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Breast Arterial Calcium: A Game Changer in Women's Cardiovascular Health?
Renato Quispe1, Mahmoud Al-Rifai2, Philip A Di Carlo3
1Department of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Insights
Breast artery calcium (BAC) detected on mammograms may improve cardiovascular disease (CVD) risk assessment in women. This review explores BAC
Area of Science:
- Cardiology
- Radiology
- Women's Health
Background:
- Cardiovascular disease (CVD) is a leading cause of death in women, necessitating improved screening.
- Current CVD prevention strategies may be insufficient for women.
- Breast artery calcification (BAC) is a potential new marker for CVD risk in women.
Purpose of the Study:
- To review the anatomy, epidemiology, pathophysiology, and measurement of BAC.
- To discuss the link between BAC and CVD.
- To explore the clinical applications of BAC for CVD risk assessment in women.
Main Methods:
- Literature review of studies on breast artery anatomy, BAC, and CVD.
- Analysis of the relationship between BAC and CVD risk factors.
- Discussion of current clinical guidelines and potential implementation of BAC screening.
Main Results:
- BAC is detectable on mammograms and associated with CVD.
- Mammography may serve as a tool for CVD risk screening in women.
- Further research is needed to establish BAC's role in routine clinical practice.
Conclusions:
- BAC shows promise as a CVD risk-screening tool for women.
- Integrating BAC assessment into routine mammography could enhance CVD prevention.
- Future research should focus on validating BAC mammography for widespread clinical use.
Abstract:
In 2018, cardiovascular disease (CVD) was the leading cause of death among women, and current CVD prevention paradigms may not be sufficient in this group. In that context, it has recently been proposed that detection of calcification in breast arteries may help improve CVD risk screening and assessment in apparently healthy women. This review provides an overview of breast arterial anatomy; and the epidemiology, pathophysiology, and measurement of breast artery calcium (BAC); and discusses the features of the BAC-CVD link. The potential clinical applications that BAC may offer for CVD prevention in the context of current clinical practice guidelines and recommendations are also discussed. Finally, current gaps in evidence gaps are outlined, and future directions in the field are explored with a focus on the implementation of BAC mammography as a CVD risk-screening tool in routine clinical practice.
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