Mammograms may reveal hidden cardiovascular risks, study finds

In an interview with Contemporary OB/GYN, Lori Daniels, MD, FACC, professor of cardiovascular medicine at UC San Diego, discussed her study on the connection between breast arterial calcification (BAC) seen on mammograms and cardiovascular outcomes, such as heart disease and mortality.

BAC is calcium buildup in breast arteries, often identified during routine mammograms. While BAC has been present in imaging for a long time, it has only recently been recognized as a potential cardiovascular risk marker. Women with BAC, especially those with higher quantities, have a greater likelihood of developing conditions such as heart failure, stroke, heart attacks, and an increased risk of all-cause death.

The study analyzed over 18,000 mammograms and followed participants for up to 11 years to observe cardiovascular events. The results revealed that women with more BAC had a significantly higher risk of adverse cardiovascular outcomes, even when adjusting for typical risk factors such as smoking, cholesterol, blood pressure, and age. This finding is particularly significant for younger women, who may not be aware of their cardiovascular risk.

Daniels emphasized that recognizing BAC on mammograms could be an important tool for early risk detection. Younger women with BAC could benefit from early intervention, such as lifestyle changes, including better diet and increased exercise. This preventive approach could reduce the risk of future cardiovascular events.

Importantly, Daniels advised that BAC should not cause panic, as it does not guarantee a poor cardiovascular outcome. However, it should prompt women to pay more attention to their heart health, much like how conditions such as high blood pressure or cholesterol are managed. She stressed that it will take time to incorporate BAC into routine clinical practice and find the best ways to use this data without alarming patients unnecessarily.

Overall, Daniels is optimistic about the potential for BAC on mammograms to serve as a low-cost, widely available indicator that could encourage women to adopt healthier lifestyles and possibly avoid more severe medical interventions in the future.