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Breast arterial calcifications on mammography: a new marker of cardiovascular risk in asymptomatic middle age women?

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Abstract

Objectives

To determine whether breast arterial calcification (BAC) detected on mammography can predict the presence of coronary artery calcification (CAC) on CT in women.

Methods

Women explored with both mammography and thoracic CT from 2009 to 2018 were retrospectively included. Women were separated in 3 categories (no BAC, few BAC, and marked BAC) using a specific 12-point scale. Similar scale was used to evaluate the amount of CAC on CT. The mean sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of BAC for the detection of CAC were calculated. Statistical significance was assessed with Pearson’s chi-squared test and Fisher’s exact test as appropriate.

Results

A total of 507 women (mean age: 62 years ± 16) were included. Patients with high amount of BAC were older (72 ± 11 vs. 59 ± 15 years old; p < .0001), were more frequently hypertensive (66% vs. 31%; p < .0001), and had more frequently renal failure (21% vs. 6%; p < .0003) than patients without BAC. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of BAC for the detection of women with marked CAC were 53.1%, 87.6%, 55.0%, 86.7%, and 79.9%, respectively. The highest diagnostic accuracy was obtained in patients under 60 years: 84.2% for detection of CAC and 93.2% for detection of women with marked CAC.

Conclusion

The presence of BAC on mammography was linked to the presence of CAC and may be used as a cardiovascular marker in patient less than 60 years.

Key Points

• The diagnostic accuracy of breast arterial calcification (BAC) to detect the presence of coronary artery calcification (CAC) was 70.4% and reached to 79.9% to detect women with high amount of CAC.

• Highest diagnostic accuracy of BAC to detect CAC (93.2%) was noticed in women under 60 years.

• The presence of BAC on mammography may be used as a cardiovascular risk marker in women, especially under 60 years

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Abbreviations

BAC:

Breast arterial calcification

CAC:

Coronary artery calcification

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Radiology Department, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France

    Lise Minssen, Thu Ha Dao, Alain Luciani, Evelyne Meyblum & Jean-François Deux

  2. Radiology Department, Hôpital Henri Mondor, 51 av Mal de Lattre de Tassigny, 94000, Créteil, France

    Lise Minssen

  3. University Paris 7 Diderot, Paris, France

    An Vo Quang

  4. Department of Public Health, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France

    Laura Martin & Etienne Andureau

  5. Univ Paris Est Creteil, INSERM Equipe 8, IMRB, F-94010, Creteil, France

    Etienne Andureau, Alain Luciani & Geneviève Derumeaux

  6. Physiology Department, FHU SENEC, AP-HP, Hôpitaux Universitaires Henri Mondor, F-94010, Creteil, France

    Geneviève Derumeaux

  7. Radiology Department, HUG, Hopitaux Universitaires de Geneve, Geneva, Switzerland

    Jean-François Deux

Authors
  1. Lise Minssen
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  2. Thu Ha Dao
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  3. An Vo Quang
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  4. Laura Martin
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  9. Jean-François Deux
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Corresponding author

Correspondence to Lise Minssen.

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Guarantor

The scientific guarantor of this publication is Thu-Ha Dao.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

An Dao and Etienne Andureau kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational study

• performed at one institution

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Minssen, L., Dao, T.H., Quang, A.V. et al. Breast arterial calcifications on mammography: a new marker of cardiovascular risk in asymptomatic middle age women?. Eur Radiol 32, 4889–4897 (2022). https://doi.org/10.1007/s00330-022-08571-3

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  • DOI: https://doi.org/10.1007/s00330-022-08571-3

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