What your mammogram can tell you about your cardiovascular health

When people check in for their annual mammogram these days, some may face a surprising question: Apart from assessing the mammogram for cancer of the breast, do you want the radiologist to look for risks to heart diseases in the mammogram?

That is what occurred recently when one of the authors visited Washington Radiology, a practice with over a dozen locations in the Washington, D.C., Maryland, and Virginia areas.

But for $119, she was informed that the practice would feed her mammogram through artificial intelligence software to check for calcification in the arteries of her breasts to show whether she could be at risk of cardiovascular disease.

Washington Radiology is one of the practices that offer this kind of screening across the United State. Here’s what you should know about the screening and whether the research backs it up.

While breast X-rays are usually utilized to diagnose the presence of breast cancer, the resulting pictures also demonstrate if these arteries in the breast have calcification, which forms parallel white streaks on the film. Some, so called, ‘benign’ structures like calcifications detected in a mammogram may be related to the person’s risk of developing heart disease.

They have been observed on images for several decades and some radiology practitioners and report them habitually. But again this information has not been transferred to the patents cutting short the period to be given to them.

Now some practices make the results available to patients — sometimes for a fee.

Washington Radiology didn’t respond to interview requests, nevertheless, in a video on its website in which the ‘Mammo+Heart’ AI screening practice of Washington Radiology is explained, Islamiat Ego-Osuala, a breast imaging radiologist at the Washington Radiology, said, “If the past few decades has taught us anything about the field of radiology, it is that the sky’s the limit. It is a great approach because the options are virtually infinite.”

Some imaging experts doubt that rosy assessment as it applies to screening for breast arterial calcification to predict heart disease.

“What we are seeing on the mammogram is calcification in the breast artery but that is not the same as the calcification in the coronary artery,” said Greg Sorensen, the chief science officer of RadNet which has nearly 400 imaging centres in eight states. Breast arterial calcification screening is not available at RadNet and RadNet will not be offering it in the future. ‘It doesn’t feel like it is delivering value today,’ said Sorensen.

RadNet does provide the patients with an AI-created report of the mammogram within the same network to enhance breast cancer detection. (As KFF Health News has reported on earlier this year.)

Coronary artery calcification is defined as robust predictor of heart disease. However, it is necessary to turn to questions when BAC is associated with cardiovascular diseases according to different studies.

First of all, you may get breast arterial calcification or not, yet still be vulnerable to heart disease, heart attack or stroke. In postmenopausal women 26% had breast arterial calcification and after 6½ years follow up, the risk of any kind of heart disease was increased by 23% and risk of heart attack or stroke by 51%. Nevertheless, the majority of cardiovascular events occurred in women without breast arterial calcification.

Dr. Sadiya Khan, a preventive cardiologist at Northwestern Medicine in Chicago, who co-authored a medical journal editorial commenting on the study, said she wouldn’t feel comfortable telling people they have a higher or lower risk of heart disease based on their breast arterial calcification. “I believe this is a very active and promising area; however, we need to be more careful.”

One can easily see why women’s health clinicians might have been excited about the thought of utilising an annual mammogram that millions of women undergo with the purpose of checking for breast cancer to also check for heart disease risk.

Heart disease is leading cause of death in America. It caused the deaths of more than 300,000 — or about one in 20 — women in 2021.

Most women have no idea of their potential heart disease or several parameters that contribute to it, including high blood pressure, diabetes, high cholesterol level, smoking, alcoholism, and obesity.

Some of the numerous online risk assessment calculators that are available can be used by people in estimating their prospects of having a cardiovascular disease. Clinicians may advise the patient to make modifications to the diet and/or start taking a statin for high blood cholesterol if the 10-year risk is 7.5% or more.

In response, its principles argued that patients already can obtain most of the information that flows from breast arterial scoring from their physicians and the risk calculators. The point is that the screening can bring the issue of heart disease risk into discussion one more time.

Another study revealed that 57 percent of patients who are told that they developed breast arterial calcification after a mammogram said they had talked to a primary care or a cardiologist about the results.

Heacock bemoaned the fact that there are few works out there which provide evidence of the notion that reporting BAC led to alterations in patient care and a reduction in the number of heart attacks and stokes.

yıevery woman who comes to the Lynn Women’s Health and Wellness Institute in Boca Raton, Florida for a mammogram gets tested for breast arterial calcification. It has been offered as a standard service since 2020 according to Heather Johnson, a preventive cardiologist in the center. In case calcification is observed the woman is then referred to a cardiologist or any other health care provider at the center for explanation of the results as well as more information on heart diseases risks.

More research needs to be done in an effort to prove a link between calcification of the arteries in the breast and heart disease, Johnson agreed. However, she said, it opens up the channel of “communication pathway” by screening.

The cost of the screening is not charged to the patients that take their treatment in the Boca Raton institute.