Asian Journal of Basic Science & Research Volume 7, Issue 3, Pages 166-174, July-September 2025 ISSN: 2582-5267 [166] Association of Breast Vascular Calcification with Atherosclerosis in the Common Carotid Artery and Its Impact on Coronary Artery Disease Dr. Rabin K Ghimire 1* & Dr. Sabin K Ghimire 2 1 Radiologist, Department of Radiology, Bir Hospital NAMS, Kathmandu, Nepal. 2 Department of Surgery, Bir Hospital NAMS, Kathmandu, Nepal. Corresponding Author (Dr. Rabin K Ghimire) Email: rabing62899@gmail.com * DOI: https://doi.org/10.38177/AJBSR.2025.7311 Copyright © 2025 Dr. Rabin K Ghimire & Dr. Sabin K Ghimire. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Article Received: 12 July 2025 Article Accepted: 19 September 2025 Article Published: 22 September 2025 ░ 1. Introduction Mammography is a widely utilized imaging modality for the screening and diagnosis of various breast pathologies. Among the findings observed on mammograms, vascular calcifications are a significant subset, often manifesting as tram-track calcifications of the internal mammary artery [1]. While typically considered benign, these calcifications may reflect broader systemic vascular changes associated with conditions such as renal disease, coronary arterial disease, hyperparathyroidism, liver disease, and calciphylaxis [2-4]. Atherosclerosis, a chronic inflammatory condition characterized by vessel wall remodeling and oxidized LDL deposition, is a prominent cause of vascular calcification, particularly in the older population [5]. Atherosclerosis serves as an independent predictor of several severe health conditions, including acute coronary syndromes [6], cerebrovascular accidents [7], chronic kidney disease [8], and peripheral vascular disease [9]. This process involves thickening and stiffening of vascular walls, often evidenced by an increased intima-media thickness (IMT) and plaque formation in arteries like the carotid [10]. The internal mammary artery, frequently involved in breast arterial calcification (BAC), may also exhibit changes akin to those seen in carotid atherosclerosis [11]. Furthermore, BAC has been associated with higher estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk, with women exhibiting both BAC and coronary arterial calcifications (CAC) showing the highest risk (13.30%) [12]. The concurrent occurrence of atherosclerosis in the internal mammary, coronary and common carotid arteries raises the possibility of a shared pathophysiological spectrum. Given that common carotid arteries ABSTRACT Introduction: Breast Arterial Calcification (BAC) seen on mammograms may indicate systemic atherosclerosis, including changes in carotid arteries and coronary arteries. This study explores whether BAC can be a marker of cardiovascular risk by examining its association with carotid intima-media thickness (IMT) and coronary calcium scores. Data and Methods: This case-control study was conducted at TUTH, Kathmandu, involving 200 women from June 2019 to November 2020. Cases (n=100) had BAC on mammograms, while controls (n=100) did not. Carotid IMT was measured with ultrasound, and coronary calcium scores were assessed with CT scans. The Agatston CT scoring system was adopted for calculating the coronary calcium score. Statistical tests were used to compare groups. Results: Women with BAC had significantly higher carotid IMT and coronary calcium scores than controls (p < 0.05). A positive correlation was found between BAC severity and carotid IMT. Odds ratio analysis showed a strong link between BAC and atherosclerosis. Conclusion: BAC is associated with higher carotid IMT and coronary calcium scores, suggesting it could be a non-invasive marker for cardiovascular risk. Including BAC in mammogram reports may help identify at-risk patients early for further evaluation. Keywords: Breast Arterial Calcification; Carotid Intima-Media Thickness; Atherosclerosis; Coronary Calcium Score; Cardiovascular Risk; Internal Mammary Artery; Atherosclerotic Cardiovascular Disease; Low Density Lipoprotein; Cerebrovascular Disease; Tram Track Calcifications; Mammogram; Agatston CT Coronary Calcium Scoring System.