title: Benign Arterial Calcification on Screening Mammogram: A Marker for Coronary Artery Disease?
abstract: BACKGROUND
  Studies have shown several risk factors for coronary artery disease (CAD), such as diabetes and hypertension, are associated with benign arterial calcifications (BACs) seen on screening mammograms. However, there are few studies examining the association of BACs with women who are diagnosed with CAD. The purpose of our study was to determine whether there is an association between BACs present on routine screening digital mammograms and the presence of CAD as documented on cardiac catheterization.
  
  
  METHODS
  A retrospective chart review was performed on women aged ≥40 years who had undergone a digital screening mammogram within two years of also having a cardiac catheterization from 1999 to 2010. Mammograms were reviewed for the presence of BACs. Cardiac catheterizations were reviewed for the presence of CAD. Patients with BACs were compared with those without BACs by chi-squared or Wilcoxon rank sum tests.
  
  
  RESULTS
  The final study cohort consisted of 198 patients with 101 patients having clinically significant cardiac vessel disease. Most patients (67.2%) did not have diabetes, while the majority was hypertensive (83.3%) and had hypercholesterolemia (80.8%). On multivariate analysis, history of smoking (p=0.003), hypercholesterolemia (p≤0.0001), and BACs (p=0.005) were significant predictors of CAD. In a second model, CAD on cardiac catheterization was a significant predictor of BACs found on mammography while a history of smoking was a negative predictor of BACs.
  
  
  CONCLUSIONS
  BACs present on digital screening mammography, history of smoking and hypercholesterolemia were all significant predictors of CAD. Routine screening digital mammography could potentially assist in stratification of patients in consideration of CAD.
authors.affiliation: 1 Department of Surgery, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: Deborah
authors.initials: D
authors.lastname: Karm
authors.affiliation: 2 Division of Cardiovascular Medicine, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: David S
authors.initials: DS
authors.lastname: Marks
authors.affiliation: 3 Department of Radiology, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: Melissa
authors.initials: M
authors.lastname: Wein
authors.affiliation: 1 Department of Surgery, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Kong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000098:blood supply*; D001941:Breast Diseases / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006973:Hypertension; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D061205:Vascular Calcification / Q000000981:diagnostic imaging*