Breast arterial calcification association with coronary artery calcium scoring and implications for cardiovascular risk assessment in women

Abstract

Breast arterial calcification (BAC) is a type of medial artery calcification that can be seen incidentally on mammography. Studies have suggested association of BAC with cardiovascular risk factors, coronary artery disease (CAD), and cardiovascular morbidity and mortality. Recently published studies have also suggested a modest correlation of BAC with coronary artery calcium (CAC) scoring. Roughly 40 million mammograms are already performed annually in the United States with overlap in patients that undergo CAD screening via CAC scoring. Thus, identification of cardiovascular risk by demonstrating an association between BAC and CAC may enable an instrumental sex-specific methodology to identify asymptomatic women at risk for CAD. The purpose of this article is to review the current state of the literature for BAC and its association with CAC, to review contemporary breast cancer screening guidelines, and to discuss the clinical implications of these findings.

Breast Arterial Calcification: A Potential Surrogate Marker for Cardiovascular Disease

“… 29) 30) 31) The presence of CAC has also been used to justify a more aggressive CAD risk-factor modification treatment, including aspirin, statins, and lifestyle modifications. 32) 33) …”

“…However, these data have limitations and should be interpreted with caution because of the small sample sizes and possible selection bias, since most studies recruited women who had already been referred for computed tomography (CT). 33) In addition, there were differences in the methods for measuring CAC and CAC scoring thresholds across the studies.…”

Mammographic Screening as a Tool for Cardiovascular Risk Assessing. Part 2. Association of Breast Arterial Calcification and Cardiovascular Diseases

“…Вместе с тем по данным целого ряда исследований КМА имеет достаточно высокую информативность в отношении коронарного кальция -признанного маркера субклинической формы ИБС. По данным обзора чувствительность КМА в отношении наличия коронарного кальция при компьютерной томографии грудной клетки составляет от 42 до 91%, специфичность -от 54 до 94%, точность -от 54 до 88% [31].…”

“…1). Рекомендованный в нашей стране возраст начала регулярного маммографического обследования и его периодичность в целом соответствует зарубежным стандартам [31].…”

Mammographic Screening as a Tool for Cardiovascular Risk Assessing. Part 1. Breast Arterial Calcification: Pathomorphology, Prevalence and Risk Factors

“…Как показало исследование MESA, высокие значения КИ>300 ассоциируются с семикратным увеличением риска коронарных событий по сравнению с лицами без ККА [42]. Наличие коронарного кальция является основанием для более активной стратегии по коррекции сердечно-сосудистых факторов риска, включая аспирин, статины, модификацию образа жизни [43,44].…”