Mammogram ‘may also screen for heart disease’

Mammogram ‘may also screen for heart disease’

A routine mammogram – used for breast cancer screening – may also identify women at risk of heart disease, suggests new research.

The study shows for the first time a link between the amount of calcium in the arteries of the breast – readily visible on digital mammography – and the level of calcium build-up in the coronary arteries.

Coronary arterial calcification, or CAC, is considered a very early sign of cardiovascular disease.

The presence of breast arterial calcification also appears to be an equivalent or stronger risk factor for CAC than other well-established cardiovascular risk factors such as high cholesterol, high blood pressure and diabetes.

Heart disease is the leading cause of death among women, but breast cancer is often the most feared.

Earlier research had shown a link between breast arterial calcification and atherosclerotic disease – even heart attack, stroke and other cardiovascular disease events.

But researchers said the data provide a more direct relationship between the extent of calcified plaque in the mammary and coronary arteries, as well as a comparison to standard risk evaluation.

Study lead author Professor Harvey Hecht, of the Icahn School of Medicine and director of cardiovascular imaging at Mount Sinai St. Luke’s Hospital in the US, said: “Many women, especially young women, don’t know the health of their coronary arteries.

“Based on our data, if a mammogram shows breast arterial calcifications it can be a red flag–an ‘aha’ moment–that there is a strong possibility she also has plaque in her coronary arteries.”

Seventy per cent of the women who had evidence of breast arterial calcification on their mammogram were also found to have CAC as shown on a non-contrast CT scan of the chest.

For women under 60 with CAC, half also had breast arterial calcification – an important finding as very few would be thinking about or considered for early signs of heart disease. There were even fewer false positives among younger patients.

Researchers said that if a younger woman had breast arterial calcification, there was an 83 per cent chance she also had CAC.

Prof Hecht said breast arterial calcification also appeared to be as strong a predictor for cardiovascular risk as standard risk scores

He said: “This information is available on every mammogram, with no additional cost or radiation exposure, and our research suggests breast arterial calcification is as good as the standard risk factor-based estimate for predicting risk.

“Using this information would allow at-risk women to be referred for standard CAC scoring and to be able to start focusing on prevention–perhaps even taking a statin when it can make the most difference.”

Prof Hecht added: “The message is if a woman is getting a mammogram, look for breast arterial calcification.

“It’s a freebie and provides critical information that could be lifesaving for some women.,”

He said he hopes the findings will prompt doctors, who rarely report breast arterial calcification, to routinely report not just the presence or absence of breast arterial calcifications but also to estimate and note the amount.

He added: “The more breast arterial calcification a women has, the more likely she is to have calcium in her heart’s arteries as well.

“If all it requires is to take a closer look at the images, how can we ignore it?”

The findings are due to be presented at the American College of Cardiology’s Annual Scientific Session.

By Stephen Beech