By integrating CV risk screening with breast screening using mammograms, two major causes of illness and death can be simultaneously identified and potentially prevented
Claire Arnott
Associate Professor Claire Arnott, global director of cardiovascular programs at George Institute, said that given the lack of access to or offering CV risk screening in the community, there is a need for a new way to identify women at risk for cardiovascular disease (CVD). “It is a common misconception that CVD mainly affects men, leading to under-diagnosis and low treatment in women. By integrating CV risk screening and breast screening through the use of mammograms, if many women are already involved in stages, cardiovascular risk increases and can be two main causes and death.
This model was designed and validated using routine mammograms from over 49,000 women in metropolitan and rural areas of Victoria, Australia, in relation to individual hospitals and death records. The researchers then compared the models with traditional models that require multiple data points based on known CV risk factors such as blood pressure and cholesterol. “We found that our model works similarly without the need for extensive clinical and medical data,” says A/Prof Arnott.
Previous studies to date have focused on specific mammographic features such as breast arterial calcification (BAC), which has been found to be associated with cardiovascular risk in some populations. However, there are limitations to relying solely on BAC.2 For example, BAC is not very accurate in predicting the risk of CVD in older women.2 “Our model is the first to use the various features of mammographic images simply combined with age. A key advantage of this approach is that it does not require additional history or medical record data, and it is not concentrated in implementation, but is still very accurate,” Professor Arnott added.
Globally, cardiovascular disease is the main cause of deaths in women, representing approximately 9 million deaths per year, or about a third of all deaths in women.3 Despite the high burden of disease, several studies have shown that cardiovascular disease symptoms and risk factors are underestimated in women, with fewer diagnostic tests, expert referrals and prescriptions in women compared to men.4 Conversely, mammography-based screening programs have very effective involvement of women in some countries, with over 67% of women in the US and UK taking part in screening mammography.5,6
Dr. Jennifer Balaclau, a researcher at the George Institute, said that leveraging existing risk screening processes already widely used by women means that the model could serve as a cardiovascular risk prediction tool for women in diverse communities across Australia and around the world. “We hope that one day we will provide more, more equitable access, as many women will already benefit from the mobile mammography unit for free,” she said. “We are looking forward to testing the model in an additional diverse population and understanding the potential barriers to its implementation, as it demonstrates the potential of this innovative new screening tool.”
References:
- Barraclough J, et al. Prediction of cardiovascular events from everyday mammograms using machine learning. heart. 2025. https://doi.org/10.1136/heartjnl-2025-325705
- Automatic breast arterial calcification scores including Allen TS, Bui QM, Petersen GM, Mantey R, Wang J, and Nerlekar N are associated with cardiovascular outcomes and mortality. JACC: Progress. 2024; 3 (11): 101283. https://doi.org/10.1016/j.jacadv.2024.101283
- Di Cesare M, et al. The center of the world. Global mind. 2024. https://doi.org/10.5334/GH.1288
- Al Hamid A, et al. Gender bias in the diagnosis, prevention and treatment of cardiovascular disease: a systematic review. Cyreus. 2024. https://doi.org/10.7759/cureus.54264
- Centers for Disease Control and Prevention. Health, USA, 2020-2021: National Center for Health Statistics. 2021. https://www.cdc.gov/nchs/hus/topics/mammography.htm#:~: ~~:text=the%20age%2Dadjusted%20percentage%20of
- S. Deandrea, A. Molina-Barceló, A. Uluturk, J. Moreno, L. Neamtiu, et al. presence, characteristics, and equity in breast cancer screening programs in 27 European countries in 2010 and 2014. Results of an international survey. Preventive medication. 2016; 91:250-263. https://doi.org/10.1016/j.ypmed.2016.08.021
sauce: George Global Health Research Institute
