关文献以筛选符合标准的研究，并采用Meta分析（Meta-analysis）方法明确减重手术前后乳腺密度的变化。

结果：本系统评价与Meta分析共纳入7项研究，涉及535名受试者。受试者的平均体质量指数从术前的45.3 kg/m²降至术后的34.4 kg/m²。以乳腺影像报告和数据系统（Breast Imaging Reporting and Data System）评分进行划分：术前术后的A级乳腺密度占比下降3.83%（183例 vs 176例），B级占比上升6.05%（248例 vs 263例），C级占比下降5.32%（94例 vs 89例），D级占比上升300%（1例 vs 4例）。整体而言，减重手术前后乳腺密度未出现显著变化（比值比OR=1.27，95%置信区间CI[0.74, 2.20]，P=0.38）。而采用Volpara密度分级（Volpara density grade）评分时，术后体积乳腺密度显著升高（标准化均数差=-0.68，95%CI[-1.08, -0.27]，P=0.001）。

讨论：减重手术后乳腺密度确实存在显著升高，但该结果依赖于乳腺密度的检测方法。未来需开展更多随机对照试验以验证本研究结论。