UTILIZATION OF PET/CT IN BREAST CANCER PATIENTS FOR SCREENING OF CARDIOVASCULAR DISEASE USING INCIDENTAL CORONARY CALCIUM: A SINGLE CENTER EXPERIENCE

Therapeutic Area

ASCVD/CVD Risk Assessment

Background

Breast cancer has been associated with increased cardiovascular events and mortality. Strategies to improve primary prevention in this population are needed. PET/CT is an opportunity to have an initial screening for presence of atherosclerosis.

Methods

We collected data from one institution from 2009-2021 of female patients with a first time diagnosis of breast cancer, undergoing PET/CT for cancer staging. We reviewed the primary images looking for presence or absence of coronary calcium and the scoped the official reports to assess if coronary calcium was reported. We registered variables including age, race, arterial age, hypertension, BMI, reporting of calcium score by radiologist, use of statin, LDL. Dichotomous variables are expressed in frequencies and percentage. For continuous variables we used mean and standard deviation.

Results

A total of 276 patients were identified. Mean age is 55 years old. Coronary calcium was present in 68 patients(24%). In those patients, the finding was mentioned for 5 patients(7.35%) in the radiologic report, mean LDL was 114 mg/dl, mean arterial age was 68 years old. Within the patients with coronary calcium, 27 patients had a calcium score >100 A, the highest calcium score was 3,747.9 A, only 12 patients from this subset were in lipid lowering therapy. 208 patients did not have coronary calcification, absence of coronary calcifications was mentioned in only 10 patients; mean LDL was 105 mg/dL.

Conclusions

There is an under-reporting of coronary calcium burden in patients undergoing PET/CT for cancer staging which represents a missed opportunity for stronger primary prevention strategies in this population of patients with higher cardiovascular risk. Awareness of incidental findings of coronary atherosclerosis has the potential of improving cardiovascular outcomes.