Breast Arterial Calcification is Associated with the Progression of Coronary Atherosclerosis in Asymptomatic Women: A Preliminary Retrospective Cohort Study

Figures

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  Figure 1. Flow diagram of the study population selection. BBC Registry, Women Health Registry for Bone, Breast, and Coronary Artery Disease; CCTA, coronary computed tomographic angiography.

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  Figure 2. Progression of CAC (A) and CAP (B) according to the presence and absence of BAC. BAC, breast arterial calcification; CAC, coronary arterial calcification; CAP, coronary atherosclerotic plaque.

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  Figure 3. The cumulative proportion of CAC (A) and CAP (B) progression according to the presence and absence of BAC. BAC, breast arterial calcification; CAC, coronary arterial calcification; CAP, coronary atherosclerotic plaque.

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  Figure 4. Representative cases. A 63-year-old asymptomatic woman with a BAC score of 5 (yellow arrow heads) on screening mammography (A) demonstrated calcified plaque without significant stenosis (percent diameter stenosis, 10–20%) at the proximal LAD and mixed plaque (percent diameter stenosis, 10–20%) at the mid LAD (yellow arrow). (B) Three years later, she was referred to the emergency department with chest pain and underwent CCTA, which demonstrated progression of the mid LAD lesion (percent diameter stenosis, 90%; yellow arrow). (C) Invasive angiography also demonstrated the tight stenosis of the mid LAD (percent diameter stenosis, 90%) and percutaneous coronary intervention was performed. A 51-year-old asymptomatic woman without evidence of BAC (red arrow heads) on screening mammography (D) demonstrated calcified plaque (percent diameter stenosis, 30%) at the mid LAD (red arrow). (E) Five years later, she visited the outpatient clinic due to epigastric pain and underwent CCTA, which demonstrated no change in the mid LAD lesion (red arrow). (F) BAC, breast arterial calcification; CCTA, coronary computed tomographic angiography; LAD, left anterior descending artery.