Mammography May Help Determine Heart Disease Risk (dateline April 1, 2003) | Breast Health News | Imaginis - The Women's Health & Wellness Resource Network

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Mammography May Help Determine Heart Disease Risk (dateline April 1, 2003)

Mammograms may help identify women at risk for heart disease in addition to screening for breast cancer, according to a recent study. Researcher said that calcium deposits in breast arteries, seen on routine mammogram films, can indicate a higher risk of developing coronary artery disease, which can lead to serious heart problems including heart attack. This is one of a number of recent studies to show that mammography—while not advocated as a heart disease detection tool on its own—can help physicians identify women who need more thorough heart screenings.

The study was conducted by Dana Waley and colleagues from the Mayo Clinic in Rochester, Minnesota and presented an the annual meeting of the Radiological Society of North America (RSNA), which was held in early December in Chicago, Illinois. The researchers studied mammogram and coronary angiograms of 1,880 women who each underwent both tests within the same year. (Mammography is typically used to help detect breast cancer; angiography is an exam that helps find blockages in the arteries). The average age of the women in the study was 65.

The findings showed that the women who had evidence of calcium deposits in breast arteries, evident on their mammogram films, had a 90% higher risk of developing coronary artery disease compared to women without these arterial calcium deposits. Over the course of the 10-year study, approximately 30% of the women with calcium deposits on their mammogram films developed heart disease.

While the researchers do not recommend using mammography for the sole purpose of determining heart disease risk, it might be useful to look for arterial calcium deposits at the same time, since women are already getting mammograms to help detect breast cancer. Since women may not have other symptoms before experiencing a heart attack, examining breast artery calcium during annual screening mammography may identify those women who need further cardiac testing. If women are found to have these calcium deposits, they can be referred for additional heart disease screening/diagnosis with exams such as electrocardiogram (EKG), exercise stress test, CT scan, or chest x-ray.

Calcium deposits in the breast arteries can suggest atherosclerosis—the narrowing of arteries due to the build-up of cholesterol, fatty substances and/or calcium—which can lead to coronary artery disease. Approximately 12.8 million Americans suffer from coronary artery disease, and every year, more than 500,000 Americans die from heart attacks caused by coronary artery disease. Coronary artery disease is also a major concern in Europe where two million people die from the disease each year.

Studies such as the one presented at the RSNA meeting do raise concerns of how to determine what/how much breast artery calcium should be considered "normal" or "abnormal." Guidelines for reporting results would have to be set and followed by each radiologist who reads mammogram films to determine which patients should be referred for further cardiac testing. Additional research in this area will likely help to address these issues.

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