Advanced Biomedical Research

Relationship between breast arterial calcification on mammography with CT Calcium scoring and coronary CT angiography results

Authors

Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Mammography as a non invasive method has been suggested to be helpful in predicting coronary artery disease. This study aimed to investigate whether presence and severity of breast artery calcification (BAC) on mammograms is associated with computed tomography coronary angiography (CTCA) finding such as coronary artery calcium (CAC) score and the severity of coronary artery stenosis.
Materials and Methods: This cross-sectional study was performed on 150 women aged >40 years who were referred for CTCA. Women who had undergone screening mammography during the first year after CTCA entered the study. CAC score was determined and the severity of coronary artery stenosis was classified into normal, non-significant stenosis, or significant stenosis. Based on the severity of BAC, patients were also grouped into normal, mild, moderate, or severe groups. Then, the correlation between BAC severity and CAC score was determined. Patients with different BAC severity were also compared regarding the relative frequency of different grades of coronary artery stenosis.
Results: Mean age of subjects with BAC (n: 35) was significantly higher than patients without BAC (n: 115) (68.03 ± 6.16 versus 54.36 ± 7.63 years, P < 0.0001). Although the relative frequency of different grades of coronary artery stenosis was significantly higher in women with BAC (P < 0.0001), after controlling for age, there was no significant difference between patients with different severity of BAC in the mean of CAC score (P: 0.09). In addition, the correlation between BAC severity and CAC score was not statistically significant (R: 0.09, P: 0.26).
Conclusion: We concluded that presence and severity of BAC have no significant correlation with CAC score on CTCA.

Keywords

1. Kataoka M, Warren R, Luben R, Camus J, Denton E, Sala E, et al. How predictive is breast arterial calcification of cardiovascular disease and risk factors when found at screening mammography? AJR Am J Roentgenol 2006;187:73-80.  Back to cited text no. 1
    
2. Schoepf UJ, Becker CR, Ohnesorge BM, Yucel EK. CT of coronary artery disease. Radiology 2004;232:18-37.  Back to cited text no. 2
    
3. Anderson JW. Whole grains protect against atherosclerotic cardiovascular disease. Proc Nutr Soc 2003;62:135-42.  Back to cited text no. 3
[PUBMED]    
4. Stary HC. Natural history of calcium deposits in atherosclerosis progression and regression. Z Kardiol 2000;89(Suppl 2):28-35.  Back to cited text no. 4
[PUBMED]    
5. Howard BV, Rodriguez BL, Bennett PH, Harris MI, Hamman R, Kuller LH, et al. Prevention Conference VI: Diabetes and Cardiovascular disease: Writing Group I: Epidemiology. Circulation 2002;105:132-7.  Back to cited text no. 5
    
6. Kondos GT, Hoff JA, Sevrukov A, Daviglus ML, Garside DB, Devries SS, et al. Electron-beam tomography coronary artery calcium and cardiac events: A 37-month follow-up of 5635 initially asymptomatic low- to intermediate-risk adults. Circulation 2003;107:2571-6.  Back to cited text no. 6
    
7. Wayhs R, Zelinger A, Raggi P. High coronary artery calcium scores pose an extremely elevated risk for hard events. J Am Coll Cardiol 2002;39:225-30.  Back to cited text no. 7
    
8. Pletcher MJ, Tice JA, Pignone M, Browner WS. Using the coronary artery calcium score to predict coronary heart disease events: A systematic review and meta-analysis. Arch Intern Med 2004;164:1285-92.  Back to cited text no. 8
    
9. Buyukterzi M, Turkvatan A, Buyukterzi Z. Frequency and extent of coronary atherosclerotic plaques in patients with a coronary artery calcium score of zero: An assessment using CT angiography. Diagn Interv Radiol 201219:111-8.  Back to cited text no. 9
    
10. Schwartz BG, Kloner RA. Cardiovascular implications of erectile Dysfunction. Circulation 2011;123:e609-11.  Back to cited text no. 10
    
11. Maas AH, van der Schouw YT, Atsma F, Beijerinck D, Deurenberg JJ, Mali WP, et al. Breast arterial calcifications are correlated with subsequent development of coronary artery calcifications, but their aetiology is predominantly different. Eur J Radiol 2007;63:396-400.  Back to cited text no. 11
    
12. Sickles EA, Galvin HB. Breast arterial calcification in association with diabetes mellitus: Too weak a correlation to have clinical utility. Radiology 1985;155:577-9.  Back to cited text no. 12
[PUBMED]    
13. Iribarren C, Go AS, Tolstykh I, Sidney S, Johnston SC, Spring DB. Breast vascular calcification and risk of coronary heart disease, stroke, and heart failure. J Womens Health (Larchmt) 2004;13:381-9.  Back to cited text no. 13
    
14. Kim H, Greenberg JS, Javitt MC. Breast calcifications due to Monckeberg medial calcific sclerosis. Radiographics 1999;19:1401-3.  Back to cited text no. 14
    
15. Cetin M, Cetin R, Tamer N. Prevalence of breast arterial calcification in hypertensive patients. Clin Radiol 2004;59:92-5.  Back to cited text no. 15
    
16. Crystal P, Crystal E, Leor J, Friger M, Katzinovitch G, Strano S. Breast artery calcium on routine mammography as a potential marker for increased risk of cardiovascular disease. Am J Cardiol 2000;86:216-7.  Back to cited text no. 16
    
17. Kemmeren JM, van Noord PA, Beijerinck D, Fracheboud J, Banga JD, van der Graaf Y. Arterial calcification found on breast cancer screening mammograms and cardiovascular mortality in women: The DOM Project. Doorlopend Onderzoek Morbiditeit en Mortaliteit. Am J Epidemiol 1998;147:333-41.  Back to cited text no. 17
    
18. Moshyedi AC, Puthawala AH, Kurland RJ, O'Leary DH. Breast arterial calcification: Association with coronary artery disease. Work in progress. Radiology 1995;194:181-3.  Back to cited text no. 18
    
19. van Noord PA, Beijerinck D, Kemmeren JM, van der Graaf Y. Mammograms may convey more than breast cancer risk: Breast arterial calcification and arterio-sclerotic related diseases in women of the DOM cohort. Eur J Cancer Prev 1996;5:483-7.  Back to cited text no. 19
    
20. Maas AH, van der Schouw YT, Beijerinck D, Deurenberg JJ, Mali WP, van der Graaf Y. Arterial calcifications seen on mammograms: Cardiovascular risk factors, pregnancy, and lactation. Radiology 2006;240:33-8.  Back to cited text no. 20
    
21. Penugonda N, Billecke SS, Yerkey MW, Rebner M, Marcovitz PA. Usefulness of breast arterial calcium detected on mammography for predicting coronary artery disease or cardiovascular events in women with angina pectoris and/or positive stress tests. Am J Cardiol 2010;105:359-61.  Back to cited text no. 21
    
22. Zgheib MH, Buchbinder SS, Abi Rafeh N, Elya M, Raia C, Ahern K, et al. Breast arterial calcifications on mammograms do not predict coronary heart disease at coronary angiography. Radiology 2010;254:367-73.  Back to cited text no. 22
    
23. Fiuza Ferreira EM, Szejnfeld J, Faintuch S. Correlation between intramammary arterial calcifications and CAD. Acad Radiol 2007;14:144-50.  Back to cited text no. 23
    
24. Abdulla J, Asferg C, Kofoed KF. Prognostic value of absence or presence of coronary artery disease determined by 64-slice computed tomography coronary angiography a systematic review and meta-analysis. Int J Cardiovasc Imaging 2011;27:413-20.  Back to cited text no. 24
    
25. Kataoka M, Warren R, Luben R, Camus J, Denton E, Sala E, et al. How predictive is breast arterial calcification of cardiovascular disease and risk factors when found at screening mammography? AJR Am J Roentgenol 2006;187:73-80.  Back to cited text no. 25
    
26. Markopoulos C, Mantas D, Revenas K, Kouskos E, Tzonou A, Liapis C, et al. Breast arterial calcifications as an indicator of systemic vascular disease. Acta Radiol 2004;45:726-9.  Back to cited text no. 26
    
27. Taskin F, Akdilli A, Karaman C, Unsal A, Koseoglu K, Ergin F. Mammographically detected breast arterial calcifications: Indicators for arteriosclerotic diseases? Eur J Radiol 2006;60:250-5.  Back to cited text no. 27
    
28. Pidal D, Sanchez Vidal MT, Rodriguez JC, Corte MD, Pravia P, Guinea O, et al. Relationship between arterial vascular calcifications seen on screening mammograms and biochemical markers of endothelial injury. Eur J Radiol 2009;69:87-92.  Back to cited text no. 28
    
29. Sedighi N, Radmard AR, Radmehr A, Hashemi P, Hajizadeh A, Taheri AP. Breast arterial calcification and risk of carotid atherosclerosis: Focusing on the preferentially affected layer of the vessel wall. Eur J Radiol 2011;79:250-6.  Back to cited text no. 29
    
30. Pecchi A, Rossi R, Coppi F, Ligabue G, Modena MG, Romagnoli R. Association of breast arterial calcifications detected by mammography and coronary artery calcifications quantified by multislice CT in a population of post-menopausal women. Radiol Med 2003;106:305-12.  Back to cited text no. 30
    
31. Reddy J, Son H, Smith SJ, Paultre F, Mosca L. Prevalence of breast arterial calcifications in an ethnically diverse population of women. Ann Epidemiol 2005;15:344-50.  Back to cited text no. 31
    
32. Maas AH, van der Schouw YT, Beijerinck D, Deurenberg JJ, Mali WP, van der Graaf Y. Arterial calcium on mammograms is not associated with inflammatory markers for heart disease risk. Heart 2006;92:541-2.  Back to cited text no. 32
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Advanced Biomedical Research
Volume 2014, February
February 2014
Pages 1-5