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Breast Arterial Calcification: Expanding the Reach of Cardiovascular Prevention

Given that millions of women undergo mammograms each year, there has been growing interest in whether the presence of breast arterial calcification (BAC), which is easily detected on a standard mammogram, could help inform cardiovascular risk assessment.

Several observational studies have demonstrated that the presence of BAC provides important prognostic information related to cardiovascular risk. In a systematic review of the data related to BAC and CVD, Hendricks et al cited studies that used either hospital admission data or municipal death records to examine the association of BAC and CVD events. The authors reported a hazard ratio of 1.32 (95% confidence interval [CI], 1.08–1.60) for incident coronary heart disease, 1.44 (95% CI, 1.02–2.05) for coronary heart disease mortality, 1.29 (95% CI, 1.01–1.66) for CVD mortality, and 1.52 (95% CI, 1.18–1.98) for heart failure.

But perhaps the greatest power in a joint screening for breast cancer and CVD lies in the potential to prevent BAC or CAC from developing in the first place. Breast cancer and CVD share several modifiable risk factors: diabetes mellitus, smoking, physical inactivity, poor diet, and obesity. If women were counseled each time they had a mammogram that controlling their risk factors could help them avoid 2 of the deadliest conditions for women, then the message of prevention could gain considerable strength.