The presence of breast arterial calcifications (BAC) on mammography exams might not be as indicative of cardiovascular risk as previously thought, according to new data.
Although a growing body of evidence supports the reporting of BAC visualized on mammograms, exactly how it relates to a woman’s risk of cardiovascular disease—coronary artery disease (CAD) in particular—is still routinely debated. Some studies have found that the presence of BAC increases a woman’s risk of developing CVD by as much as 23%, while others have not found significant associations between the image findings and patients’ cardiovascular health.
The corresponding author of a new paper in the European Journal of Radiology, Eliana Aguiar Petri Nahas of Botucatu Medical School in Brazil and colleagues suggested that the conflicting data could be due to the way in which it was obtained, in addition to clinical context [1]. For example, studies that utilized CCTA in conjunction with BAC presence more frequently correlated BAC with CAD. In contrast, research using invasive coronary angiography (ICA) does not support the association.
“The differing results may be related to variation in the way the primary CAD outcome was defined, whether self-reported by the patient or based on the diagnosis in the medical record, or by coronary artery calcification detected by CCTA or ICA,” the authors explained.
For this study, researchers focused on associations between BAC identified via mammography and CAD visualized during ICA. Imaging was interpreted and classified by two blinded physicians.
Though nearly 22% of the 183 postmenopausal women included in the research displayed BAC on imaging, the experts did not observe a difference in the number of affected vessels upon ICA in women with or without BAC. Even after adjusting for age, time since menopause and smoking history, an increased presence of BAC was not found to increase the severity of CAD.
The authors suggested that, due to the ongoing debate surrounding BAC in relation to CAD risks, a consensus that addresses the quantification of BAC is needed to better understand the associations and how to best inform patients with BAC of their potential risks.
The study abstract is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.