Mammographically Detected Breast Arterial Calcification—A Marker of Coronary Artery Disease in Women
04 May 2018 (online)
Background and Aim Coronary artery disease (CAD) resulting from atherosclerosis is one of the major causes of mortality and morbidity worldwide and is still a leading cause of death in women older than 40 years. The gold standard for diagnosis of CAD is by coronary angiography (CAG). However, this procedure is both invasive and expensive and thus is not suitable as a screening tool in asymptomatic individuals. Like coronary calcification, atherosclerotic vascular calcification involving small-to-medium–sized arteries is also observed in the breast. Modern mammographic equipment is very sensitive in the detection of microcalcifications. The aim of this study is to study the relationship between mammographically detected breast arterial calcification (BAC) and CAD and to evaluate the role of BAC as a marker for CAD.
Methods Twenty female patients older than 40 years who had undergone CAG for suspected CAD were included in the study. Screening mammograms were performed and analyzed for the presence of BAC. The results were analyzed for correlation between severity of BAC and CAD.
Results Twenty patients with mean age of 56.45 (age range: 40–68) were evaluated. BACs were found in 60% of these cases with a peak age group of 56 to 60 years. BAC was bilateral (92%) in most cases. CAG reports were positive for CAD in 45% of patients. The sensitivity of BAC in predicting CAD was 77.7% with a specificity of 54.5%, positive predictive value (PPV) of 58.3%, and negative predictive value (NPV) of 75%. Conclusion Screening mammography has a potential to serve as a noninvasive tool for early detection of CAD in asymptomatic women. Larger population-based studies with controls will be required to establish the utility of this screening tool.
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