Ask Dr. Ulissey

Michael J. Ulissey, M.D., is a partner at the Breast Diagnostic Centers of Auburn and Federal Way.

Q. A patient recently came into our center for a routine mammogram and brought a photocopy of a newspaper clipping (source unknown) regarding news that mammograms, in addition to providing early detection for breast cancer, may also detect early heart disease in women. She asked me what I thought.

A. I told her that this was not news to me, and that I found it interesting this information is only being published now. Back in 2000 or 2001, my former partner and I began discussing arterial calcifications on mammograms, with the notion that if women had significant calcifications in their breast, why would they not have similar calcifications in their coronary or other arteries? And further, if they were young, such as under 55, and had significantly more calcifications than we were “used to seeing,” could this be a portend of kidney disease or other systemic medical illness? Even though there was no published research on this at the time, my partner and I decided to report what we thought were significant breast calcifications on mammograms, in an effort to alert that woman’s primary physician to a potential problem.

However, with regard to medical advancements, timing is always critical. Soon after beginning to report breast calcifications on mammograms (for me, around 2000 or 2001), I received several phone calls from primary physicians who were irritated that I was causing them to go on wild goose chases and run up medical bills, so I decided to hold off – only because I did a literature search and could find no scientific evidence at the time, to back up my theory.

There is, however, now research that corroborates the notion that arterial calcifications on a mammogram correlate to risk of having, or developing coronary artery disease. The paper I cite is: Margolies L., Salvatore M., et al.: Digital Mammography and Screening for Coronary Artery Disease. Journal of the American College of Cardiology Imaging 2016; 9(4) 350-360.

This paper indicates that the more breast calcifications a woman has on her mammogram, directly correlates to the amount of coronary artery calcifications she has, and further, it correlates to an increasing risk for her to have heart disease. The paper ends on a cautionary note that this information is preliminary, and needs to be replicated, and I think it will be. So keep your eyes out for new information, and I will also keep you posted here.

Michael J. Ulissey, M.D., is a partner at the Breast Diagnostic Centers of Auburn and Federal Way. In addition to taking care of patients locally, he continues to participate in research as an adjunct professor at the University of Texas Health Sciences Center. You can reach him at Mike@breastdiagnostic.com.