MAMMOGRAPHIC BREAST ARTERIAL CALCIFICATIONS AND THEIR ASSOCIATION WITH CORONARY ARTERY CALCIFICATION SEVERITY AND DISTRIBUTION IN SAUDI WOMEN

Abstract

Background: Breast arterial calcifications (BAC) detected on mammography have been associated with systemic vascular disease, but their relationship with coronary artery calcifications (CAC) remains underexplored in regional populations. This study assessed the association between BAC severity and CAC severity, distribution, and multi-vessel coronary involvement in Saudi women while accounting for age, hypertension (HTN), and diabetes mellitus (DM).

Methods: This retrospective study included 60 women aged 40–88 years who underwent digital mammography and chest CT within the same year. BAC and CAC were graded visually using standard radiologic criteria. Ordinal logistic regression assessed the association between BAC severity and CAC severity after adjustment for age, HTN, and DM. Fisher’s exact test evaluated CAC artery distribution and multi-vessel involvement, with additional stratified analyses by HTN and DM status. Analyses were performed using IBM SPSS Statistics version 27.

Results: BAC was present in 33.3% of participants, while CAC was identified in 21.7%. Mild BAC showed a borderline association with increasing CAC severity after adjustment (p = 0.054), whereas moderate and severe BAC were not statistically significant. Women aged 60–69 years had significantly greater CAC severity than those aged 40–49 years (p = 0.036). Significant unadjusted associations were found between BAC severity and CAC artery distribution (p = 0.020) and multi-vessel CAC involvement (p = 0.007). Stratified analyses by HTN and DM revealed no significant subgroup differences.

Conclusions: BAC severity was associated with CAC distribution and unadjusted multi-vessel coronary involvement in Saudi women. Although adjusted analyses showed only a borderline association with CAC severity, BAC may serve as a useful adjunct marker for identifying women who could benefit from cardiovascular risk assessment.