Mammograms may reveal heart disease risk, not just breast cancer

If you are a woman over 40, your doctor has probably told you to get a mammogram as part of routine breast cancer screening. But these scans can provide another important clue as well.

A mammogram may show no evidence of breast cancer while still revealing calcium deposits in the medium-sized arteries that supply blood to the breast. Those deposits can offer insight into a woman’s future heart health.

I am a cardiologist who studies cardiovascular health around menopause. My colleagues and I have looked at whether mammograms can help identify women at higher risk of heart disease and stroke. Artificial intelligence now makes these calcium deposits, known as breast arterial calcification or BAC, easier to detect and measure.

Maryland became the first U.S. state to require mammography centers to notify patients in writing when these deposits are found. Other states may follow. Research suggests the finding is a strong marker of cardiovascular risk, and its use is likely to expand.

Here is what women should know about calcium deposits in the breast, and what they may mean if they appear on a mammogram.

What is breast arterial calcification?

Breast arterial calcification is calcium buildup in the walls of medium-sized arteries that carry blood through the breast. On a mammogram, the deposits appear as parallel white lines following those vessels.

This is not a sign of breast cancer. It is also different from the fatty and calcified plaque that can narrow arteries supplying the heart muscle. In breast arterial calcification, the calcium is mainly in the muscular wall of the artery, where it is linked to stiffening of blood vessels.

Finding breast arterial calcification on a mammogram does not by itself mean a woman has heart disease or a blocked coronary artery. But studies now clearly show that it is associated with a higher risk of those outcomes.

It is also important to note that not having this finding does not rule out cardiovascular disease or an elevated risk of heart attack or stroke.

A well-studied connection

Doctors have known about breast arterial calcification for decades. Studies in the 1980s linked it to diabetes and advanced kidney disease. Early research on its connection to heart disease was mixed, and many studies were small or depended on radiologists visually reviewing mammograms.

In 2022, my colleagues and I published a 10-year study in which radiologists reviewed mammograms from more than 1,000 women to identify these calcium deposits. Women who had them had about three times the odds of developing coronary heart disease and five times the odds of having a stroke compared with women who did not, even after age was taken into account.

To further confirm that breast arterial calcification predicts cardiovascular risk, we reviewed 45 published studies involving more than 68,000 women in a meta-analysis. Published in 2026, it found that women with these deposits had about twice the risk of stroke, heart failure and death from any cause, and nearly three times the risk of dying from heart disease, compared with women without them.

The studies we reviewed varied widely in design and quality, so these averages cannot precisely predict one woman’s individual risk. And although the findings show an association between breast arterial calcification and cardiovascular disease, they do not prove that the calcium itself causes those outcomes.

Using AI and age together

Radiologists can see breast artery calcium on a routine mammogram, but there is no widely accepted standard for grading or reporting how much is present. Artificial intelligence tools, which doctors are using more often, can measure the amount from the same images without adding radiation.

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These deposits become more common with age, so my colleagues and I used AI to analyze data from more than 100,000 women in nine countries to map how calcium builds up in breast arteries over time. We developed and tested a measure that, when added to standard tools, improved doctors’ ability to estimate cardiovascular risk more accurately.

Adding a new risk marker

Maryland became the first state to require a notice about breast arterial calcification in screening results. The aim is to give women who have this finding a reason to discuss heart health with their doctor.

The bill’s sponsor modeled the law on a 2023 regulation about breast density notices, which required mammography centers to tell patients and their doctors about breast density and its role in cancer detection. That rule first took effect in Connecticut, was later adopted by many other states, and then became a national requirement.

An Australian trial called TIM-TAM will test whether using breast arterial calcification to guide care improves heart health measures. Researchers still need to determine whether treating women based on this finding can prevent heart attacks or strokes. But the evidence already shows a link to cardiovascular disease, and I expect reporting on this marker to spread in a way similar to breast density reporting.

Until more states change their requirements, look for “breast arterial calcification” or “vascular calcifications” in the radiologist’s report. Reporting practices vary, so some mammogram results may not mention BAC even when it is visible. Some imaging centers also offer an optional AI review for breast arterial calcification as an extra out-of-pocket service with a screening mammogram.

What this means for your care

By itself, breast arterial calcification on a mammogram does not decide whether someone needs a heart test or a new medication. Still, it can be a useful prompt to get a current assessment of cardiovascular health.

Your doctor may recommend checking blood pressure and ordering blood tests for cholesterol and kidney function. One measure, called eGFR, shows how well the kidneys filter blood.

Your doctor can combine those results with age, smoking, diabetes and other factors in the American Heart Association’s PREVENT calculator. It estimates the chance of developing cardiovascular disease over the next 10 years for adults ages 30 to 79 who have not already been diagnosed with cardiovascular disease.

From there, you and your doctor can decide which steps would make the biggest difference for your heart health. That could include becoming more active, eating heart-healthy foods or getting help to quit smoking. Depending on your overall risk, your doctor may also advise a statin to lower cholesterol or changes to blood pressure medication. These treatments can lower the risk of heart attack or stroke.

A routine breast screening appointment can therefore become a chance to better understand cardiovascular risk and take steps to reduce it.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Matthew Nudy, Penn State

Matthew Nudy is supported by the National Center for Advancing Translational Sciences, Grant KL2 TR002015 and Grant UL1 TR002014.