title: Breast arterial calcification and risk of carotid atherosclerosis: focusing on the preferentially affected layer of the vessel wall.
abstract: OBJECTIVE
  To assess the relationship between breast arterial calcification (BAC) detected on screening mammography and atherosclerosis of carotid arteries considering the most likely involved layer of the arterial wall.
  
  
  METHODS
  A total of 537 consecutive women who underwent screening mammography were enrolled in this study. Seventy-nine subjects having BAC, aged 46-75 years, and 125 age-matched controls from those without BAC were selected for ultrasound examination of carotid arteries assessing intima-media thickness (IMT) and plaque presence. Participants were divided into three groups of risk including, low-risk: IMT<0.6mm without plaque, medium-risk: 0.6mm≤IMT≤0.8mm without plaque and high-risk: IMT>0.8mm and/or plaque. Risk factors for atherosclerosis were obtained from medical records for independent effects.
  
  
  RESULTS
  BAC was present in 14.7% of mammograms. According to multivariable logistic regression analyses, significant association was identified between the carotid atherosclerosis risk and presence of BAC. Compared to women with IMT<0.6mm, those with 0.6mm≤IMT≤0.8mm and IMT>0.8mm had OR (95% CI) of 4.88 (1.47-16.16) and 23.36 (4.54-120.14), respectively. The OR (95% CI) for carotid plaque was 3.13 (1.3-7.57). There was no interaction between IMT category and plaque. Significant associations were also detected with postmenopausal duration (P=0.02) and hypertension (P=0.004).
  
  
  CONCLUSIONS
  The risk of carotid atherosclerosis increases with the presence of BAC. Women with BAC are more likely to have thicker IMT than plaque, which could be attributed to the preferentially similar affected layer of media causing thick IMT rather than plaque.
authors.affiliation: Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, North Kargar Ave., Tehran 14114, Iran. nsedighi@sina.tums.ac.ir
authors.forename: Nahid
authors.initials: N
authors.lastname: Sedighi
authors.forename: Amir Reza
authors.initials: AR
authors.lastname: Radmard
authors.forename: Ali
authors.initials: A
authors.lastname: Radmehr
authors.forename: Pari
authors.initials: P
authors.lastname: Hashemi
authors.forename: Abdolmahmoud
authors.initials: A
authors.lastname: Hajizadeh
authors.forename: Amir Pejman Hashemi
authors.initials: AP
authors.lastname: Taheri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging*; D001940:Breast / Q000098:blood supply*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008327:Mammography; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography