Routine mammograms, commonly used for breast cancer screening, may also provide important information about a person's risk for cardiovascular disease. New research presented at the Radiological Society of North America meeting by Matthew Nudy, assistant professor at Penn State College of Medicine, found that the severity and progression of calcium buildup in breast arteries detected on mammograms can predict future cardiovascular events.
The study analyzed data from over 10,000 women who had sequential mammograms with an average interval of 4.1 years between scans. The average age of participants was 56. Researchers used an investigational version of the cmAngio artificial intelligence software developed by CureMetrix to assess the presence and severity of arterial calcification in the breast. Participants were grouped into four categories based on their calcification scores: negative, mild, moderate, and severe.
Vascular calcification was found in nearly one-fifth of participants at baseline. Women with more severe or progressing calcification had a higher risk—up to double—for major heart-related events such as heart attack, stroke, heart failure, and death compared to those without significant calcification.
"We know that women are more likely to be diagnosed at later stages of cardiovascular disease and have worse outcomes following a heart attack compared to men. That may be in part because the current cardiovascular risk assessment tools underestimate risk in women. We need better tools," said Nudy. "In the future, assessment of breast arterial calcification may help improve our ability to predict risk and prevent cardiovascular disease."
Currently, calcium buildup seen in breast arteries is not routinely reported since it is not linked to breast cancer diagnosis. However, previous studies led by Nudy have shown associations between this type of calcification and increased risk for cardiovascular disease and mortality.
The study also found that progression can occur within as little as a year; faster progression correlated with greater cardiovascular risk. Those without initial calcium deposits had the lowest risk but faced a 41% higher chance for adverse events if new deposits appeared during follow-up mammograms over an average period of 5.6 years. Progression from mild or moderate categories led to even higher risks—59% and 93%, respectively.
"This could be a way to use data that may already be available for different reason and to potentially use it to risk stratify an individual for the development of cardiovascular disease," Nudy said. He emphasized that further research is needed before these findings can influence clinical practice.
Other contributors included researchers from Monash University, University of Southern California, and CureMetrix—the latter also providing support for this work.
For studies presented at the Radiological Society meeting there is a double-blind peer-review process.
