Fat-enlarged axillary nodes on mammogram may indicate higher CVD risk

Fat-enlarged axillary nodes on screening mammograms can predict the risk for cardiovascular disease (CVD), according to a study presented at the annual meeting of the American Roentgen Ray Society, held May 5–9 in Boston.

Jessica Rubino, M.D., from the Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, and colleagues used electronic medical record data from 907 women (ages 40 to 75 years) without known coronary artery disease who had a routine screening mammogram and cardiovascular risk factors available within one year of the index mammogram (2011 to 2012).

The researchers found that 19.1 percent of women had fat-enlarged nodes (>20 mm in length due to an expanded fatty hilum). Women with fat-enlarged nodes had a high risk for CVD defined by pooled cohort equation (>7.5 percent likelihood of major adverse cardiovascular events [MACE] within 10 years; odds ratio [OR], 2.6; 95 percent confidence interval [CI], 1.5 to 4.2), as well as a higher prevalence of type 2 diabetes (OR, 4.0; 95 percent CI, 2.1 to 7.7) and hypertension (OR, 2.5; 95 percent CI, 1.6 to 4.0).

There was also an association observed between fat-enlarged nodes and a trend toward a higher risk for MACE (OR, 1.7; 95 percent CI, 0.9 to 3.1) and low-density lipoprotein cholesterol (OR, 1.4; 95 percent CI, 0.9 to 2.1).

"Incorporating fat-enlarged nodes into CVD risk models has the potential to improve CVD risk stratification without additional cost or additional testing," Rubino said in a statement.

"Fat-enlarged axillary lymph nodes visualized on screening mammography may increase the ability to identify women who would benefit from CVD risk reduction strategies and more intensive risk assessment with coronary artery computed tomography."

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