Can mammography findings offer a new calcification guide to CV risk?


By Mardi Chapman

26 May 2022

Breast arterial calcification (BAC) identified via mammography may have a future role in screening women for cardiovascular risk, Monash University researchers say.

An exploratory study of potential new markers of risk for cardiovascular disease enrolled 153 women who had previously undergone digital mammography and coronary computed tomography angiograph (CCTA).

The Australian-led study, published in the International Journal of Cardiology, found BAC was apparent in 24% of women.

BAC-positive women had a significantly higher risk of cardiovascular disease than other women (44% vs 26%, P < 0.0001) and greater prevalence of CAD (89% vs 63%, P = 0.003).

The study found BAC-positive women also had a significantly higher epicardial adipose tissue volume (EATv) but not epicardial adipose tissue density (EATd) or peri-coronary adipose tissue (PCAT).

When adjusting for modifiable cardiac risk factors, BAC was no longer associated with EATv (P = 0.26) but patients with both BAC and high EATv had greater CV risk (OR: 4.26) and were more likely to have CAD (OR: 7.55).

“While an independent association between BAC and EATv was not seen, both share significant association with CVD risk factors and therefore may be suitable independent risk markers,” the study said.

The authors said as BAC was an easily accessible, low radiation test which could be assessed at screening mammography, it could be used as an indication of CV risk and initiate earlier review for primary prevention.

However it first needed further development.

“We found semi-quantitative BAC severity to be associated with EATv and CAD. This may suggest that development of a quantitative BAC scoring tool, much like a CAC score, may improve diagnostic precision beyond a binary metric of presence or absence. Current algorithms using deep learning technology are currently exploring this potential.”

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