Breast artery calcium noted on screening mammography is predictive of high risk coronary calcium in asymptomatic women: a case control study.
BACKGROUND
The relationship between breast artery calcification (BAC) noted on mammography and both coronary artery disease and cardiovascular risk remains controversial. Few studies have examined the clinical significance of BAC in asymptomatic women. In the present study we evaluated the relationship between BAC and coronary artery calcium (CAC) as identified by multi-slice CT scanning (MSCT).


METHODS
Consecutive women (n = 98) with BAC noted on routine mammography but without known coronary artery disease (CAD) were assessed for CAD risk factors and had assessment of coronary calcium by MSCT. A control cohort of consecutive women who were BAC(-) (n = 104) underwent an identical assessment.


RESULTS
Women who were BAC(+) were older than those who were BAC(-); otherwise, there were no differences between the 2 groups with regard to traditional cardiac risk factors. Significantly more BAC(+) vs. BAC(-) women were found to have high risk CAC scores, defined as CAC > 400 (11.2 % vs. 1.0 %, p = 0.006). However, the rates of CAC scores of 0 were not different between the two groups (50.0 % vs. 54.8 % for BAC(+) and BAC(-) , respectively, p = 0.586). When examined in a multivariate model including the traditional risk factors of diabetes, increasing age, smoking, hyperlipidemia, and family history of CAD, the presence of BAC remained significantly associated with CAC > 400 (OR = 22.6, 95 % CI = 2.1 - 237.1).


CONCLUSIONS
The presence of breast artery calcium on screening mammography was a strong independent predictor (odds ratio > 22) of high risk coronary artery calcium scores (defined as CAC > 400). The presence of BAC in those with significant CAD risk factors may warrant further evaluation.
Department of Cardiology, Cardiovascular Research Institute, Lehigh Valley Health Network, Allentown, USA.
Martin E
ME
Matsumura
Crystal
C
Maksimik
Matthew W
MW
Martinez
Michael
M
Weiss
James
J
Newcomb
Kenneth
K
Harris
Michael A
MA
Rossi
D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D001940:Breast / Q000098:blood supply*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008323:Mammary Arteries / Q000000981:diagnostic imaging*; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D061205:Vascular Calcification / Q000000981:diagnostic imaging*
coronary calcium; risk assessment