In view of the growing concern about the potential adverse health effects of CT scans (including increased cancer risk), the enthusiasm for performing CT scans of the heart and coronary arteries, as a noninvasive method of diagnosing asymptomatic heart disease, has been decreasing. Now, an innovative clinical research study, which has just been published in the journal Obstetrics & Gynecology, has evaluated the potential value of mammograms (which use low-dose x-rays to screen for breast cancer) to predict the risk of cardiovascular disease.
Calcification of the arteries within the breast are detected in approximately 10 to 20 percent of mammograms, and the incidence of these vascular calcifications rise in proportion to a woman’s age. Previous clinical research studies have suggested that the presence of vascular calcifications on mammograms may be an important early indicator of cardiovascular disease risk. However, the clinical research data in this area has been somewhat inconsistent, to date.
In this prospective clinical research study, 1,919 women, with an average age of 56 years, who presented for routine annual screening mammograms were subsequently followed for 5 years. Data was collected regarding their cardiovascular disease risk factors, and their own personal history (if any) of cardiovascular disease, as well as the presence or absence of cardiovascular disease in family members. This data was collected at the beginning of the study, and was updated throughout the course of the study.
The findings of this study were quite dramatic. During the 5-year course of this study, 21 percent of the women who were noted to have vascular calcifications within the breast, on routine mammography, were found to have coronary artery disease, while only 5 percent of the women without vascular calcifications on mammography had clinical evidence of coronary artery disease. Among those women with no clinical evidence of coronary heart disease at the beginning of this clinical study, 6 percent of those with vascular calcifications eventually developed coronary artery disease during the brief 5-year course of this study (compared to 2 percent of the women without vascular calcifications of the breast). Moreover, among healthy women with no history of coronary artery disease at the beginning of this study, 58 percent went on to experience a stroke if they had vascular calcifications in the breast, while 13 percent of the women without vascular calcifications of the breast experienced a stroke during this 5-year study.
The findings of this clinical research study strongly suggest that vascular calcifications of the breast, in women who are undergoing routine annual screening mammograms, may be a powerful indicator of increased risk for both coronary artery disease and stroke. While larger and longer-term prospective clinical research studies should be performed to validate the findings of this relatively small clinical research study, the findings of this study are consistent with earlier studies that have also linked vascular calcifications of the breast with a significant increase in the risk of cardiovascular disease. Therefore, the results of this study suggest that there may be an important secondary role for screening mammograms, beyond early detection of breast cancer. As women who have evidence of arterial calcifications of the breast by mammography (when compared to women without vascular calcifications) appear to be nearly 4 times more likely to have coronary artery disease, and have more than 4 times the risk of stroke, the presence of vascular calcifications on screening mammograms should prompt patients and their physicians to look for risk factors that can be modified to reduce the risk of premature illness and death related to cardiovascular disease.
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