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Can Mammograms Spot Heart Disease?

Breast screening may catch indirect signs of heart trouble

WEDNESDAY, Dec. 4, 2002 (HealthDayNews) -- Mammography makes headlines as a screening test for breast cancer, but the technology may do double duty as a predictor of heart disease.

Women whose mammograms spot calcium deposits in their breast arteries are more vulnerable to heart attacks and other fallout of cardiovascular disease than those with clean vessels, new research has found. While the calcifications in the breast don't harm the heart, they appear to echo narrowing of the coronary arteries that feed the pump.

"Most people don't worry about [the deposits] because they're not cancer," says Dr. Kirk Doerger, a radiology resident at the Mayo Clinic and a collaborator on the research. "But now we're finding that they do have some importance."

In 1998, for example, Dutch doctors found that women with calcified breast arteries faced a sharply higher risk of cardiovascular death, especially if they had diabetes. And last year, Israeli scientists also found the deposits, which increase with age, upped the risk of cardiovascular disease in women -- enough to lead the researchers to conclude that mammography might be a cheap and effective screening tool for heart and vessel problems.

However, the latest study can't make so strong a statement, says Doerger, who presented the findings today at the Radiological Society of North America's annual meeting in Chicago.

Doerger and his colleagues reviewed medical records of 1,803 women who'd had mammography as well as angiograms to examine their coronary arteries. They found that after adjusting for a woman's age -- which is tightly linked to cardiovascular illness -- the presence of breast artery calcifications on mammograms increased the risk of significantly narrowed blood flow to the heart by 20 percent.

Smoking raised that risk by 50 percent, and diabetes drove it up 210 percent, Doerger says, so the effect is on the modest side. Still, he adds, "it's free information" that radiologists now ignore.

Each breast has three main arteries supplying blood. Calcifications on at least three of those vessels raised the risk of coronary artery blockage, Doerger says. However, more extensive breast artery lesions didn't magnify that risk, he says.

Turning mammography into a tool to detect heart disease underscores a common misperception about women's health. While many women express more fear of breast cancer than cardiovascular disease, it's the latter that's more likely to kill them.

Heart disease kills nearly a half million American women each year, more than all cancers combined. And nearly two-thirds of women who suddenly die of heart problems have no previous symptoms.

Still, Dr. Susan Orel, a radiologist at the University of Pennsylvania School of Medicine, says she's not sure what to make of the new research.

Since the women already had signs of artery trouble, the study group was "very biased" from the start, she says. What's more, "you see [calcification of the breast vessels] almost all the time in older women," diluting the potential significance of the marker.

On the other hand, Orel adds, calcifications on the mammograms of women in their 30s and 40s stir her concern.

What To Do

For more on women and heart disease, try the American College of Obstetricians and Gynecologists or the American Heart Association.

SOURCES: Kirk Doerger, M.D., radiology resident, Mayo Clinic, Rochester, Minn.; Susan Orel, M.D., associate professor, radiology, University of Pennsylvania, Philadelphia; Dec. 4, 2002, presentation, Radiological Society of North America annual meeting, Chicago
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