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Mammographic Calcifications in Lung Transplant Recipients: Prevalence and Evolution
Jonathan Saenger1, Jasmin Happe1, Caroline Maier2
1Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, 8091 Zurich, Switzerland.
Biomedicines
|September 27, 2025
Summary
Lung transplant recipients show more breast arterial calcifications (BAC) and grouped microcalcifications. These calcifications progress faster in LTX patients, potentially complicating mammograms and requiring tailored screening.
Area of Science:
- Radiology and Imaging
- Transplant Medicine
- Oncology
Background:
- Mammographic screening is crucial for early breast cancer detection.
- Lung transplant recipients (LTX) have unique health considerations post-transplant.
- The impact of LTX on breast calcification patterns is not well-established.
Purpose of the Study:
- To determine the prevalence and progression of breast arterial calcifications (BAC) and microcalcifications in women after lung transplantation (LTX).
- To compare mammographic findings between LTX recipients and age-matched controls.
- To assess the potential for calcifications to mimic malignancy in LTX patients.
Main Methods:
- Retrospective cohort study of 176 adult female patients (82 LTX recipients, 94 controls) with mammography data.
- Mammographic findings assessed using BI-RADS criteria and a visual BAC scoring system.
- Statistical analysis included multivariable logistic regression and cumulative incidence; interobserver agreement assessed using Fleiss' kappa.
Main Results:
- LTX recipients showed significantly higher prevalence of BAC (OR 6.57) and grouped microcalcifications (OR 14.6) compared to controls (p < 0.001).
- Accelerated progression of BAC and grouped microcalcifications observed in LTX recipients (p ≤ 0.01).
- BAC was often extensive, potentially mimicking malignant findings; interobserver agreement varied by finding type.
Conclusions:
- LTX recipients exhibit increased prevalence and faster progression of BAC and grouped microcalcifications.
- These calcifications can complicate mammographic interpretation in LTX patients.
- Tailored screening strategies may benefit LTX recipients due to elevated malignancy risk and diagnostic overlap.
