Mammograms May Actually Be Good for Your Heart

Routine mammograms can do more than detect breast cancer. A new study suggests that breast imaging may also serve as an early warning for heart disease.

The study focused on what’s known as breast arterial calcification, calcium deposits within breast tissue that look like white flecks on a mammogram and can sometimes indicate precancerous cells but are most often benign. Breast calcification is common and becomes more prevalent with age; more than half of women have these deposits visible on mammograms by the time they’re in their mid-seventies.

Several causes of breast calcification — including advanced age, high blood pressure, and type 2 diabetes — are also risk factors for cardiovascular disease. Because of this, scientists wanted to see whether mammograms might be a good way to predict which women have an increased risk for events like heart attacks and strokes.

Researchers examined electronic health records for more than 5,000 women ages 60 to 79 who had no history of breast cancer or heart disease and had at least one screening mammogram between October 24, 2012, and February 13, 2015. Mammograms found breast calcification in 25.5 percent of the participants.

After the mammograms, researchers followed the women for an average of 6.5 years. During this time, the scientists identified 155 cases of so-called atherosclerotic cardiovascular disease (ASCVD) events, which included heart attacks, strokes, and death from cardiovascular causes. More broadly, they found 427 cases involving any type of cardiovascular disease, including heart disease, stroke, heart failure, and diseases of the peripheral arteries.

Women who had breast calcification were 51 percent more likely to develop atherosclerotic cardiovascular disease in particular and 23 percent more likely to experience any type of heart disease, the study found. The results were published March 15 in Circulation: Cardiovascular Imaging.

Currently, it’s not standard practice for radiologists to note breast calcification on mammogram reports, particularly when these deposits appear benign.

“Some radiologists do include this information on their mammography reports, but it’s not required,” says the lead study author, Carlos Iribarren, MD, PhD, MPH, of the Kaiser Permanente Northern California Division of Research in Oakland.

“We hope that our study will encourage an update of the guidelines for reporting breast arterial calcification from routine mammograms,” Dr. Iribarren adds.

Doing this might help better identify heart disease among women. This is badly needed, because the standard risk calculator for predicting which people are most likely to develop or die of heart disease is more accurate for men than for women, Iribarren notes.

Heart disease is the leading cause of death among U.S. women, accounting for about one in five female deaths each year, according to the Centers for Disease Control and Prevention (CDC). But only about half of women know this, the CDC reports.

Tracking breast calcification on mammograms might give doctors another way to catch heart disease in women earlier, when it’s easier to treat and prevent serious complications.

Discussing these results with patients might also help doctors start conversations about heart-healthy lifestyle habits like eating well, exercising more, and maintaining a healthy weight, says Sadiya Khan, MD, a coauthor of an editorial accompanying the study and an assistant professor of medicine in the division of cardiology at Northwestern University’s Feinberg School of Medicine in Chicago.

“It is really important to note that the absence of breast arterial calcification did not translate into low risk and should not be falsely reassuring when no breast arterial calcification is present,” Dr. Khan says. “Optimal risk factor control is equally important for all women with and without breast arterial calcification.”

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