Breast arterial calcification may predict coronary artery calcification

Results of a study presented at the American Roentgen Ray Society Annual Meeting indicated that breast arterial calcification on digital mammography predicted coronary artery calcification in women.

Laurie Margolies, MD, FACR, associate professor of radiology at Icahn School of Medicine at Mount Sinai and director of breast imaging at Mount Sinai Hospital, and colleagues analyzed 371 women who had a digital mammogram and an unenhanced CT scan performed within 1 year of each other. The researchers identified calcified breast vessels on the mammogram and characterized them by number of vessels involved and length of involvement (less than one-third, one-third to two-thirds, or greater than two-thirds). They also characterized density of involvement as mild (one vessel wall, no increase in density of vessel or both), moderate (increased density of vessel manifested as clouding) or severe (lumen obscured by calcium). They compared those characteristics with ordinal coronary artery calcification (CAC) score.

Seventy-six percent of women who had an ordinal CAC score of 0 also had an ordinal breast arterial calcification (BAC) score of 0, and 55% of women who had an ordinal CAC score of 4 to 12 also had an ordinal BAC score of 4 to 12. Margolies and colleagues determined that the presence of any BAC conferred a significant increased risk for CAC (HR = 2.8).

Length of BAC and number of vessels involved both correlated with increased risk for CAC (P < .0001 for both), but density of involvement was the most significant predictor of CAC. Of the 26 women with severe BAC density, 88% had CAC and 69% had an ordinal CAC score of 4.

“The opportunity to diagnose [CV] risk on mammography heralds a paradigm shift in imaging,” Margolies said in a press release. “Providing this knowledge to physicians increases the opportunity for patients to take advantage of [CV] risk-reduction strategies while screening for breast cancer.”

The researchers wrote in an abstract that “these results argue for the inclusion of BAC in mammography reports and education of primary care physicians about this important additional risk predictor for [CAD] so that primary [CVD] prevention strategies can be implemented as clinically warranted.” – by Erik Swain

Reference:

Margolies L, et al. Abstract 1226. Presented at: American Roentgen Ray Society Annual Meeting; April 19-24, 2015; Toronto.

Disclosure: Margolies reports consulting for ACR Image Metrix, CareFusion, Fujifilm Medical Systems USA and Konica Minolta Medical Imaging USA.