Breast arterial calcifications are benign calcium buildups that in mammograms look like white parallel lines. Measuring these calcifications may improve cardiovascular risk in women, according to a study published Sept. 27 in JACC: Advances.
Researchers from University of California San Diego analyzed 18,092 women's mammogram results from 2007 and 2016 and quantified a breast arterial calcification score using an AI. The score was then evaluated against patient mortality and cardiovascular event incidence data.
What to know from the study
- Breast arterial calcification was found in 4,223 women.
- Mortality occurred in 7.8% of women with breast arterial calcification and 2.3% of women without.
- Acute myocardial infarction, heart failure, stroke and mortality occurred in 12.4% of women with breast arterial calcification and 4.3% of women without.
- Breast arterial calcification was especially predictive of future cardiovascular events among younger women, the study authors said, adding that the use of AI to quantify breast arterial calcification is feasible and clinically relevant.
What does this mean for providers?
Lori Daniels, MD, cardiologist and director of UC San Diego Health's cardiovascular ICU, spoke to Becker's about how the study's findings might translate to cardiovascular care.
Note: Responses have been edited for clarity and length.
Question: How do you envision hospitals integrating breast arterial calcification scoring into mammogram workflows?
Dr. Lori Daniels: Implementing this into the mammogram workflow will require a lot of collaboration and discussion. Ideally it will not need to be specifically ordered, but rather will be routinely reported.
Q: How might scoring affect early screening practices or preventive care approaches within oncology and cardiology departments?
LD: breast arterial calcification could identify women, especially younger women, who are at risk for future cardiovascular disease and may not have known it. We have a lot of tools at our disposal for prevention of heart attacks, strokes and heart failure. Depending upon the specific situation, this could range from dietary changes, lifestyle interventions, or even earlier institution of certain medications, in some cases. Hopefully we can perform studies of early interventions and develop evidence-based pathways that are individualized to a woman's particular profile.
How do you foresee cardiology departments utilizing breast arterial calcification scores from mammograms to refine risk assessment protocols for patients who may not exhibit cardiovascular risk factors?
LD: We need research which will help us develop evidence-based pathways on the best ways to report breast arterial calcification — and respond to breast arterial calcification — once it is discovered. We need to figure out how to incorporate breast arterial calcification into a woman's overall cardiovascular risk profile and how to use the added information to make a more personalized and more accurate risk assessment.