ASSOCIATION BETWEEN MAMMOGRAPHIC AND CORONARY ARTERY CALCIFICATIONS, CALCIFICATION BURDEN AND CARDIOVASCULAR DISEASES AND RISK FACTORS IN PATIENTS WITH NEWLY DIAGNOSED BREAST CANCER

Aada Lattu1,2, Kalle Kaapu*1,2 , Leena Pakarinen*1,2 , Petteri Kauhanen3, Annukka Salminen1,2, Marja Hedman3,4, Velipekka Suominen5, Sami Mustajoki6, Ari Mennander7, Irina Rinta-Kiikka1,2, Tanja Skyttä2,8), Otso Arponen1,2,4,8 , 1 Department of Radiology, Tampere University Hospital, Elämänaukio 2, 33520, Tampere, Finland, 2 Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland 3 Heart Center, Kuopio University Hospital, Kuopio, Finland 4 Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland. 5 Centre for Vascular Surgery and Interventional radiology, Tampere University Hospital, Tampere, Finland. 6  Department of Medicine, Tampere University Hospital, Tampere, Finland. 7 Tampere University Heart Hospital, Cardiac Research and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland, 8  Department of Oncology, Tampere University Hospital and Tays Cancer Center, Tampere, Finland. 

*Shared second authorship. 

Females diagnosed with breast cancer routinely undergo imaging, including mammograms and radiotherapy (RT) planning computed tomography (CT) scans. These images can be used to detect breast and coronary arterial calcifications (BACs and CACs), both independently associated with cardiovascular diseases (CVDs). However, the literature on their coexistence and joint association with CVDs is limited. We aimed to examine the associations between BACs, CACs, their coexistence and degree (calcification burden), and CVDs and related risk factors in newly diagnosed breast cancer patients. 

This retrospective study included 653 patients treated for newly diagnosed breast cancer at Tampere University Hospital in 2019–2020. BACs and CACs were assessed from mammograms and RT planning CT scans using established criteria. Cardiovascular risk factors and major CVD diagnoses were collected from medical records. 

Of the patients, 187 (28.6%) had BACs, 255 (39.1%) had CACs, and 120 (18.4%) had both, indicating an association but not a direct correlation. The presence of BACs and CACs was associated with higher risk of type 2 diabetes, hypercholesterolemia, hypertension, aortic regurgitation, and a history of transient ischemic attack or stroke. Increasing calcification burden was linked to a higher likelihood of cardiovascular risk factors. 

Opportunistic assessment of BACs and CACs from routine preoperative mammograms and RT planning CT scans may help identify breast cancer patients at elevated cardiovascular risk. Prospective studies assessing the detection of previously unrecognized cardiovascular risk factors and diseases, as well as long-term outcomes in breast cancer patients with arterial calcifications, are warranted to confirm these findings.