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Mammograms: Another way to screen for heart disease?

Routine mammography–widely recommended for breast cancer screening–may also be a useful tool to identify women at risk for heart disease, potentially allowing for earlier intervention, according to a study scheduled for presentation at the American College of Cardiology’s 65th Annual Scientific Session.

Data from this study show 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 buildup in the coronary arteries. Coronary arterial calcification, or CAC, is considered a very early sign of cardiovascular disease. Importantly, 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. 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 these 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.

“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,” said Harvey Hecht, M.D., professor at the Icahn School of Medicine and director of cardiovascular imaging at Mount Sinai St. Luke’s hospital, and lead author of the study.

All told, 70 percent of the women who had evidence of breast arterial calcification on their mammogram were also found to have CAC as shown on a noncontrast CT scan of the chest. For women under 60 years of age 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 percent chance she also had CAC.