{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:49:34Z","timestamp":1792003774925,"version":"4.4.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004361","name":"Swiss Cancer League","doi-asserted-by":"publisher","award":["KFS-5524-02-2022"],"award-info":[{"award-number":["KFS-5524-02-2022"]}],"id":[{"id":"10.13039\/501100004361","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006447","name":"University Zurich","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006447","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluated (1) the reproducibility of 5 visual scoring systems for breast arterial calcifications (BACs) on mammography and their correlation with coronary artery calcifications (CACs), (2) their diagnostic accuracies, and (3) clinical applicability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, 90 women (median aged 57 years, interquartile range [IQR] 15) who underwent both mammography and cardiac CT were included. Breast arterial calcification was scored using 5 visual systems: (1) dichotomous (present\/absent), (2) 4-level vessel count, (3) 4-level severity, (4) combined 4-level (severity + vessel count), and (5) an advanced 3-level scale (incorporating vessel count, length, and density). Diagnostic performance was evaluated via sensitivity, specificity, and area under the curve (AUC). Interobserver agreement was assessed with Cohen\u2019s kappa; correlation with CAC (Agatston score) used Spearman\u2019s rho.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Breast arterial calcification was present in 17.8% (16\/90) and showed a trend toward correlation with CAC (P = .05). The 4-level vessel count scale showed the strongest correlation with CAC (rho = 0.373; P &amp;lt;.001). The highest AUC (0.604) was achieved by the 4-level severity scale (sensitivity 44%, specificity 77%). Interobserver agreement was highest for the combined 4-level scale (\u03ba = 0.835), followed by the 4-level vessel count (\u03ba = 0.833), severity-only (\u03ba = 0.819), 3-level vessel count (\u03ba = 0.833), and the dichotomous scale (\u03ba = 0.740). The dichotomous scale required the least time (mean 19 s\/patient); the 3-level scale required the most (mean 51 s). The vessel count scale balanced accuracy, reproducibility, and efficiency (mean 34 s).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Grading BACs is feasible, with consistently high interobserver agreement across scoring systems. The 4-level vessel count scale demonstrated a favorable balance of accuracy, reproducibility, and practicality, suggesting it may warrant further evaluation as a potential tool in mammography-based cardiovascular risk assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jbi\/wbaf069","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T11:51:13Z","timestamp":1760356273000},"page":"149-159","source":"Crossref","is-referenced-by-count":2,"title":["Breast Arterial Calcifications in Mammography: Evaluating Diagnostic Accuracy, Reproducibility, and Clinical Feasibility of Visual Scoring Systems"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8667-3884","authenticated-orcid":false,"given":"Jonathan Andreas","family":"Saenger","sequence":"first","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin","family":"Happe","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjarne","family":"Kerber","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kilian","family":"Kaim","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ela","family":"Uenal","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9585-9787","authenticated-orcid":false,"given":"Denise","family":"Bos","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich , Zurich ,","place":["Switzerland"]},{"name":"Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen , Essen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3295-6619","authenticated-orcid":false,"given":"Thomas","family":"Frauenfelder","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Boss","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich , Zurich ,","place":["Switzerland"]},{"name":"Institute of Diagnostic and Interventional Radiology, GZO Regional Health Center , Wetzikon ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"issue":"10292","key":"2026032712525018100_wbaf069-B1","doi-asserted-by":"publisher","first-page":"2385","DOI":"10.1016\/S0140-6736(21)00684-X","article-title":"The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030","volume":"397","author":"Vogel","year":"2021","journal-title":"Lancet"},{"key":"2026032712525018100_wbaf069-B2","doi-asserted-by":"crossref","first-page":"643","DOI":"10.4018\/978-1-4666-8603-8.ch022","volume-title":"Modern Concepts and Practices in Cardiothorac Critical Care","author":"Arora","year":"2015"},{"issue":"8","key":"2026032712525018100_wbaf069-B3","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1161\/CIRCULATIONAHA.117.028595","article-title":"Gender\/sex as a social determinant of cardiovascular risk","volume":"137","author":"O\u2019Neil","year":"2018","journal-title":"Circulation"},{"issue":"19","key":"2026032712525018100_wbaf069-B4","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.1161\/CIRCULATIONAHA.110.968792","article-title":"Sex\/gender differences in cardiovascular disease prevention: what a difference a decade makes","volume":"124","author":"Mosca","year":"2011","journal-title":"Circulation"},{"issue":"10159","key":"2026032712525018100_wbaf069-B5","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1016\/S0140-6736(18)32203-7","article-title":"GBD 2017 Causes of Death Collaborators. 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