Related Experiment Video
Updated: May 9, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Joint BrEast CAncer & CardiOvascular ScreeniNg: BEACON Study to Assess Opportunistic Cardiovascular Screening Using
Hayley McKee1, Teresa Bianco2, Kaitlin Zaki-Metias3
1Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Insights
Breast arterial calcifications (BAC) found on mammography are linked to coronary artery calcification (CAC). Notification of BAC and CAC prompted significant primary care provider follow-up and lifestyle changes in patients without known cardiovascular disease.
Area of Science:
- Cardiology
- Radiology
- Preventive Medicine
Background:
- Breast arterial calcifications (BAC) on mammography are associated with coronary artery calcification (CAC) and cardiovascular disease (CVD) events.
- BAC are not routinely reported, limiting their clinical utility.
- Understanding the link between BAC and CAC is crucial for cardiovascular risk assessment.
Purpose of the Study:
- To evaluate primary care provider (PCP) follow-up rates after notification of BAC and CAC.
- To assess the association between the presence of BAC on mammography and CAC detected by CT.
- To determine the impact of BAC and CAC notification on patient management and outcomes.
Main Methods:
- Prospective recruitment of 286 participants without known CVD undergoing mammography.
- Qualitative scoring of BAC by breast radiologists and quantitative scoring of CAC using cardiac CT (Agatston method).
- Collection of baseline data, risk factors, and follow-up information via questionnaires.
Main Results:
- BAC prevalence was 13%; CAC was present in 37% (106/286) of participants.
- BAC demonstrated high specificity (92%) but low sensitivity (23%) for detecting CAC.
- Participants with BAC and CAC showed high PCP follow-up rates (92%) and initiated lifestyle modifications (46%).
Conclusions:
- Mammography-detected BAC can serve as an indicator for underlying CAC in asymptomatic individuals.
- Notification of BAC and CAC encourages patient engagement with PCPs and adoption of healthier lifestyles.
- Further research is needed to optimize the reporting and management of BAC for CVD risk stratification.
Abstract:
Purpose: Breast arterial calcifications (BAC) are not routinely reported on mammography but are linked to coronary artery calcification (CAC) and cardiovascular disease (CVD) events. We sought to assess primary care provider (PCP) follow-up after BAC and CAC notification and the association between BAC on mammography and CAC on CT. Methods: Participants without known CVD undergoing mammography at a single centre were prospectively recruited over 18 months. BAC were qualitatively scored (none/mild/moderate/severe) by 2 breast radiologists. All participants had research cardiac CT for CAC within 6 months, scored using the Agatston method. Questionnaires collected baseline demographics, risk factors, and follow-up data. Results: 286 participants were included (median age 62 ± 10). Prevalence of BAC was 13% (38/286), 248 had none, 18 mild, 16 moderate, and 4 severe. For CAC: 180 had none, 70 had mild (CAC 1-99), 28 had moderate (CAC 100-399), and 8 had severe (CAC >400). For detecting CAC, BAC presence had 92% specificity (166/180), 23% sensitivity (24/106), and 67% negative predictive value (166/248). Most participants with BAC and CAC (71%, 17/24) were not on lipid-lowering therapy and 63% (15/24) did not believe they had elevated CVD risk. At follow-up (median 202 days), 46% (11/24) with BAC and CAC implemented lifestyle modifications, 92% (22/24) scheduled PCP follow-up, and 56% (10/18) underwent further CV risk assessment following their appointment. One participant with BAC and CAC had a stroke during follow-up. Conclusion: In a prospective cohort without known CVD undergoing mammography, notification of BAC and CAC status prompted high follow-up rates with PCPs and lifestyle modifications.
More Related Videos
10:32Combined Use of Tail Vein Metastasis Assays and Real-Time In Vivo Imaging to Quantify Breast Cancer Metastatic Colonization and Burden in the Lungs
Published on: December 19, 2019
06:57Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
