Tamuna Chadashvili MD, PhD, Presenter: Nothing to Disclose

Priscilla Jennings Slanetz MD, MPH, Abstract Co-Author: Nothing to Disclose

Diana Litmanovich MD, Abstract Co-Author: Nothing to Disclose

Ferris M. Hall MD, Abstract Co-Author: Nothing to Disclose

To examine whether breast arterial calcifications (BAC) seen on mammography correlates with coronary artery calcium score, as a potential marker for increased risk of developing symptomatic coronary artery disease (CAD).

Retrospective review of the imaging database at our institution identified 145 female patients who underwent coronary CT within a year of mammography.The mammograms were reviewed by breast radiologists who were blinded to patients'coronary calcium scores. The CT calcium score was calculated by multiplying area of calcification by weighted value assigned to its highest Hounsfield unit and summed for all lesions.Calculated scores were risk stratified for developing CAD as follows:0-no risk;1-10-minimal;11-100-mild;101-400-moderate;>400-high risk.  Percentile distribution of calcium score adjusted by age, gender and race,was calculated based on results of the Multi-Ethnic Study of Atherosclerosis (MESA). The calcium scores and corresponding percentiles were correlated with BAC. Cardiac risk factors such as, diabetes, hypertension, hyperlipidemia, family history of CAD and smoking, were recorded for each patient. Data was analyzed using Χ2 tests and multiple logistic regression analysis. 

BAC correlated with coronary calcium score of >11 (p=0.0001), corresponding to mild or greater risk of developing CAD.  Specifically, calcium score of >11 was seen in 68% (25/37) of patients with BAC and 31% (34/108) of patients without BAC.  Accounting for race, gender and age, presence of BAC showed statistically significant correlation with percentile scores of >25. Namely, 70.4% (19/27) of patients with BAC vs. 44.6% (41/92) of patients without BAC showed percentile score of >25.Statistically significant association was observed of BAC with diabetes (p=0.01) and chronic reneal disease (p=0.005). BAC showed no significant association with hyperlipidemia, hypertension, smoking and family history of CAD.

BAC predicts coronary artery calcium score of >11, which indicates mild or greater risk of developing CAD. Statistically significant correlation exists between BAC and cardiac risk factors, namely diabetes and chronic renal disease. Our study suggests that BAC on mammography can be utilized as a potential marker for increased risk of developing CAD.

BAC on mammography is a noteworthy finding, as it correlates with coronary calcium score, elevated risk of CAD and cardiac risk factors.

Chadashvili, T, Slanetz, P, Litmanovich, D, Hall, F, Does Breast Arterial Calcifications on Mammography Predict Elevated Risk of Developing Symptomatic Coronary Artery Disease?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009770.html