The mammography This is the most effective method for diagnosing breast cancer. However, a study recently published in Circulation: Cardiovascular Imaging shows that it could also be useful in predicting the likelihood of developing heart disease or stroke.
The authors of the study, Kaiser Permanente Center of Northern California, chose to study this question after noticing two very important factors. On the one hand, that the calculators commonly used to assess cardiac risk factors are much more effective in men than in women. On the other hand, that the mammography It is a very useful tool, since it is carried out regularly to all women over a certain age. Or at least it should.
In images taken by mammography, you can see if there is mammary arterial calcification. They suspected that this phenomenon could be used to predict the likelihood of developing heart disease. But to be sure they needed a large sample of women. For this reason, they resorted to MINERVE study (Multi-ethnic study of mammary arterial calcium gradation and cardiovascular disease), which includes more than 200,000 attendees.
What does a mammogram tell us?
Mammography is a diagnostic technique consisting of the analysis of the mammary glands through X-rays. Although it has been refined over time, it has been used since 1913 to diagnose breast canceras well as other pathologies associated with the breasts.
Today, it is so effective that it can even be used to diagnose a tumor three years before the first symptoms appear. For this reason, most countries include regular screening protocols for women of a certain age in their public health plans. In Spain, for example, it is recommended a mammogram every two years for women between 50 and 69 years old. Above or below this age will depend on the predisposition of each patient. Also, it could be that some in this range had to do it on a more continuous basis. Now what does all this have to do with heart disease?
Discrimination in heart disease risk calculation
For a long time, scientific discourse focused on the male figure of the human being. It also included a medical investigation made by and for men. Fortunately, today the situation is not so extreme. However, there are still some details that make us see that the discrimination, although unconscious, continues. For example, the dosage of many drugs is based on clinical trials conducted only on men. Amounts considered safe for a man can be dangerous for a womanso it could become a problem.
Something similar happens with the symptoms of diseases. Many have been studied especially in men. For example, symptoms normally associated with a heart attack, such as pain in the left arm, are more common in men. Women may have other signs, such as back pain, but this is something that is not widely reported. And it’s the same with heart disease risk calculators. They were developed based on studies typically conducted with men, so the results are not as accurate for women.
Therefore, these scientists chose to resort to mammary arterial calcification. This consists of the accumulation of calcium in the middle layer of the arterial wall of the breast. It is not the same as the inner layer calcificationvery common in smokers or people with high cholesterol. This is rather associated with aging. In fact, it is known to be present in about a quarter of women between the ages of 60 and 79. And it seems to be even more associated with the presence or risk of heart disease. As this is something that is easily seen on a mammogram, these scientists decided to follow the women participating in the MINERVE study. They could thus verify whether a cardiovascular risk would be associated with the presence of this breast calcification. So that was it.
A more efficient calculator
About 200,000 women participated in the study. no history of breast cancer or heart disease. All of them had at least one mammogram between October 2012 and February 2015. They were then followed for approximately 6 and a half years.
The aim was to check how many developed heart disease and compare it with the presence or absence of mammary artery calcification. Thus, they found that those who exhibited this trait on mammography had 51% more likely to develop heart disease or stroke. Moreover, it was more likely to occur in women. white or latin only in black. This is an important detail, since the MINERVA study includes a wide variety of ethnic groups, precisely to be able to take into account these data, which despite their importance are sometimes left out.
In a press release, the authors of the study recall that in the United States It is not mandatory that radiologists indicate in the results of the mammogram if there is arterial calcification. However, in view of their results, they believe that the protocols could be modified to make it mandatory. This is very useful data, which is obtained periodically and easily. Mammography was giving us more efficient cardiovascular risk calculators on a plateau and we didn’t realize it. What less than to take it into account now?