Association of Mammographic Features and Major Adverse Cardiac Events in Postmenopausal Women: A 10-Year Retrospective Cohort Study

Objective: Cardiovascular disease is the leading cause of death in postmenopausal women, and certain mammographic features have been linked to cardiovascular risk. This study aimed to investigate the association between mammographic features and the incidence of major adverse cardiac events (MACE) over a 10-year follow-up period in postmenopausal women. Methods: This retrospective cohort study included postmenopausal women with available mammographic data, including mammographic breast density (MBD), breast arterial calcification (BAC), and microcalcifications at the Central Hospital of Wuhan between January and December 2012. The primary outcome was the incidence of MACE over a 10-year period. Results: Among the 857 postmenopausal women, the average age was 59.51 +/- 7.31 years. Participants were categorized into four MBD types: Type A (n=249), Type B (n=254), Type C (n=228), and Type D (n=126). Participants with Type B MBD exhibited the highest risk of MACE (13.7%), followed by Type A (10.6%), Type C (4.8%), and Type D (4.0%). Kaplan-Meier analysis revealed that MBD classification and BAC were significantly associated with MACE incidence (P < 0.05). The Cox proportional hazards regression found that type A (HR = 3.12, 95% CI: 1.21-8.02), Type B (HR = 2.57, 95% CI: 0.98-6.73) and BAC (HR = 2.37, 95% CI: 1.12-5.0) were significantly associated with an increased risk of MACE. No significant correlation was found between microcalcifications and MACE risk (P > 0.05). Conclusion: Mammographic features such as MBD and BAC may be associated with an increased risk of MACE in postmenopausal women. These findings suggest that incorporating cardiovascular risk assessment into routine mammography screening could enhance health management and preventative strategies for postmenopausal women.