Can Mammography Identify a Woman's Risk for Heart Disease?

Radiologist reviewing results of patient's mammogram
Ian Lishman/Getty Images

If, like many women, you dread getting a mammography, you may tend to put off scheduling one on a regular basis. Well, there may now be another reason for having a mammogram besides early detection for breast cancer. If a mammography may also be able to identify a risk for heart disease, would that be the additional motivation you might need to have one regularly?

While, as women, most of us fear breast cancer more than heart disease, heart disease kills more of us than breast cancer does. Yes, breast cancer changes our lives; it changes our self-image and leaves us living with the fear of recurrence. Heart disease compromises our quality of life, often limits our mobility, and for many women, significantly shortens life.  

The results of one study indicate that mammography may successfully screen for both of these diseases. How do you say no to that kind of early intervention?

The study, supporting using mammography as a possible screening tool, is called, "Digital Mammography: Screening for Coronary Artery Disease?” It was presented in April 2016, at the American College of Cardiology's 65th Annual Scientific Session in Chicago.

Did you know that calcium in the arteries of the breast, which is picked up in mammography, predicts early buildup of plaque in the heart's arteries? Digital mammography, which is considered the gold standard for breast cancer screening, is now being considered as a possible screening tool for identifying women, especially young women, at risk for heart disease. Identifying this risk in a mammography may potentially allow for early intervention.

Data from this study demonstrates, for the first time, a link between the amount of calcium in the arteries of the breast, which can easily be seen on digital mammography, and the presence of calcium buildup in the coronary arteries. Coronary arterial calcification is recognized as an early sign of cardiovascular disease.

Dr. Harvey Hecht, professor at the Icahn School of Medicine and director of cardiovascular imaging at Mount Sinai St. Luke's Hospital, in New York City, is the lead author of the study. He commented on the study in a recent press release that appeared in EurekAlert!, a science news publication. “Many women, especially young women, don't know the health of their coronary arteries. Based on our data, if a mammogram shows breast arterial calcification, it can be a red flag, an 'aha' moment, that there is a strong possibility she also has plaque in her coronary arteries."

The study included 292 women. Almost 70 % of women, in the study, whose mammogram showed breast arterial calcification on their mammogram, were found to have coronary arterial calcification. Researchers shared that if a younger woman’s mammogram showed breast arterial calcification, she has an  83 % chance of having coronary arterial calcification.There were few false-positives.

Given that there is no additional cost, discomfort or exposure to radiation for a woman if she is screened for both breast abnormalities and breast arterial calcification, the study message is to look and report breast arterial calcification. “This information could be a life saver for some women,” reported  Dr. Hecht. He added, “I hope these findings will prompt clinicians, who rarely report breast arterial calcification, to routinely report not just the presence or absence of breast arterial calcification but also to estimate and note the amount.The more breast arterial calcification a woman has, the more likely she is to have calcium in her heart's arteries as well. If all it requires is to take a closer look at the images, how can we ignore it? "

About 37 million mammograms are performed each year in the United States. Women who are getting mammograms should, whenever possible, get a digital mammography as it is more sensitive to the presence of calcification. Finding a screening center that uses digital mammography should not be too difficult as digital mammography is now available in 96 % of mammography units in the U.S.

Dr. Hecht stresses that these findings warrant further evaluation and validation in larger studies. Once such study, a very large outcome study of 39,000 subjects is currently underway in the Netherlands.  

This study will be available online in JACC: Cardiovascular Imaging.

If you have the opportunity to identify breast cancer at its earliest stage, and a heart disease risk as well, isn’t it worth the anxiety and discomfort you may associate with having a mammography?

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