Can Coronary Artery Blockage Be Predicted from a Mammogram?

The title may seem unusual, but there is no typo. A study at the American College of Cardiology’s 65th Annual Meeting showed that mammography, used to diagnose breast cancer, could predict heart disease risk.

Heart disease, also known as coronary artery blockage, accounts for more than 20% of all deaths. Cancer has similar mortality proportions, and breast cancer is women’s most common cancer.

Millions of mammograms are performed annually worldwide, mostly for breast screening (37 million annually in America alone). According to recent American Cancer Society recommendations, women aged 40-54 should have annual mammography, and those over 55 every 2 years.

How Can Mammography Predict Heart Disease?

Mammograms, particularly digital ones, can detect calcium deposits, medically called calcification(most current devices are digital). Breast arterial calcification visible on mammograms may be an important marker for calcification in the coronary arteries supplying the heart.

Coronary artery calcification is a very early finding of coronary artery disease (CAD). Another recent study showed that breast and coronary arterial calcification are associated with heart attack and stroke , known as blockage of brain vessels.

These findings suggest breast arterial calcification predicts future heart disease better than high cholesterol, high blood pressure (hypertension) and diabetes.

Mammograms of 292 women without known heart disease were assessed for breast arterial calcification. Results can be summarized as follows:

• Breast arterial calcification (BAC) was detected in 42,5% and became more frequent with age.
• Hypertension and chronic kidney disease were significantly more common in those with BAC.
• Those with BAC had a 3 times greater risk of coronary artery calcification than those without.

Mammography thus promises valuable information about these two diseases affecting women most—breast cancer and heart disease. However, this single study requires support from larger studies before breast arterial calcification becomes a standard heart disease risk prediction method. Scientists have begun work; a study with approximately 39 thousand participants is already underway in the Netherlands.