When a radiologist examines a mammogram for signs of breast cancer, he or she may also look for arterial calcification in the chest, which is associated with cardiovascular disease risk. BSIP/Universal Images Group/Getty Images Hide caption
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These days, some of you may be faced with some surprising questions when you go for your annual mammogram. In addition to a mammogram for breast cancer, do you want a radiologist to check your risk for heart disease?
That’s what happened recently when a colleague visited the Washington Department of Radiology, which has more than a dozen locations in Washington, D.C., Maryland and Virginia.
She was told that for $119, the clinic would use artificial intelligence software to analyze her mammogram for calcifications in the arteries in her breasts, which could indicate she was at risk for cardiovascular disease. Ta.
Washington Radiology is one of many clinics nationwide that offer this type of testing. Here’s what you need to know about screening and whether research supports it.
Breast X-rays are typically used to detect and diagnose breast cancer, but the photos also show if there is calcification in the arteries of the breast, which appears as parallel white lines on the film. Although calcifications are considered an “incidental” finding unrelated to breast cancer, they may be associated with heart disease risk.
They have been seen on images for decades, and some radiologists regularly note them in their reports. However, that information is usually not communicated to patients.
Some clinics now make the results available to patients (sometimes for a fee).
Washington Radiology did not respond to requests for an interview, but in a video on its website explaining the clinic’s Mammo+Heart AI screening, Islamat, a breast imaging radiologist at the clinic, Mr. Ego Osuara said: As with anything when it comes to the field of radiology, there are limits. The possibilities are endless. ”
Some diagnostic imaging experts question this rosy assessment regarding screening for breast artery calcification to assess heart disease risk.
“What you see on a mammogram is calcification in the breast arteries, but that’s not the same as calcification in the coronary arteries,” said Greg Sorensen, chief scientific officer at RadNet, which has about 400 imaging centers in eight states. say. RadNet does not offer, and does not plan to offer, breast artery calcification screening. “I don’t think we’re providing value today,” Sorensen said.
(RadNet provides AI analysis of mammograms to patients to improve breast cancer detection, KFF Health News reported on earlier this year.)
Coronary artery calcification is recognized as a strong marker of heart disease risk. However, while studies have shown an association between thoracic artery calcification (BAC) and cardiovascular disease risk, questions remain.
First, even if you don’t have thoracic artery calcification, you may be at risk for heart disease, heart attack, or stroke. In a study of postmenopausal women, 26% had breast artery calcification, which increased the risk of all types of heart disease by 23% and increased the risk of heart attack and stroke by 51% over the 6.5-year study period. % increased. However, most cardiovascular events occurred in women without breast artery calcification.
“I’m reluctant to tell people that they have a high or low risk for heart disease based on calcification in their breast arteries,” says Roberts, a preventive cardiologist at Northwestern Medicine in Chicago, who commented on the issue in a medical journal. said Sadiya Khan, co-author of the editorial. study. “I think this is an interesting area, but we need to tread carefully.”
It’s understandable that female doctors would be enthusiastic about the idea of using breast cancer screenings, which millions of women undergo each year, to also test for heart disease risk.
Heart disease is the number one killer in the United States. In 2021, it was responsible for the deaths of more than 300,000 women (approximately 1 in 5 women).
Many women are unaware of their risk for heart disease and the many factors that increase it, including high blood pressure, diabetes, high cholesterol, smoking, drinking too much alcohol, and being overweight.
There are online calculators that can help you assess your risk of cardiovascular disease. If your 10-year risk is 7.5% or higher, your clinician may recommend lifestyle changes or prescribe statins to lower your blood cholesterol.
Laura Heacock, a radiologist who specializes in breast imaging at NYU Langone Health in New York City, said patients already have a lot of information available to them from breast artery scoring and their use of risk calculators from their doctors. pointed out. Importantly, screening provides another opportunity to talk about heart disease risk.
In one study, 57% of women who were told they had breast artery calcification after a mammogram reported discussing the results with their doctor or cardiologist.
Heacock said he would like to see more research showing that reporting BAC leads to changes in patient care and leads to fewer heart attacks and strokes.
All women who come to Lynn Women’s Health and Wellness Institute in Boca Raton, Florida for a mammogram will be screened for breast artery calcification. This has been a standard service since 2020, said Heather Johnson, a preventive cardiologist at the center. If calcifications are found, women are referred to a cardiologist or other health care provider at the center to discuss the findings and receive more information about their risk of heart disease.
Johnson acknowledged that more research is needed to understand the relationship between thoracic artery calcification and heart disease. Still, she said the screenings “create a channel of communication.”
Boca Raton Institute patients are not charged a screening fee.
Jackie Fortier reported the audio story.
KFF Health News is a national newsroom producing in-depth journalism about health issues and is one of KFF’s core operating programs.
