Author + information
- Received April 2, 2018
- Revision received June 28, 2018
- Accepted July 5, 2018
- Published online March 13, 2019.
- Renato Quispe, MD, MHSa,
- Mahmoud Al-Rifai, MD, MPHa,b,
- Philip A. Di Carlo, MDc,
- Erin D. Michos, MD, MHSa,d,e,
- Nivee P. Amin, MD, MHSf,
- Sina Kianoush, MD, MPHa,g,
- Catherine E. Handy, MD, MPHa,h,
- John W. McEvoy, MBBCh, MHSa,d,
- Michael J. Blaha, MD, MPHa,e,
- Khurram Nasir, MD, MPHa,i,
- Roger S. Blumenthal, MDa,
- Rajesh Tota-Maharaj, MDa,
- Joao A.C. Lima, MD, MBAj,
- Josep Comin-Colet, MD, PhDk,l and
- Miguel Cainzos-Achirica, MD, MPHa,k,m,∗ ()
- aDepartment of Cardiology, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Medical Institutions, Baltimore, Maryland
- bDepartment of Medicine, University of Kansas School of Medicine, Wichita, Kansas
- cBreast Imaging Division, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
- dWelch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- eDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- fDivision of Cardiology, Weill Cornell Medical College, New York, New York
- gYale University School of Medicine, New Haven, Connecticut
- hSidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
- iCenter for Prevention and Wellness, Baptist Health South Florida, Miami, Florida
- jCardiac Imaging Unit, Department of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Maryland
- kCardiology Department, Bellvitge University Hospital and Bellvitge Biomedical Research Institute, L’Hospitalet de Llobregat, Barcelona, Spain
- lDepartment of Clinical Sciences, University of Barcelona, Barcelona, Spain
- mResearch Triangle Institute Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain
- ↵∗Address for correspondence:
Dr. Miguel Cainzos-Achirica, Hospital Universitari de Bellvitge, Servei de Cardiologia, Planta 19. Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain.
• The growing burden of cardiovascular disease among women highlights the need for improved preventive approaches.
• Detectable breast arterial calcium in screening mammograms may identify women at increased cardiovascular risk.
• Research of the optimal risk assessment and management that these women should undergo is needed.
• The finding of breast arterial calcium should trigger healthy cardiovascular lifestyle modification.
• Systematic reporting of breast arterial calcium burden as part of a standard mammography is encouraged.
In 2018, cardiovascular disease (CVD) was the leading cause of death among women, and current CVD prevention paradigms may not be sufficient in this group. In that context, it has recently been proposed that detection of calcification in breast arteries may help improve CVD risk screening and assessment in apparently healthy women. This review provides an overview of breast arterial anatomy; and the epidemiology, pathophysiology, and measurement of breast artery calcium (BAC); and discusses the features of the BAC-CVD link. The potential clinical applications that BAC may offer for CVD prevention in the context of current clinical practice guidelines and recommendations are also discussed. Finally, current gaps in evidence gaps are outlined, and future directions in the field are explored with a focus on the implementation of BAC mammography as a CVD risk-screening tool in routine clinical practice.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 2, 2018.
- Revision received June 28, 2018.
- Accepted July 5, 2018.
- 2019 American College of Cardiology Foundation
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