Monday, April 4, 2016

A “Two-fer” for Women?

Digital mammograms may offer benefits beyond screening for early stage breast cancer.  A new study suggests that mammograms may also help in detecting heart disease in women before clinical symptoms develop.  How?  It turns out that a retrospective study found a strong correlation between calcification in the arteries of the breast seen on mammograms and calcification of the coronary arteries seen on chest CT scans – a recognized risk for heart disease.  The positive predictive value of breast arterial calcification (BAC) identifying coronary artery calcification (CAC) in the study was almost 70%.
While this finding will need to be confirmed in other studies, it should be easy for mammographers to document BAC in their reports.  This information could be used by internists to help identify women at increased risk for heart disease and to redouble their efforts to reduce smoking, obesity, high cholesterol, hypertension, and diabetes before a heart attack occurs.  Conservatively, this translates into approximately 4 million women nationwide undergoing screening mammography who will exhibit BAC and 2-3 million with premature coronary atherosclerotic disease.
Remember: half of all women will die of heart disease, yet many have no or unrecognized symptoms compared to men.  Any intervention that may help identify women at high risk for a cardiac event, especially one already routinely utilized in cancer screening, is worth pursuing.
                                        Judith Wolf, MD
Associate Director, WHEP
For more information, see original article and accompanying editorial.
L. Margolies, M. Salvatore, H.S. Hecht, et al.  Digital mammography and screening for coronary artery disease.  J Am Coll Cardiol Img, 9 (2016)
K. Nasir and JW MCEvoy. Recognizing Breast Arterial Calcification as Atherosclerotic CVD Risk Equivalent From Evidence to Action.  J Am Coll Cardiol Img, 9 (2016)

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