Association Between Coronary Artery Disease Diagnosed by Coronary Angiography and Breast Arterial Calcifications on Mammography: Meta-Analysis of the Data

Background: Previous studies evaluating breast arterial calcifications (BAC) as a risk marker for coronary artery disease ( CAD) have been limited by sample size and have yielded mixed results. Our objective was to evaluate the association of BAC and CAD. Methods: Data sources included Medline (1970-2010), the Cochrane Controlled Trials Register electronic database (1970-2010), and CINAHL (1970-2010). The search strategy included the keywords, breast artery calcification, vascular calcification on mammogram, coronary angiography, and meta-analysis. Eligible studies included female patients who had undergone coronary angiography, the gold standard for diagnosing CAD, and had screening mammograms that revealed the presence or absence of BAC. Information on eligibility criteria, baseline characteristics, results, and methodologic quality was extracted by two reviewers. Disagreements were resolved by consensus. Results: A total of 927 patients were enrolled in the five studies. There was a 1.59 (95% confidence interval [CI] 1-21-2.09) increased odds of angiographically defined CAD in patients with BAC seen on mammography. Conclusions: The presence of BAC on mammography appears to increase the risk of having obstructive CAD on coronary angiography; thus, BAC may not be a benign finding.