Study Finds Mammograms May Help Detect Cardiovascular Disease

On Wednesday, the investigators presented the results of a study that examined whether breast arterial calcifications (BAC) on mammograms were associated with the prevalence of myocardial infarction, heart failure and coronary artery disease, as well as stroke, diabetes and chronic kidney disease.

“I expected to find an association of breast arterial calcifications and prevalence of heart disease, but was surprised by the strength of the results,” Dr. Watanabe said. “I was also surprised that the association was also significant for all of the other health conditions that we studied.”

The investigators retrospectively examined screening mammograms of 18,092 women (mean age of 56.8+/- 11 years) along with electronic health records from 2007 to 2016 at a single academic institution. 

The researchers used a commercial AI tool to detect the presence of BAC. They then employed logistic regression analyses to determine odds ratios (OR) between BAC presence and the various health conditions. They adjusted their calculations for Framingham covariates and age.

Identifying Potentially Unrecognized Health Conditions

Of the 19.7% of patients with BAC, the OR for pooled acute conditions was 2.37 (95% CI: 1.91-2.94) and 1.51 (95% CI: 1.39-1.65) for pooled chronic conditions. 

The odds of having prevalent conditions such as heart attack, heart failure or chronic kidney disease were more than double in women with BAC compared to those who did not have BAC, according to Dr. Watanabe.

“Mammography, with the aid of AI-based BAC detection, can identify a subset of women who may benefit from workup and identification of potentially unrecognized prevalent health conditions, including cardiovascular disease,” Dr. Watanabe said.

Mammography can screen for cardiovascular disease—the leading cause of mortality in U.S. women—as well as other health conditions without any additional radiation or patient exam time, the researchers asserted. 

Based on the study results, the investigators noted that opportunistic reporting of the presence of BAC can make it possible for physicians to provide early interventions to women with health conditions such as cardiovascular disease and improve their outcomes.

“Over 40% of adults in the U.S. have undiagnosed hypertension,” Dr. Wang said. “Reporting BAC presence on mammograms provides an opportunity to address the risk of cardiovascular disease and other treatable conditions.”

BAC is currently underreported by radiologists, Dr. Watanabe noted, adding that she and her fellow researchers recommend that BAC be reported routinely on screening mammograms.

Access the presentation, “Breast Arterial Calcifications Detected by Artificial Intelligence Model Are Associated with Significant Prevalence of Cardiovascular Disease: A Study of over 18,000 Women,” (W7SSCA08-6) on demand at RSNA.org/MeetingCentral