Breast arterial calcifications linked to cardiovascular disease risk

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Breast arterial calcifications may be linked to cardiovascular disease risk, according to a recent study presented at the 2024 Annual Meeting of The Menopause Society.¹

While cardiovascular disease is the leading cause of mortality in women, linked to 1 in 3 deaths among female individuals in the United States per year, risk assessment tools for this condition are lacking. Data about how to identify warning signs in women also remain unreliable.

Heart disease may present differently in women than men, and presentations may vary among women from different backgrounds. However, the new data indicates a mammogram may be able to identify a common risk factor.

The study included approximately 400 women, who were followed for 18 years. Results indicated a potential association between breast arterial calcifications and cardiovascular disease risk. These breast arterial calcifications, normally benign, can be identified as white parallel lines on a mammogram.

Atherosclerotic cardiovascular disease, which presents as a buildup of plague in the walls of the arteries and limits blood flow to the organs, presented in 23% of patients with breast arterial calcifications on a mammogram vs 13.9% in those without. According to Hannah Daley, lead author, this indicates that breast arterial calcifications identified from a mammogram should be routinely reported.

Additional study details were discussed at the 2024 Annual Meeting of The Menopause Society during the presentation, “The association between breast arterial calcifications observed on mammography and cardiovascular disease: preliminary results from an 18-year prospective study.”

“Studies like this one are encouraging because they provide information on a tool that health care professionals could use to determine the risk of heart disease in women,” said Stephanie Faubion, MD, MBA, medical director for The Menopause Society. “In addition, it reinforces that the risk factors for cardiovascular disease in women are different than for men.”

This data is supported by a prior study about cardiovascular risk assessment in women conducted by investigators at Penn State College of Medicine.² The meta-analysis included data from 9 studies and found that patients with breast arterial calcification were at an increased risk of stroke, cardiovascular death, atherosclerotic cardiovascular disease, and congestive heart failure.

Data was obtained from 46,958 women aged a mean 61.5 years. The mean follow-up was 11.5 years and breast arterial calcification in mammograms was reported in 16% of participants. Outcomes were assessed using odds ratios (ORs) and 95% confidence intervals, while I² values were used to assess heterogeneity.

Stroke, cardiac mortality, atherosclerotic cardiovascular disease, congestive heart failure, and all-cause mortality were all significantly linked with breast arterial calcification presence, with ORs of 1.99, 3.04, 1.87, 1.88, and 1.87, respectively. Only myocardial infarction had no association, with an OR of 1.36.

“I think this study is important for primary care physicians, and also cardiologists, and really any clinician that looks at cardiovascular disease risk assessment,” said study investigator Matthew Nudy, MD, assistant professor of Medicine and Public Health Sciences at Penn State College of Medicine.

Alongside discussing key considerations for interoperating the data, Nudy recommended further research to increase understanding of the predictive value of breast arterial calcification on mammograms.

References

1. Breast arterial calcification could be warning sign of heart disease. The Menopause Society. September 10, 2024. Accessed September 12, 2024. https://menopause.org/press-releases/breast-arterial-calcification-could-be-warning-sign-of-heart-disease
2. Campbell P. Leveraging mammograms to improve cardiovascular risk assessment. Contemporary OB/GYN. May 2, 2024. Accessed September 12, 2024. https://www.contemporaryobgyn.net/view/leveraging-mammograms-to-improve-cardiovascular-risk-assessment