Widely used mammography screening for breast cancer could potentially serve as a tool for detecting heart risk in women as well, a new study suggests.
Researchers said the study, involving 292 women, showed a strong correlation between the amount of calcium detected in breast arteries on a mammogram and the level of calcium in coronary arteries. Calcium in the arteries that nourish the heart is an important predictor of risk for heart attacks and strokes.
The findings of the study were presented at the American College of Cardiology’s 65th Annual Scientific Session and published March 24 in the journal Cardiovascular Imaging.
The new study identifies “an accessible way with no extra cost and no extra radiation [exposure] of determining someone’s risk for cardiovascular disease,” said Laurie Margolies, chief of breast imaging at Mount Sinai Medical Center, New York and lead author of the study.
Breast-artery calcium was at least as strong at predicting calcium in the coronary arteries as more traditional measures such as blood pressure, cholesterol and the widely used Framingham Risk Score, the study showed. “We hope this could be practice-changing,” Dr. Margolies said.
Some 37 million mammography exams are done in the U.S. each year, and often detect what doctors call “calcifications”—tiny spots of calcium that are generally benign, but can sometimes indicate breast cancer.
Mammography also picks up calcium in the breast arteries, which cardiologists have long considered potentially useful in assessing a woman’s heart risk.
While breast cancer takes the lives of approximately 40,450 women in the U.S. each year, according to the American Cancer Society, it’s not the top killer of women. Most women, it turns out, should be much more fearful of heart disease, since heart attack and stroke take the lives of more than 292,000 American women annually.
This new study showed that women with a high breast-artery calcium score—between four and 12—were more than three times as likely to have calcium in their coronary arteries as women who scored zero on the mammogram.
If such information were routinely included in a mammogram report, it could lead women to undergo further tests, including blood tests or heart scans to evaluate their heart risk. That could prompt such preventive strategies as changes in diet and exercise or use of cholesterol-lowering drugs called statins to reduce heart risk, Dr. Margolies said.
It is estimated that if 10% of women undergoing mammography tested positive for breast-artery calcium, nearly three million would turn out to have early signs of heart disease.
Bottom line: Mammography is now proven to have the additional benefit of screening for cardiovascular disease in women, without additional radiation or risk.
About the author: Raja P. Reddy, MD is a board certified diagnostic radiologist specializing in breast imaging. He is also a contributing editor for Digital Mammography Specialists, a leading provider of outpatient women’s imaging services in the greater Atlanta, GA.