Assessing Breast Arterial Calcification in Mammograms and Its Implications for Atherosclerotic Cardiovascular Disease Risk

Cardiovascular disease and its risk factors are continuously researched, but it remains the leading cause of death worldwide. Gender disparities exist along the continuum of care, highlighting the need to improve the prevention of atherosclerotic vascular disease (ASCVD) for women. ASCVD involves plaque buildup in artery walls, which can cause conditions such as heart attack, stroke, and peripheral arterial disease. 

Numerous studies suggest an association between breast arterial calcifications noted on mammography and cardiovascular disease. Since mammography screening is widely used for the early detection of breast cancer, there has been interest in its potential to identify women who may also be at risk for cardiovascular disease.  

In a recent study published in Clinical Imaging, Dr. Shadi Azam, postdoctoral associate in the Department of Population Health Sciences, Dr. Rulla Tamimi, chief of the Division of Epidemiology and associate director of population science at the Sandra and Edward Meyer Cancer Center, Dr. Jessica Peña, director of the HeartHealth Program in the Dalio Institute of Cardiovascular Imaging and associate professor of clinical medicine and medicine in clinical radiology, and colleagues investigated the determinants of BAC in women undergoing mammography screening, and the relationship between BAC, coronary arterial calcifications (CAC), and estimated 10-year risk of ASCVD 

The results of the study support the notion that BAC detected in routine mammograms may aid in identifying women with elevated risk for cardiovascular disease. Older age, systolic and diastolic blood pressures, higher parity, and younger age at first birth were significantly associated with greater odds of BAC. The estimated risk for developing ASCVD is at its lowest when neither BAC nor CAC are detected in women. 

Our data suggests that if a mammogram reveals breast arterial calcifications, it can serve as a reminder to women to undergo risk assessment for cardiovascular disease,” said Dr. Azam. She emphasizes that these findings warrant further evaluation and validation in larger studies. Future prospective trials are needed to determine what the clinical significance of breast arterial calcification might be. 

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