Some health care providers are trying to give mammograms a new purpose — assessing heart disease risks. The practice is not unanimously accepted among health experts, however.
Mammograms are X-ray examinations that detect breast disease, and they’ve helped diminish the United States’ breast cancer mortality rate by almost 40% since 1990. According to Piedmont Healthcare, mammograms can also detect breast arterial calcification — plaque buildup in the breasts’ arteries.
The buildup of plague could be a red flag for coronary heart disease, and health care providers like Washington Radiology are offering mammograms that use artificial intelligence to detect those buildups. Other providers aren’t yet convinced.
“What we’re seeing on the mammogram is calcification in the breast artery, but that’s not the same as the calcification in the coronary artery,” Greg Sorensen, chief science officer at RadNet, told KFF Health News. “It doesn’t feel like it’s delivering value today.”
Piedmont Healthcare reported that physicians detect breast arterial calcification in around 10% to 12% of patients. Roughly 70% of women with BAC on their mammograms also had coronary artery calcification, which is associated with coronary artery disease.
“Taking this into account, a doctor reviewing a woman’s mammogram can look for breast arterial calcification and then refer the woman to a preventive cardiologist for further evaluation,” Piedmont reported. “The ability to look for calcification allows doctors to use screening exams, such as coronary artery calcium scans, to further risk stratify women for premature coronary artery disease. Then, if the calcium score is high, such as greater than 400, further screening for significant blockages with stress testing can be completed.”
Preventive cardiologist Dr. Sadiya Khan said she thinks the research is just not there yet.
“I wouldn’t feel comfortable telling people they have a higher or lower risk of heart disease based on their breast arterial calcification,” she told KFF Health News. “I think this is an exciting area, but we need to move cautiously.”
Heart disease is the leading cause of death in the U.S., and someone dies of cardiovascular disease every 33 seconds. In fact, 702,880 people died of heart disease in 2022, accounting for 20% of all U.S. deaths. Heart disease also cost the country around $252.2 billion from 2019 to 2020 alone, according to the Atlanta-based Centers for Disease Control and Prevention.
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