Women with breast arterial calcification on digital mammography are at a higher risk of cardiovascular diseases and mortality, according to a new study of postmenopausal women published in the journal Circulation: Cardiovascular Imaging.¹

This study was conducted in Northern California, United States and included a subgroup of 5059 postmenopausal women selected from more than 200,000 women who underwent at least one digital screening mammogram as part of MINERVA (MultIethNic study of brEast aRterial calcium gradation and cardioVAscular disease) study between October 24, 2012 and February 13, 2015. None of the study subjects had a history of breast cancer or heart disease. They were followed up for 6.5 years through their electronic health records for any heart disease. Breast arterial calcification and calcium mass were assessed with the help of digital mammograms.

After a mean follow-up of 6.5 years, 155 ASCVD events and 427 global CVD events were recorded. Presence of breast arterial calcification on mammograms was associated with 51% increased risk of developing ASCVD events such as heart attack or stroke or CVD death after adjusting for traditional CVD risk factors. They were also 23% more likely to develop any cardiovascular disease besides acute MI, stroke such as heart failure, peripheral arterial disease, DVT/PE, cardiomyopathy or CVD death. White or Hispanic/Latina women had higher prevalence of breast arterial calcification compared to Black or Asian women. They were also more likely to be older, have prediabetes/diabetes, higher systolic BP or hypertension.

Based on their findings, the researchers suggest that “breast arterial calcification should be considered a risk-enhancing factor for ASCVD among postmenopausal women”. No dose-response association was noted between cardiovascular disease and breast arterial calcification, unlike coronary artery calcification, which is an established marker of cardiovascular events. Usually regarded as an incidental finding, they are also hopeful that their study would encourage routine reporting of breast arterial calcification including its extent and use it to calculate cardiovascular risk and strategize for optimal heart health with the patients. However, absence of breast arterial calcification should not be considered as indicative of low cardiovascular risk.

Reference

1. Iribarren C, et al. Breast arterial calcification: a novel cardiovascular risk enhancer among postmenopausal women. Circ Cardiovasc Imaging. 15 Mar 2022. https://doi.org/10.1161/CIRCIMAGING.121.013526