Prevalence of breast arterial calcifications in an ethnically diverse population of women.

PURPOSE Breast arterial calcifications (BAC) identified on routine mammography have been associated with coronary heart disease (CHD) risk factors including diabetes and hypertension, angiographically defined CHD, and increased cardiovascular mortality. Accumulating evidence suggests that the mammogram may be an important tool to identify women at risk for CHD, however, the epidemiology of BAC has been poorly defined and previous studies limited to white populations. METHODS The mammograms of 1905 consecutive women (51.2% Hispanic, 25.8% white, 15.3% black, 5.4% other, 2.2% Asian, ages 35-92 years) were evaluated for the presence of BAC and the number of calcified arteries. RESULTS The overall prevalence of BAC was 29.4% and was significantly higher for Hispanics compared with whites (34.5% vs. 24.0%, p=0.0002) and lower for Asians compared with whites (7.1% vs. 24.0%, p < 0.02). Among BAC-positive women aged 65 years or less, blacks had more calcified arteries than whites (p < 0.01). The presence of BAC increased with age (p for trend < 0.0001). In age-adjusted models, older Hispanics were more likely to be BAC-positive than whites of similar age (p < 0.02). CONCLUSION These results indicate that BAC varies significantly by age and race/ethnicity. These findings should be taken into consideration when designing future studies of BAC and CHD.

[1]  Constance K Haan,et al.  Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women , 2004, Circulation.

[2]  É. Fondrinier,et al.  Breast Microcalcifications: Multivariate Analysis of Radiologicand Clinical Factors for Carcinoma , 2002, World Journal of Surgery.

[3]  Y. van der Graaf,et al.  Arterial calcification found on breast cancer screening mammograms and cardiovascular mortality in women: The DOM Project. Doorlopend Onderzoek Morbiditeit en Mortaliteit. , 1998, American journal of epidemiology.

[4]  G. Whitehouse,et al.  Factors which influence the occurrence of vascular calcification in the breast. , 1987, The British journal of radiology.

[5]  P. Bennett,et al.  Medial arterial calcification and its association with mortality and complications of diabetes , 1988, Diabetologia.

[6]  S. Oparil,et al.  AHA/ACC scientific statement: consensus panel statement. Guide to preventive cardiology for women. American Heart Association/American College of Cardiology. , 1999, Journal of the American College of Cardiology.

[7]  T. Pearson.  New Tools for Coronary Risk Assessment: What Are Their Advantages and Limitations? , 2002, Circulation.

[8]  R. D'Agostino,et al.  Sudden coronary death in women. , 1998, American heart journal.

[9]  Mark A Hlatky,et al.  Differences in Medical Care and Disease Outcomes Among Black and White Women With Heart Disease , 2003, Circulation.

[10]  Carlos Iribarren,et al.  Breast vascular calcification and risk of coronary heart disease, stroke, and heart failure. , 2004, Journal of women's health.

[11]  C. Comstock,et al.  Intramammary arterial calcifications associated with diabetes. , 1980, Radiology.

[12]  L. Mosca,et al.  Tracking Women’s Awareness of Heart Disease: An American Heart Association National Study , 2004, Circulation.

[13]  M. Brown,et al.  Current practice of screening mammography in the United States: data from the National Survey of Mammography Facilities. , 1994, Radiology.

[14]  M. Çetin,et al.  Prevalence of breast arterial calcification in hypertensive patients. , 2004, Clinical radiology.

[15]  M. Engelgau,et al.  Diabetes trends in the U.S.: 1990-1998. , 2000, Diabetes care.

[16]  L. Niskanen,et al.  Medial Artery Calcification Predicts Cardiovascular Mortality in Patients With NIDDM , 1994, Diabetes Care.

[17]  D. O'leary,et al.  Breast arterial calcification: association with coronary artery disease. Work in progress. , 1995, Radiology.

[18]  Y. van der Graaf,et al.  Breast arterial calcifications: association with diabetes mellitus and cardiovascular mortality. Work in progress. , 1996, Radiology.

[19]  J. Leor,et al.  Breast artery calcium on routine mammography as a potential marker for increased risk of cardiovascular disease. , 2000, The American journal of cardiology.

[20]  W. Mali,et al.  Prevalence and determinants of breast arterial calcium in women at high risk of cardiovascular disease. , 2004, The American journal of cardiology.

[21]  Stephen W. Sorensen,et al.  Lifetime risk for diabetes mellitus in the United States. , 2003, JAMA.

[22]  S. Oparil,et al.  Guide to Preventive Cardiology for Women , 1999 .

[23]  M Suhonen,et al.  Medial artery calcification. A neglected harbinger of cardiovascular complications in non-insulin-dependent diabetes mellitus. , 1996, Arteriosclerosis, thrombosis, and vascular biology.

[24]  J. Skyler,et al.  Diabetes trends in the USA , 2002, Diabetes/metabolism research and reviews.

[25]  E. Sickles,et al.  Breast arterial calcification in association with diabetes mellitus: too weak a correlation to have clinical utility. , 1985, Radiology.