Breast Artery Calcification Increases ASCVD Events Risk

Breast artery calcification on a digital mammogram was found to increase the risk of atherosclerotic cardiovascular disease (ASCVD) events by 50%, according to the results of a large cohort study.

Breast artery calcification is commonly found during mammography and is associated with coronary artery disease and cardiovascular disease (CVD). To explore the association between such calcification and hard atherosclerotic CVD or global CVD, investigators studied a cohort of more than 5000 women aged 60 to 79 years who had been recruited after receiving digital mammography between October 2012 and February 2015.

They found that 26% of the cohort had some breast artery calcification. After a mean follow-up period of 6.5 years (range, 1.6 yr), 155 women in the cohort (3%) had atherosclerotic CVD events, and 427 women (8.4%) had global CVD events.

After using Cox regression and adjusting their results for traditional CVD risk factors, the investigators found that the presence of breast artery calcification was associated with an increased hazard ratio of 1.51 (95% CI, 1.08-2.11; P=0.02) for atherosclerotic CVD events and of 1.23 (95% CI, 1.00-1.52; P=.04) for global CVD.

At the 95th percentile of breast artery calcification, a threshold effect was noted for global CVD, although no indication of a dose-response association was found between breast artery calcification and atherosclerotic CVD.

The researchers also determined that adding breast artery calcification status to the 10-year pooled cohorts equation improved its ability to stratify risk.

“Our results indicate that [breast arterial calcification] has potential utility for primary CVD prevention and, therefore, support the notion that [breast arterial calcification] ought to be considered a risk-enhancing factor for ASCVD among postmenopausal women,” the researchers concluded.


—Ellen Kurek



Iribarren C, Chandra M, Lee C, et al. Breast arterial calcification: a novel cardiovascular risk enhancer among postmenopausal women. Circ Cardiovasc Imaging. 2022;15:e013526. doi:10.1161/CIRCIMAGING.121.013526