Mario R. Castellanos MD, Presenter: Nothing to Disclose

Shalom S. Buchbinder MD, Abstract Co-Author: Nothing to Disclose

Mohammad Zgheib MD, Abstract Co-Author: Nothing to Disclose

Kathleen Ahern PhD, Abstract Co-Author: Nothing to Disclose

Carolyn Raia, Abstract Co-Author: Nothing to Disclose

Marwan Elya, Abstract Co-Author: Nothing to Disclose

Pascal Karam, Abstract Co-Author: Nothing to Disclose

Ali Homayuni, Abstract Co-Author: Nothing to Disclose

Marianne Smith, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Observational studies suggest that breast arterial calcifications (BAC) seen on mammography, may be a marker of coronary artery disease (CAD). The assumption being that BAC is associated with CAD risk factors and potentially an increased risk of having a future cardiovascular death. Though promising, the significance of BAC is unresolved due to conflicting studies. A limitation is that studies use self-reported data to establish CAD. We examine the mammograms of women undergoing cardiac catheterization, presumed to be a gold standard for CAD, to determine if BAC is appropriate to screen for CAD.

This is a prospective case control study. Female patients referred for cardiac catheterization for the evaluation of suspected CAD were recruited. Consecutive patients formed 2 groups:(+)CAD included women with all degrees of stenosis. Grading of CAD included: luminal narrowing of 70% or more, 50%-70%, less than 50%, and vessels with plaques/calcifications. Negative CAD included pts with completely normal arteries. A mammographer, blinded to CAD status, determined the presence of BAC.

A total of 172 women were included. There were 104 with (+)CAD and 68 with (-)CAD. Frequency of BAC in (+)CAD group was 35.6% (37/104) vs. 29% (20/68) in (-)CAD, not statistically significant p=.40. The mean age of patients with BAC was significantly higher; therefore, subjects were divided into age less than 65 and above. In the less than 65 group, BAC in (+)CAD group was 10.4% (5/48) vs. 15.3% (6/39) in (-)CAD, again not significant p=.48. Similarly, no correlation was seen in the above 65 group. Furthermore to identify a correlation, BAC was examined among the different grades of CAD, no association was found.

Our study, which examines mammography and CAD by angiography, did not show an association between BAC and any degree of CAD. Rather, BAC correlated with age. Most patients younger than 65 with CAD had no BAC. Based on these results, caution should be advised on using BAC to screen for CAD

Using the gold standard of angiography, this study compares the presence of CAD to BAC on mammography. We found no correlation; therefore, we do not recommend using BAC to screen for CAD.

Castellanos, M, Buchbinder, S, Zgheib, M, Ahern, K, Raia, C, Elya, M, Karam, P, Homayuni, A, Smith, M, et al, , et al, , Do Breast Arterial Calcifications on Mammography Really Correlate with Coronary Artery Disease? A Coronary Angiography Mammography Analysis.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5002677.html