Prevalence Of Breast Arterial Calcification Research Articles

Evaluation of breast arterial calcification as a predictor coronary artery calcification

Cardiovascular diseases (CVD) are socially significant diseases and one of the main causes of death among women. There are no effective and uniform screening methods to prevent the prevalence and mortality of CVD. Breast artery calcifications may be one of the available tools for CVD risk stratification. The pathogenesis of calcification of the middle vessel wall, known as Mönckeberg's arteriosclerosis, is different from the pathogenesis of coronary atherosclerosis that coronary arteries. However, research data supports a correlation between breast artery calcifications and risk factors for CVD. These factors include coronary atherosclerosis, detected by CT-coronarography. Purpose . To assess the prevalence of breast arterial calcification and to determine the association with cardiovascular risk factors, coronary artery calcification, atherosclerosis of brachiocephalic arteries and visceral branches of the abdominal aorta. Material and methods . 21 patients were hospitalized in the cardiology department. The patients underwent digital mammography to detect breast arterial calcifications. All patients also underwent CT coronary angiography with angiography of the abdominal aorta. Results . The use of the Wilcoxon-Mann-Whitney W-test with an abnormal distribution showed a correlation between the breast arterial calcifications and the calcium index (p = 0.0028), coronary artery stenosis (p = 0.040), calcification of the thoracic aorta wall (p = 0.035) and stenosis of the visceral branches of the abdominal aorta (p = 0.037). Conclusions . The breast arterial calcifications correlates with a more frequent detection of calcifications in the walls of the coronary arteries and a higher calcium index.

Abstract 10905: Breast Arterial Calcification as a Novel Predictor of Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis

Introduction: Mammographically detected breast arterial calcification (BAC) is purported as a surrogate marker for cardiovascular disease (CVD). We conducted a systematic review and meta-analysis to determine the prevalence of BAC and its association with CVD risk and disease. Methods: Online databases were searched until March 2021 for studies reporting BAC. Four endpoints were evaluated: (1) BAC prevalence, (2) association with CVD risk factors, (3) prevalent and incident vascular disease and (4) BAC prevalence based on estimated CVD risk. Random-effects models were used. Data was analysed as odds ratio (OR), hazard ratio (HR) or effect size (ES) obtained through data transformation for differentially reported data. A CVD-specific risk metric was calculated as the product of CVD risk factor proportion and HR risk estimate from the CAD Consortium Risk Calculator and summed for all risk factors. Meta-regression modelling with predicted BAC prevalence stratified by age was performed. Results: There were 77 studies (104,710 patients) included. Pooled BAC prevalence was 22% (95%CI: 19-25%) with cumulatively increasing prevalence annually. Significant BAC predictors were age, hypertension, diabetes, hypercholesterolemia (p<0.01). BAC was associated with CAD (OR 2.65, 95%CI: 2.17-3.23, p<0.01) and non-coronary vascular disease (ES 0.80, 95%CI: 0.51-1.09, p<0.01). BAC associated with incident cardiovascular events (HR 1.61, 95%CI: 1.11-2.32, p=0.001). Predicted BAC prevalence associated significantly with increasing CVD risk regardless of age (Figure). Conclusions: BAC is significantly associated with prevalent and incident vascular disease affecting intimal and medial arterial beds. BAC is highly prevalent and associated with CVD risk factors individually and cumulatively. Routine assessment of BAC should be considered in screening mammography to potentially trigger CVD risk consultation.

Breast Arterial Calcifications on Mammography among Patients Attending the Radiology Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Breast arterial calcifications are common mammographic findings which are associated with coronary artery disease. The aim of this study was to find the prevalence of breast arterial calcifications in women presenting for mammography in a tertiary care centre. This descriptive cross-sectional study was performed in the Department of Radiology, in a tertiary care hospital after taking ethical clearance, Reference number 352(6-11)E-2, 077/078, data was collected from Syngovia database from March-June 2021 which included 1614 mammograms. Convenience sampling was done and mammograms evaluated for presence of vascular or non-vascular calcification. Further, vascular calcification was graded. Data was entered in Statistical Package for Social Sciences version 25. Point estimate at 95% Confidence Interval was done, and frequency and proportion were calculated. The prevalence of breast arterial calcification was 188 (11.6%) at 95% Confidence Interval (10.03-13.2). The mean age of women included in this study was 48.42±9.55 years with the largest number of patients in the age group 40-49 years, 682 (42.3%), and least in the age group 80-89 years, 3 (0.2%). All patients in the age group 80-89 years, 3 (100%) had vascular calcifications followed by 70-79 years group, 22 (57.5%) and none in patients younger than 30 years. We found an increase in the number and grade of vascular calcifications in breasts with the patient's age. When present breast arterial calcifications must be mentioned in mammogram report. Identification of such calcifications on mammogram should prompt further screening for atherosclerotic disease.

Breast Arterial Calcifications on Mammography: A Survey of Practicing Radiologists.

To explore current practice patterns of reporting and issuing recommendations based on the presence of breast arterial calcifications on mammography and existing knowledge of their prevalence and associated factors. An online anonymous 19-question survey was distributed to 2583 practicing radiologists who were members of the Society of Breast Imaging. Questions covered demographics, breast imaging training, practice type, and knowledge regarding the epidemiology and potential clinical significance of breast arterial calcifications detected on mammograms. Differences between groups were calculated using the chi-square test or Fisher exact test. An α level of 0.05 was used to determine statistical significance. Response rate was 22% (364/1662). The median age of respondents was 51 years (range: 29-76) and most were female (248/323, 77%). The most prevalent characteristics among respondents were as follows: 69% (223/323) had completed a breast imaging fellowship, 55% (179/323) were in private practice, 49% (158/323) practiced dedicated breast imaging, and 38% (124/323) had been in practice for more than 20 years. The prevalence of breast arterial calcifications was correctly estimated to be 1%-30% by 39% (125/323) of respondents. Most respondents correctly recognized the growing evidence of an association between breast arterial calcifications and coronary artery disease (275/323, 85%). However, only 15% (48/323) always reported the presence of these calcifications, and of those who report them at any time, only 0.7% (2/274) always issued recommendations. There are differences in both knowledge of the epidemiology of breast arterial calcifications and practices around their reporting amongst breast radiologists.

Association Between Breast Arterial Calcification on Mammography and Coronary Artery Disease: A Systematic Review and Meta-Analysis.

Background: Breast arterial calcification (BAC), which may be detected during screening mammography, is hypothesized to be a noninvasive imaging marker that may enhance cardiovascular risk assessment. Materials and Methods: In this systematic review and meta-analysis, we sought to assess the association between BAC and coronary artery disease (CAD) by conducting a meta-analysis. We conducted a literature search of PubMed, Scopus, Cochrane library, ClinicalTrials.gov, and conference proceedings, from inception through December 24, 2019. The outcome of interest was the presence of CAD in patients with BAC. This was reported as crude and adjusted odds ratio (OR). Results: A total of 18 studies comprising 33,494 women (mean age of 60.8 ± 3.7 years, 25% with diabetes, 57% with hypertension, and 21% with history of tobacco smoking) were included in the current meta-analysis. The prevalence of BAC among study participants was 10%. There was a statistically significant association between BAC and CAD (unadjusted OR 2.14; 95% confidence interval [CI] 1.63-2.81, p < 0.001, I2 = 76.5%). Moreover, adjusted estimates were available from 10 studies and BAC was an independent predictor of CAD (OR 2.39; 95% CI 1.68-3.41, p < 0.001, I2 = 61.7%). In the meta-regression analysis, covariates included year of publication, age, hypertension, diabetes mellitus, and history of tobacco smoking. None of these study covariates explained the heterogeneity across studies. Conclusions: BAC detected as part of screening mammography is a promising noninvasive imaging marker that may enhance CAD risk prediction in women. The clinical value of BAC for cardiovascular risk stratification merits further evaluation in large prospective studies.

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

Breast arterial calcification (BAC) is a type of calcification of the media of the middle and small arteries (Menkeberg's calcification). This distinguishes it from calcification associated with the atherosclerotic process and localized in the intima of the vessel. There are data on the association of BAC with cardiovascular diseases (CVD). This allows it to be considered as a new marker of cardiovascular risk in women. The purpose of the first part of the review is to analyze the current literature on the prevalence of BAC, factors related to its occurrence and the association of BAC with traditional CVD risk factors. The prevalence of BAC (data from cancer screening programs) is about 12.7%, and it increases with age to 50% in 80-year-old women. It is not an attribute of healthy aging, but depends on race and ethnicity. There is a connection with reproductive function. The frequency of BAC increases with the number of children born, with breastfeeding, in menopause, and decreases during hormone replacement therapy. Smoking women have a BAC frequency 2 times less than non-smokers. Detection of BAC on mammograms is associated with conditions pathogenetically associated with CVD: an increase in the frequency of hyperlipidemia, diabetes, chronic kidney disease, a decrease in bone mass. There is a strong correlation of BAC with coronary calcium (indicator of coronary atherosclerosis). A statistically significant association of BAC with overweight, obesity, and smoking was not found, but there is a weak association with arterial hypertension. This may indicate an independent pathophysiological role of BAC in the development of vascular disorders and allows us to consider BAC as an independent marker for improving cardiovascular risk stratification in women. BAC is believed to be a marker of a more generalized trend towards the development of medial calcification in other vascular areas. This leads to a systemic increase in arterial stiffness and contributes to the development of CVD.

MON-515 Lack Of Association Between Bone Mineral Density And Breast Arterial Calcification: The Minerva Study

Background: Prior studies have documented inverse associations of bone mineral density (BMD) with coronary and extra-coronary vascular calcification, indicating a biological interplay between bone and vascular systems. However,the relation between BMD and breast arterial calcification (BAC) remains controversial. This study aims to correlate BMD status with presence and severity of BAC in a large sample of post-menopausal women free of clinical cardiovascular disease (CVD) at baseline. Methodology: We used data from the MultIethNic study of brEast aRterial calcium gradation and cardioVAscular disease (MINERVA), a multiethnic cohort of women aged 60 to 79 years at baseline (10/24/2012-2/13/2015) who were free of symptomatic CVD, all recruited after mammography screening at Kaiser Permanente of Northern California (KPNC). The sample available for analyses with complete data on BMD, BAC and covariates was 1,273 (mean ± SD age=67 ± 4, 52% white, 18% Asian, 15% African-American and 12% Latina). BMD assessments in spine, hip and head of the femur up to 3 years prior to the baseline exam was done with dual-energy X-ray absorptiometry (DXA) as part of routine medical care and participants were categorized into 3 groups: normal, osteopenia and osteoporosis using WHO criteria. A BAC continuous mass score (mg) was obtained from digital mammograms using a validated densitometry method. BAC presence was BAC score > 0 mg, and severe BAC was defined as BAC score > 20 mg. Data was analyzed using the Chi-Square for contingency tables and multivariable logistic regression. Results: Overall, 54% (686/1,273) had osteopenia and 21% (267/1,273) had osteoporosis. The prevalence of BAC > 0 mg did not differ significantly by BMD status (Chi-Square=0.03;2df;p=0.98): it was 30% (97/320) among women with normal BMD, 31% (212/686) among women with osteopenia, and 31% among women with osteoporosis (82/267). Likewise, the prevalence of BAC > 20 mg did not differ significantly by BMD status (Chi-Square=2.4;2df;p=0.65): it was 5% (16/320) among women with normal BMD, 3% (23/686) among women with osteopenia, and 5% among women with osteoporosis (13/267). The odds ratios (ORs) of BAC > 0 vs. BAC=0 mg after adjustment for age, race, education level, BMI, smoking, alcohol consumption, total physical activity score, diabetes, hypertension, calcium supplement use, menopausal hormone therapy, history of breast feeding and parity were 1.09 (95% CI, 0.81-1.47) for osteopenia and 1.05 (95% CI, 0.70-1.56) for osteoporosis. The adjusted OR for BAC > 20 vs BAC ≤20 mg were 0.96 (95%CI, 0.48-1.94) for osteopenia and 1.58 (95 CI, 0.64-3.93) for osteoporosis. Conclusion: Our findings do not support an association of either osteopenia or osteoporosis with BAC presence or severity.

Breast arterial calcification on mammography and risk of coronary artery disease: a SCOT-HEART sub-study

AIMTo assess the prevalence of breast arterial calcification (BAC) in patients who also underwent routine surveillance mammography, and to determine the association with cardiovascular risk factors, coronary artery calcification, and coronary artery disease on coronary computed tomography angiography (CCTA).MATERIALS AND METHODSFour hundred and five female participants were identified who had undergone CCTA and subsequent mammography in the SCOT-HEART randomised controlled trial of CCTA in patients with suspected stable angina. Mammograms were assessed visually for the presence and severity of BAC.RESULTSBAC was identified in 93 (23%) patients. Patients with BAC were slightly older (63±7 versus 59±8 years, p<0.001), with a higher cardiovascular risk score (19±11 versus 16±10, p=0.022) and were more likely to be non-smokers (73% versus 49%, p<0.001). In patients with BAC, coronary artery calcification was present in 58 patients (62%; relative risk [RR] 1.26, 95% confidence intervals [CI]: 1.04, 1.53; p=0.02), non-obstructive coronary artery disease in 58 (62%; RR 1.27, 95% CI: 1.04 to 1.54, p=0.02), and obstructive coronary artery disease in 19 (20%; RR 1.62, 95% CI: 0.98, 2.66; p=0.058). Patients without BAC were very unlikely to have severe coronary artery calcification (negative predictive value 95%) but the diagnostic accuracy of BAC to identify coronary artery disease was poor (AUC 0.547).CONCLUSIONAlthough BAC is associated with the presence and severity of coronary artery calcification, the diagnostic accuracy to identify patients with coronary artery disease or obstructive coronary artery disease is poor.

Association between breast arterial calcifications found on mammography and coronary artery calcifications in asymptomatic Saudi women

BACKGROUNDCurrently, there are no data on the prevalence of breast arterial calcification (BAC) in Saudi women. Furthermore, there are no data on the relationship between BAC and coronary artery calcium score (CACS) as a coronary artery disease (CAD) risk factor in Saudi women who undergo mammography.OBJECTIVEExamine the role of BAC as a potential female-specific risk factor for CAD in Saudi women in order to investigate the relationship between BAC and CACS in women who undergo a screening mammography, and study the relationship between BAC and CAD risk factors, including age, diabetes mellitus, hypertension, chronic kidney disease (CKD), dyslipidemia, and family history of CAD.DESIGNRetrospective, medical records review.SETTINGSingle tertiary care center.PATIENTS AND METHODSThe study cohort included women who had mammograms and a CACS scan, and for whom data on CAD risk stratification and CAD risk factors had been collected within one year of each other from 2014 to 2017. Women with CAD were excluded from the study.MAIN OUTCOME MEASURESBreast arterial calcification as a marker for coronary artery disease.SAMPLE SIZE307 Saudi women.RESULTSBAC was found in 142 (46%) patients in the study population. BAC+ women were significantly older than the BAC− women (P=.001), and a strong association was found between BAC and CACS (P=.0001), diabetes (P=.0001), hypertension (P=.021), and CKD (P=.0031). However, no association was found between BAC and tobacco smoking, dyslipidemia, and family history of CAD. In addition, a strong correlation was found between CACS and the components of the BAC score (P<.001). Multivariate linear regression analysis revealed that age, CAC, and CKD are the only strong predictors of BAC.CONCLUSIONSThe proportion of BAC in Saudi women is 46%, and there may be a strong association between BAC and CAC, age, hypertension, and CKD. A large-scale prospective research study is necessary to validate the role of BAC on screening mammography as a CAD risk stratification tool and before routine reporting of BAC on a mammography report.LIMITATIONSBecause this was a retrospective study, patient selection bias cannot be excluded.

MultIethNic Study of BrEast ARterial Calcium Gradation and CardioVAscular Disease: cohort recruitment and baseline characteristics

PurposeMultIethNic Study of BrEast ARterial Calcium Gradation and CardioVAscular Disease (MINERVA) was designed to answer the question of whether a novel continuous breast arterial calcification (BAC) mass score improves cardiovascular risk stratification among asymptomatic postmenopausal women. This article describes recruitment and baseline characteristics. MethodsMINERVA is a multiethnic longitudinal cohort study. The phenotype data include BAC mass by densitometry applied to digital mammograms, sociodemographic factors, self-reported medical history, medications, parental history, reproductive history, smoking, alcohol consumption, physical activity, anthropometry, ankle-brachial index, blood pressure, laboratory panel, breast volumes, cognitive function, bioelectrical impedance, habitual diet, dietary supplements, sleep, psychosocial factors, and sun exposure. ResultsA total of 5145 women aged 60 to 79 years with available digital, uncompressed mammograms were recruited from the membership of Kaiser Permanente of Northern California between October 24, 2012 and February 13, 2015 and completed a baseline clinic visit or an abbreviated phone questionnaire. Of those, 4153 underwent phlebotomy and have blood biomarkers. Overall prevalence of BAC was 26%, and it varied by age and race. The mean (SD) BAC mass was 12 (23) mg and the range 0–342 mg. ConclusionsMINERVA is the first cohort with a continuous measure of BAC. The cohort is large, ethnically diverse, and deeply phenotyped in terms of socioeconomic, behavioral, and clinical factors, and blood biomarkers.

Increased vascular calcification in patients receiving warfarin.

Matrix gla protein is a vitamin K-dependent inhibitor of medial arterial calcification whose synthesis and activity are blocked by warfarin. Warfarin induces arterial calcification in experimental models, but whether this occurs in humans is unclear. This was addressed by examining breast arterial calcification, which is exclusively medial and easily identified on mammograms. Screening mammograms from women with current, past, or future warfarin use were examined for the presence of arterial calcification and compared with mammograms obtained in untreated women matched for age and diabetes mellitus. Women with a serum creatinine >2.0 mg/dL or a history of end-stage renal disease were excluded. In 451 women with mammograms performed after ≥1 month of warfarin therapy, the prevalence of arterial calcification was 50% greater than in 451 untreated women (39.0% versus 25.9%; P<0.0001). However, in 159 mammograms performed before warfarin therapy, the prevalence of arterial calcification was not increased (26.4% versus 25.8%). The increased prevalence varied with duration of treatment, from 25.0% for <1 year to 74.4% for >5 years. In a multivariable logistic model, only age and duration of warfarin, but not the period of time after stopping warfarin, were significant determinants of arterial calcification in women with current or past warfarin use. The prevalence of breast arterial calcification is increased in women with current or past warfarin use independent of other risk factors and conditions predating warfarin use. This effect appears to be cumulative and may be irreversible.

Prevalence and Degree of Breast Arterial Calcifications on Mammography: A Cross-sectional Analysis

Objectives:The purpose of this study is to establish a database including prevalence and degree of breast arterial calcifications (BAC) in our population of women presenting for mammography.Materials and Methods:The mammograms of 1786 women over the age of 40 years were examined for the presence and degree of BAC. Statistical analysis was performed to correlate patient's age and ethnic origin with the presence and degree of BAC.Results:There was statistically significant and strong correlation between the patient's age and presence of BAC. There was also a less strong yet statistically significant correlation between patient age and degree of BAC. Regression analysis showed the likelihood of BAC at various ages. The prevalence of BAC is only 2% of women under 50 years of age; the prevalence of Grade 2-3 BAC is only 1% in women under 60 years of age.Conclusion:There is a predictable increase with age in both prevalence and degree of BAC in women. The presence of high degree BAC in women under 60 years of age or any BAC in women under 50 years of age is unusual.

Breast arterial calcification and hypertension associated with vertebral fracture

Arterial calcification and osteoporosis commonly accompany one another in postmenopausal women. Hypertension is a known contributing factor to arterial calcification. Thus, we aimed to investigate any associations between hypertension, arterial calcification and vertebral fractures in a cross-sectional study in Japanese postmenopausal women. The medical histories of 421 postmenopausal Japanese women diagnosed with hypertension, diabetes mellitus or hyperlipidemia were investigated. Bodyweight, body height and ultradistal bone mineral density (BMD) were measured. The prevalent vertebral fractures were diagnosed by a semiquantitative method, and the number of breast arterial calcifications (BAC) was investigated by mammography screening. Patients with vertebral fractures were of a significantly higher age, lower height, lower ultradistal BMD and had a higher number of BAC compared with those without vertebral fractures. Furthermore, a significantly higher prevalence of hypertension was observed in the patients with vertebral fractures as compared with those without. A multivariate stepwise regression analysis using these variables for vertebral fractures showed that the significant odds ratios (OR) of age (OR 1.76, 95% CI 1.11-2.77, P = 0.016), the prevalence of BAC (OR 2.52, 95% CI 1.62-3.93, P < 0.001) and the presence of hypertension (OR 1.76, 95% CI 1.11-2.80, P = 0.017) were found as significant independent risk factors for vertebral fractures. This is the first report of the relevance of BAC or hypertension to vertebral fractures in Japanese women. The results suggest that hypertension, BAC and osteoporotic fractures share a common metabolic pathway in their pathogenesis.

Risk factors associated with breast arterial calcifications

A number of studies have linked the presence of breast arterial calcifications (BACs) with an increased risk of diabetes, hypertension, coronary artery disease (CAD), and cardiovascular mortality. Because there is a well-established screening system for breast cancer, it has been proposed that the presence of BACs can be used as a warning sign indicating an increased risk of metabolic and vascular diseases. To determine the relation between BAC and early renal dysfunction. A retrospective review of 6118 mammograms identified 701 cases with BACs. Women with BACs were compared to a random selection of 362 women without BACs based on available laboratory data. Univariate analysis was conducted according to age groups. The prevalence of BACs was 11.5% in our study. Hyperglycemia increased the odds of BACs by 8.1 (95% CI 3.0-22.1, P < 0.001) in the 50-59-year age group. The presence of an elevated blood urea nitrogen (BUN) and serum creatinine increased the odds of BACs by 2.6 (95% CI 1.2-6.0, P = 0.016) and 2.3 (95% CI 1.0-5.2, P = 0.045) in women ≥70 years of age. Hyperlipidemia was not a significant risk factor for BACs in any age group. Our results support the view that the presence of BACs on mammography may be indicative of diabetes in middle-aged women. On the other hand, BACs are not very useful for predicting early renal dysfunction in women <70 years of age.

Prevalence of breast arterial calcification by mammography contributes to breast cancer

Mammographic breast arterial calcifications (BACs) are regarded as aging-related benign changes in breast cancer screening practices. BACs have recently attracted attention, because several researchers proposed using them as a surrogate marker of arteriosclerosis or osteoporosis. No studies have thus far evaluated an association between BACs and breast cancer, however. The percentage of BAC positivity was compared between a group of women aged 40years or older with breast cancer detected in 2004 through 2009, and a group of women of the same age range in whom breast cancer was not detected by screening mammography in 2009. The BAC-positive rate in the group of 243 breast cancer patients was 9.88% (24 of the 243) and was lower than that in the group of women without breast cancer, 14.34% (506 of 3528 women). The analysis by age revealed that the differences in this parameter between the two groups were significant in women aged 60years or older. Multivariate analysis including demographic characteristics revealed that when adjusted for age and body weight, BAC positivity was a significant risk factor for breast cancer. The study results suggest that BAC positivity and, in turn, arteriosclerosis may have an antinomic relationship with breast cancer.

Breast Arterial Calcification Is Associated with Reproductive Factors in Asymptomatic Postmenopausal Women

The etiology of breast arterial calcification (BAC) is not well understood. We examined reproductive history and cardiovascular disease (CVD) risk factor associations with the presence of detectable BAC in asymptomatic postmenopausal women. Reproductive history and CVD risk factors were obtained in 240 asymptomatic postmenopausal women from a community-based research study who had a screening mammogram within 2 years of their participation in the study. The mammograms were reviewed for the presence of detectable BAC. Age-adjusted logistic regression models were fit to assess the association between each risk factor and the presence of BAC. Multiple variable logistic regression models were used to identify the most parsimonious model for the presence of BAC. The prevalence of BAC increased with increased age (p < 0.0001). The most parsimonious logistic regression model for BAC presence included age at time of examination, increased parity (p = 0.01), earlier age at first birth (p = 0.002), weight, and an age-by-weight interaction term (p = 0.004). Older women with a smaller body size had a higher probability of having BAC than women of the same age with a larger body size. The presence or absence of BAC at mammography may provide an assessment of a postmenopausal woman's lifetime estrogen exposure and indicate women who could be at risk for hormonally related conditions.

Simple Obesity Is Associated with Reduced Breast Arterial Calcification and Increased Plasma Osteopontin Level

We undertook this study to evaluate whether simple obesity is associated with breast arterial calcifications. Mammograms and patient records of 1309 women who underwent screening or diagnostic mammography were reviewed retrospectively. Patients were divided into two groups according to body mass index. Mammograms were evaluated for the presence of arterial calcification and results were coded. Plasma osteopontin levels were measured. The prevalence of breast arterial calcification of patients classified with simple obesity was lower than the non-obese group. Obese group exhibited significantly increased circulating osteopontin concentrations as compared with non-obese group. Plasma osteopontin level is an independent protective factor for the presence of breast arterial calcification. Simple obesity is associated with reduced breast arterial calcification. Our study indicates the use of breast artery calcification as an indicator of cardiovascular disease or arterial status should be reconsidered.

The Relationship between the Breast Arterial Calcification Detected by Mammography and the Hypertensive Retinopathy in Hypertensive Women

ObjectiveThe purpose of this study was to investigate the relationship between the breast arterial calcification (BAC) detected by mammograms and the hypertensive retinopathy (HR) in hypertensive women who underwent ophthalmologic examination.Materials and MethodsScreening mammography was performed in 99 hypertensive women and these women also underwent an ophthalmologic examination. The presence of arterial calcification and the number of calcified blood vessels in each breast were evaluated. The grade of HR was determined. The presence of BAC and the number of blood vessels involved was compared according to the presence of HR and the grade of HR.ResultsAmong the 99 patients, HR was detected in 70 patients, and of these 70 patients, 42 patients had grade I HR and 28 had grade II HR. BAC was detected in 54 cases. Forty-six patients with HR (66%) and eight patients without HR (27%) were diagnosed with BAC after they underwent mammographic examination. The prevalence of BAC in the subjects who had HR was statistically higher than that in those subjects who did not have HR (p < 0.01). The grade of HR was not significantly associated with BAC (p > 0.05). The positive predictive value of the BAC detected on mammography for HR was 0.80 in those subjects who were ≥ 60 years old.ConclusionThe detection of BAC by mammography is associated with an increased risk of HR, and particularly for patients after the age of 60. The findings of BAC may be related to hypertensive end-organ damage, and performing mammograms might contribute to predicting the presence of ophthalmologic hypertensive complications in these patients.

Reduced Bone Mineral Density Is Associated with Breast Arterial Calcification

Arterial calcification, a marker of atherosclerosis, results from a complex process of biomineralization resembling bone formation. Breast arterial calcification (BAC) has been associated with angiographic and clinical cardiovascular disease. The purpose of this study was to determine the association between reduced bone mineral density (BMD) and BAC, which may share a common pathophysiology. We conducted a retrospective study of 228 women (55% Hispanic, mean age 64 +/-10 yr) who had both mammography and BMD evaluation at Columbia University Medical Center from 2001-2003. Each mammogram was reviewed for the presence of BAC using standardized methods. BMD was measured using dual-energy x-ray absorptiometry and categorized as normal, low bone density (osteopenia), or osteoporosis as defined by the World Health Organization. Univariate and multivariate logistic regression analyses were performed to evaluate the association between reduced BMD and BAC. The prevalence of BAC, low bone density (osteopenia), and osteoporosis was 39, 42, and 29%, respectively. Women with BAC were significantly more likely to be older, Hispanic, and postmenopausal and have osteoporosis as compared with women without BAC. In age-adjusted analyses, women with BAC were more likely to have reduced BMD (odds ratio 3.0, P < 0.01) as compared with women without BAC. Furthermore, osteoporosis was strongly associated with the presence of BAC (odds ratio 3.5, P < 0.01). These data suggest that osteoporosis and arterial calcification are strongly and independently correlated. Reduced BMD may identify women at risk of vascular disease.

Mammography as Screening for Coronary Artery Disease

Coronary artery disease (CAD) is the leading cause of death in American women. Screening mammograms are recommended for women starting at age 40 for the early detection of breast cancer. An additional benefit of this routine screening tool may be to detect breast arterial calcifications (BAC) as a possible sign of CAD. The purpose of this study was to determine further the relationship between mammographically detected BAC and CAD. The medical records of 44 women who had undergone coronary artery bypass grafting at our institution over 5 years were reviewed. These mammograms were examined for evidence of BAC. For all women included in the study, 18 of 44 (41%) had evidence of BAC on screening mammogram. This was statistically significant (P < 0.0001) compared with the prevalence of BAC reported in the general population in previous studies. Most were also overweight (61.1%), had hypertension (88.8%), and hypercholesterolemia (55.5%). This is the first study to look at the direct correlation between patients with known CAD requiring revascularization and BAC. Perhaps women with BAC seen on screening mammography should undergo further workup for CAD, with the potential benefit of early intervention.