May 13, 2022

Mammograms offer new clues to heart health

Kaiser Permanente research ties breast arterial calcification to increased risk of cardiovascular disease.

Researchers found that the women who had breast arterial calcifications were more likely to develop any form of cardiovascular disease.

Mammography may do more than find breast cancer. Results from a new Kaiser Permanente study suggest mammograms may also help spot women who are at higher risk for heart attack, stroke, or cardiovascular disease — the leading cause of death in women in the U.S.

“Our findings reinforce previous studies that suggest breast arterial calcification seen on a mammogram of a postmenopausal woman can be used to learn more about a woman’s heart health,” said Carlos Iribarren, MD, a research scientist at the Kaiser Permanente Division of Research who led the study.

Calcium deposits in the breast

Breast arterial calcifications are calcium deposits that show up on a mammogram as white parallel lines in the breast’s arteries. These deposits are more common in older women. They are also seen more often in women who have diabetes, high blood pressure, or inflammation.

Breast arterial calcification is not the same as the calcification that occurs in the inner layer of the arteries that is seen in smokers and people with high cholesterol levels. About 1 in 4 women in the study had breast arterial calcifications.

Finding a tie to heart health

The study included about 5,000 female Kaiser Permanente members in Northern California between age 60 and 79 who had had a routine mammogram between 2012 and 2015. After Kaiser Permanente radiologists reviewed the mammograms for signs of breast cancer, they were sent to members of Dr. Iribarren’s research team, who looked for the breast arterial calcifications.

Over 6.5 years, the researchers found that the women who had breast arterial calcifications were 51% more likely to be diagnosed with a heart attack or stroke and 23% more likely to develop any form of cardiovascular disease than the women who did not have these calcifications.

The researchers also used a risk calculator to assess each woman’s risk of developing heart disease in the next 10 years. They found that about 1 in 8 women with breast arterial calcification were at high risk, compared to about 1 in 18 women with no calcifications.

“Our study has moved the needle in support of revising guidelines for reporting breast arterial calcification on mammography,” Dr. Iribarren said. “Under current American College of Cardiology and American Heart Association guidelines, radiologists do not have to include breast arterial calcifications in a mammography report. This information would be valuable for use in heart disease calculators.”

Going forward, Dr. Iribarren and his colleagues hope to study whether breast arterial calcification is also helpful in predicting cardiovascular disease in younger women, ages 40 through 59.

“Because mammography is a routine part of a woman’s health care, it makes sense to find a way to use the information these images provide about heart disease risk,” said Dr. Iribarren.