Cardiovascular disease is the number one killer of women in the United States. There are many possible reasons for this, but two have been identified as relevant: (1) women do not experience the same ”classical” symptoms of heart disease as do men therefore their heart disease goes undiagnosed until too late and organ damage is done; (2) a recent study has now shown that many women avoid seeing their doctor for possible heart problems because they are slightly overweight and fear they will judged as eating too much or not exercising enough.  Delaying medical help may lead to irreparable damage and early death.

There is now a very interesting development that could be of direct benefit to women. A new study has reported that measuring the calcification in breast arteries (Breast Arterial Calcification – BAC) can be better than the available standard assessment for heart disease risk now used.

Higher levels of BAC were associated with hypertension, increasing age and chronic kidney disease, all of which are known risk factors for heart disease in their own right. In addition, the correlation between BAC and Coronary Artery Calcification (CAC) was found to be highly significant. There is still controversy surrounding concordance between CAC and conventional risk factor screening. However the importance of this study is in showing that a simple mammogram can identify up to 70% of women who have CAC, without subjecting them to more costly or invasive investigations. It can also identify women at risk before any obvious symptoms arise, so can be truly preventative.

Millions of women each year could thus be screened for two deadly conditions by means of a routine mammogram. As with all investigations, the accuracy is determined by both the sophistication of the technique and the skill of the person interpreting the findings. BAC is a new field in USA, and will hopefully soon be available here too and be reported on routinely, just as are the comments on breast density at present.

Current guidelines for mammography may thus be changing – a mammogram may be able to screen for two major killers at once ; breast cancer and heart disease.