About 70% of women over age 40 get mammograms due to the fear of breast cancer. Many of these women don’t get other routine medical care.
A new study with a gigantic data set (about 125,000 women followed for 7 years) showed that calcium in the breast arteries could be analyzed by AI and strongly correlated with cardiovascular disease – which is the #1 killer of women. Severe calcification of breast arteries is correlated with almost triple the risk of cardiovascular disease.
This is Macroeconomic in the sense that half the population is affected. Detecting a major killer disease from a test that is being run anyway – that’s really great. A genuinely worthwhile use of AI.
Thanks, @WendyBG ….of interest to me in a general sense, as you might imagine. However, on first brief reading (on early am granny duty today ) it seems that it’s not the sort of breakthrough that would’ve been of any value to me in early primary prevention (as opposed to belated disease detection)
Hidden among the Big Data (as relevant details frequently are) is the implication that these high correlations were noticeable in (older) women who were already determined to be at higher risk of ASCVD. Some already on statins. What it suggests to me is again evidence of “past tense thinking” in the context of ASCVD risk…..either on the part of patient management (care delivery) or patient acceptance (cholesterol denialism/statin phobia…..we all know that’s a reality…..still)
Mind you, if any of my mammograms had shown this calcification, I would’ve been given a heads-up early than my CAC scan did and onnit toot sweet. No issues there, though ..… likewise my CIMT scan.
@VeeEnn I think this is more of a breakthrough for the many, many women who don’t have primary care but do have access to mammograms due to programs that extend mammography to women of lower socioeconomic status. The detection of calcium would enable the radiologist to say, “Your mammogram did not detect cancer but it did detect calcification that could potentially endanger your life. Make an appointment with a primary care doctor to discuss this.”
Remember the vast majority who don’t have your education or resources.
Whilst it’s tempting to think that this insight might apply to women who’re otherwise not accessing medical care, the primary document doesn’t show that. The study cohorts were all part of established Healthcare systems. They had various biomarkers on record…BMI, BP, total cholesterol (but not LDL-C), eGFR etc. It’s a mistake to extrapolate these data to the many who are outside of the system. It doesn’t look as if the study authors are trying to do that…..but, mark my words, once the health and science writers get ahold of this, the banner headlines will be promoting it for just that.
Not to be a contrarian, but women without education or resources don’t generally pitch up for mammograms as their only access to the healthcare system. Not even for appropriate interventions for their dental health
I wonder if the majority of people even have primary care doctors anymore. I know that I now see a LNP (Licensed Nurse Practitioner) who reports to a doctor that I never see.
Do you all still see primary care doctors or instead go to LNPs or Physician Assistants or something?
@StalledOut I went to a Nurse Practitioner for 20 years until recently. I currently have an M.D. primary care but she isn’t the sharpest knife in the drawer – she never listened to my heart and missed a heart murmur that was discovered by a NP at a clinic and needed open-heart surgery to save my life.
The primary care of whatever rank (NP, PA, low-trained MD) is useful to adjust meds for well-known chronic diseases (e.g. diabetes, high blood pressure) and to make referrals to specialists for new and/or complex problems.
Primary care people need data. I get an annual “Complete Wellness” blood test from LabTestsOnline that for $100 gives data on many aspects of health. I also test my blood pressure and blood sugar periodically. The primary care should do hands-on exams like listening to your heart, gyn or male type exams.
Of course, we are all responsible for health-preserving lifestyle factors like diet, exercise, sleep and social interactions.
@StalledOut….husband and I both still see a primary care physician for our annual physicals, to which chronic care management visits are now added. In practical terms a doctor’s visit every 6 months. Primary care is an odd setup nowadays because, in spite of increasing sophistication in diagnostics and available data, it seems to me that there’s less “thinking medicine” going on. It’s a very rare occurrence to encounter a provider who doesn’t see themselves as a “box checker”…..making sure that they’re clicking all the right boxes in order to move on to the next screen in the EMR (always reminds me of the checkout person at the supermarket if you’re purchasing alcohol…..no matter how old you look, gotta get that driver’s license out else they can’t complete the transaction)
This mindless medicine can end up with what I call The Curse of the Healthy Lifestyle, in that, if you’re someone who shows all the signs of being a good custodian of your body like myself and Wendy, say, there’s a strong chance that what ought to be considered a Red Flag gets dismissed….or, worse yet, a fundamental part of a physical exam (use of a stethoscope) is ignored. Beats me how basic doctoring is fast becoming a historical oddity.
I found out a seriously odd piece of information a few visits back. What Medicare reimburses in lieu of an annual physical….called a “wellness check” …. does not actually include use of stethoscope or all the other aids and accoutrements that go along with a doctor’s visit. As disbelieving as I was when my doctor told us this, I guess it didn’t match hers when thinking that there are providers who, apparently, don’t bother (I’d actually recounted Wendy’s experience of aortic stenosis deteriorating to the point of needing open heart surgery in spite of regular visits)
It is pretty amazing when you think of it…..given that Medicare usually kicks in at an age when things start to go wrong in ways that aren’t readily discernable just by looking at the answers to an online questionnaire.