New findings suggest that analyzing a routine mammography exam may help physicians determine if their patients are likely candidates for cardiovascular diseases. The study was conducted by researchers at the Icahn School of Medicine at Mount Sinai.

In their study, Dr. Harvey Hecht, professor of medicine at the Icahn School of Medicine at Mount Sinai, director of cardiovascular imaging at Mount Sinai St. Luke’s Hospital, and study author, and Dr. Laurie Margolies, lead study author and associate professor of radiology, Icahn School of Medicine at Mount Sinai and chief of breast imaging, Dubin Breast Center, Mount Sinai Hospital, illustrate a correlation between the amount of calcium found in breast arteries and the level of calcium build-up in the coronary arteries.

“On every mammogram, we can see the breast arteries, and just as breast arteries can become calcified, so can the coronary arteries,” Hecht told HCB News.
An early sign of cardiovascular disease is coronary arterial calcium (CAC), the buildup of calcium in plaque on the walls of the coronary arteries. The researchers have found that the presence of breast arterial calcification (BAC) can potentially be an equivalent — or stronger — indicator of CAC presence than well-known factors such as a high cholesterol, high blood pressure, and diabetes.

“More women actually die from cardiovascular disease than breast cancer; while breast cancer is more feared, it is actually cardiovascular disease such as stroke and heart attacks that kill more often,” said Margolies. “When the radiologist gets all the information possible out of a mammogram, including breast arterial calcification detection, the opportunity to save lives is increased.”

The diagnostic value of these additional insights is compounded by the fact that it could be derived from the routine mammography exams that women are already undergoing. There is no extra cost or additional radiation exposure, according to Hecht, and it takes less than fifteen seconds to analyze.

Hecht said that allowing at-risk women to be referred for standard coronary arterial calcium scoring would ensure that preventative action could be taken while it could still make the most difference.

Margolies hopes that patient BAC information may someday be included as a standard part of the mammography exam diagnostics. “By federal law, all patients in the United States are getting a lay letter report of their mammogram and in many states that includes a paragraph that discusses breast density. In a similar vein, we could add a paragraph to the lay letter report about breast arterial calcification,” she stated.

Currently, there are two machines that show calcium build-up in the coronary arteries: electron beam computed tomography and multidetector computed tomography, according to the National Institutes of Health.

The findings will be presented next week at the 65th Annual Scientific Session and Expo of the American College of Cardiology, and published online in the Journal of the American College of Cardiology Imaging on April 3.

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