Mammogram research and heart disease
June 15, 2016 | by The Polyclinic

Did you know that a routine mammogram can detect more than just possible breast cancer risk? A mammogram can potentially indicate a woman’s risk for heart disease later in life as well. According to new research published in the Journal of American College of Cardiology (JACC), the digital images from a mammogram can detect calcium deposits in the breast arteries, which overwhelmingly suggest a similar calcium deposit concentration in that patient’s coronary arteries, called coronary arterial calcification, or CAC. CAC is an early sign of cardiovascular disease, and calcium in breast arteries is now considered as strong a risk factor for CAC as high cholesterol, diabetes, or high blood pressure.

Strong Link Between Calcium Deposits in Breast Arteries and Calcium Deposits in Coronary Arteries

If such calcification is showing in the breast arteries of a woman in her 40s with no other symptoms (high blood pressure, high cholesterol, diabetes), it can be the only early warning sign for her heart disease risk. The correlating evidence is strong: 70 percent of the study group showing calcification in breast arteries were also shown to have CAC. The researchers of the study reported that for younger women the percentage is even higher: a younger woman stands an 83 percent chance of having CAC if she has evidence of breast arterial calcification.

“It’s a secondary finding on mammograms,” says Dr. Arpita Swami, radiologist at The Polyclinic’s Breast Imaging Center. “I always comment in my report (which goes to the patient’s provider) on calcified vessels that are seen in women younger than 50 years of age and recommend that her primary care physician (PCP) request a metabolic panel to look for any familial reasons that need to be addressed since it is an uncommon finding in that age group.”

Mammograms Offer Early Detection, Intervention for Younger Women

Because heart disease screening is not a routine part of a younger patient’s standard annual exam, calcification findings during a mammogram can signal an opportunity for early intervention. Older patients are at higher risk for coronary diseases, so calcification in the arteries is not unusual, and risk is typically already being addressed by their PCP. “For any patient older than age 50, we expect that providers are looking into lipid profiles and cardiac screening as a part of their annual wellness exam,” says Dr. Swami.

Considering that heart disease is the leading cause of chronic ill health and death among women, if early detection is possible through mammography, making the practice standard could save lives .

Considering that heart disease is the leading cause of chronic ill health and death among women, if early detection is possible through mammography, making the practice standard could save lives . The added benefits to patients of the combined screening include no extra cost and no added radiation exposure.

The report is a starting place for both the patient and her physician to look more closely at her routine mammogram, and to act accordingly for her care. Of the millions of American women undergoing mammography screening, 4 million of them will show breast arterial calcification, according to the accompanying editorial to the report in the JACC online. “Two to 3 million of them (will) likely have signs of premature coronary atherosclerotic disease,” the authors say.

Women now have more screening options for heart health, thanks to the connection between calcium deposits in breast arteries seen on a mammogram and calcium deposits in coronary arteries. Early identification of heart disease risk factors can help prevent the progression of a more serious, chronic condition and may bring us closer to reducing the number of women with this life-threatening disease. Talk with your primary care physician or cardiologist if you have questions about mammography screening and your heart health.