Breast arterial calcification may indicate women’s future CV risk

Breast arterial calcification identified during routine mammography was associated with greater risks for coronary artery disease and stroke within 10 years, data published in Menopause show.

Routine mammography is widely accepted in screening for breast cancer and detects breast arterial calcification (BAC) in 14% of women who undergo screening mammography, according to study background.

“Breast arterial calcifications, however, are rarely documented on mammogram reports because there is no known association between BAC and breast cancer,” Matthew Nudy, MD, an assistant professor of medicine and public health sciences at the Penn State Hershey Medical Center and Penn State College of Medicine, and colleagues wrote. “However, this incidental finding may be a potential risk stratification tool for CVD.”

Nudy and colleagues prospectively enrolled women presenting for screening mammography at four radiology facilities between June and August 2004. At 10 years, 1,039 women completed follow-up questionnaires on the development of coronary artery disease (CAD) and stroke since enrollment, as well as CVD risk factors.

Among participants who completed follow-up, 114 (11%) had BAC at baseline and 925 (89%) did not. At baseline, the mean age of women was 55.5 years, and 58.7% were postmenopausal. At follow-up, 87.7% were postmenopausal.

At follow-up, 99 (86.8%) women with BAC at baseline and 706 (76.3%) women with no BAC at baseline had at least one CVD risk factor, such as hypertension, diabetes, tobacco use or family history of CVD.

The researchers excluded 38 (3.7%) women who had CAD at baseline, leaving 1,001 women for analyses of the development of the disease. Controlling for age, women who had BAC identified at baseline were more likely to develop CAD compared with those who did not have BAC at baseline (9.9% vs. 4.9%; OR = 3.14; 95% CI, 1.86-5.27). When also controlling for CAD risk factors, baseline BAC presence was associated with an even greater risk for CAD (OR = 3.76; 95% CI, 1.94-7.28).

Separately, Nudy and colleagues analyzed data from 1,032 women who had not had a stroke at baseline. Controlling for age, women who had BAC present at baseline were more likely to have had a stroke at follow-up compared with those who did not have BAC present at baseline (5.3% vs. 1.1%; OR = 5.1; 95% CI, 1.82-14.3).

The study is the longest a cohort investigating the link between BAC and CVD has been followed, according to the researchers.

“Large, prospective, population-based studies are needed to confirm the association between BAC and CVD and to determine what role BAC may have in stratifying a women's risk of developing CVD,” Nudy and colleagues wrote.