124th ARRS Annual Meeting:
Enlarged Lymph Nodes on Screening Mammograms Predict Cardiometabolic
Disease, Cardiovascular Risk
Boston, MA | May 5, 2024—According to the Summa Cum
Laude Award-Winning Online Poster presented during the 124th ARRS Annual Meeting,
fat-enlarged axillary nodes on screening mammograms can predict high
cardiovascular disease (CVD) risk, Type 2 diabetes (T2DM), and hypertension
(HTN).
“Incorporating fat-enlarged nodes into CVD risk models has
the potential to improve CVD risk stratification without additional cost or
additional testing,” said Jessica
Rubino, MD, from Dartmouth Hitchcock Medical Center in Lebanon, NH.
“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
CT.”
Rubino et al. reviewed patients (women, 40–75 years) without
known coronary artery disease who had a routine screening mammogram and
cardiovascular risk factors available in the EMR within 1 year of the index
mammogram (January 1, 2011–December 31, 2012). Evaluating major adverse
cardiovascular events (MACE) within 10 years of the index mammogram, the
researchers used clinical parameters at the time of the index mammogram to
determine high estimated CVD risk via the pooled cohort equation (PCE) —defined
by the American Heart Association as more than a 7.5% likelihood of MACE within
10 years. Two breast imagers evaluated screening mammograms to measure the
length of the largest visible axillary LN in each breast in the mediolateral
oblique view, analyzing the largest visible node for each patient. Logistic
regression then examined associations between lymph node size, 10-year CVD
risk, MACE, T2DM, HTN, low density lipoprotein (LDL), age, and BMI.
Ultimately, among 1,216 women included in this ARRS Annual Meeting Summa Cum
Laude Scientific Poster, 907 (74.6%) had a visible axillary LN on the
index mammogram, and 232 (19.1%) women had fat-enlarged nodes—defined as larger
than 20 mm in length due to an expanded fatty hilum. Women with fat-enlarged
nodes had a high risk of CVD defined by PCE (OR = 2.6, 95% CI 1.5–4.2), as well
as a higher prevalence of T2DM (OR = 4, 95% CI 2.1–7.7) and HTN (OR = 2.5, 95%
CI 1.6–4.0). Fat-enlarged nodes were also associated with a trend toward higher
risk of MACE (OR = 1.7, 95% CI 0.9–3.1) and LDL (OR = 1.4, 95% CI 0.9–2.1).
“These results support further investigation of fat-enlarged
lymph nodes,” Rubino added, “particularly with studies leveraging AI evaluation
of mammographic fat-enlarged LNs and cardiometabolic disease.”
North America’s first radiological society, the American
Roentgen Ray Society (ARRS) remains dedicated to the advancement of
medicine through the profession of medical imaging and its allied sciences. An
international forum for progress in radiology since the discovery of the x-ray,
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Annual Meeting, the world’s longest continuously published radiology
journal—American Journal of Roentgenology
(AJR)—InPractice
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as well as awarding scholarships via The
Roentgen Fund®.
PIO CONTACT:
Logan K. Young
lyoung@arrs.org
44211 Slatestone Court
Leesburg, VA 20176