Breast tissue density change after oophorectomy in BRCA mutation carrier patients using visual and volumetric analysis

Objective: BRCA1/2 mutations account for 30–50% in fibroglandular volume. There was a higher abso-of hereditary breast cancers and bilateral oopho-lute decrease in VBD in patients aged between 40–50 rectomy is associated with a reduced risk of breast (p < 0.01). Using Volpara Density Grades (analogous to cancer in these patients. Breast density is a well-BI-RADS 4th edition density categories), 84% of females established breast cancer risk factor and is also asso-displayed a decrease in density category over the study ciated with increased risk in BRCA carriers. The aim of period compared to only 76% using the radiologists’ the study was to evaluate the impact of oophorectomy visual classification (p < 0.001) on mammographic breast density and to assess which Conclusion: Oophorectomy is associated with a decrease method of breast density assessment is more sensitive in breast density and younger patients exhibit a larger to change over time. absolute decrease. Volpara is more sensitive to identify Methods: Retrospective study of 50 BRCA1/2 patients change over time compared to visual assessment. who underwent bilateral oophorectomy and had at least a Advances in knowledge: Oophorectomy is associated baseline and post-surgery mammogram. Mammographic with a significant decrease in VBD in patients with breast density was determined by Volpara and consensus BRCA mutations and Volpara Density Grades were more visual assessment by two radiologists. The primary sensitive to identify decreases in density compared to endpoint was change in density between baseline and visually assessed BI-RADS categories. Decreases in the first mammogram post-surgery. breast density following oophorectomy surgery in BRCA Results: At baseline, there was a non-significant trend patients may be one of the mechanisms contributing to for decreased density with increasing age. Volumetric the observed decreased breast cancer risk after surgery. breast density (VBD) significantly decreased after However, further studies are needed to investigate the oophorectomy from a median VBD of 12.5% at baseline relationship between breast density, oophorectomy and to 10.2% post-surgery which was driven by a reduction breast cancer risk in BRCA patients.