Could your routine mammogram be revealing more than just your breast health? New research suggests these X-ray images may also offer an early warning sign for cardiovascular disease—the number one killer of women.
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Researchers have discovered that calcium deposits visible during mammograms can help predict a woman’s risk of heart attack, stroke, heart failure, and even death.
- A study presented at the Radiological Society of North America meeting revealed a link between breast arterial calcification and future cardiovascular events.
- Nearly one in five women show detectable vascular calcification on initial mammograms.
- Progression of calcification—even over just one year—significantly increases cardiovascular risk.
- Identifying breast arterial calcification doesn’t require additional testing or radiation exposure.
A study presented at a Radiological Society of North America meeting found that calcium deposits visible in the arteries of the breast can help predict a woman’s future risk of heart attack, heart failure, stroke and death. The findings add to growing evidence that mammograms may hold untapped value beyond cancer screening.
What is Breast Arterial Calcification?
The condition—called breast arterial calcification, or BAC—is relatively common, appearing in an estimated 15% to 25% of screening mammograms, according to Matthew Nudy, an assistant professor of medicine and public health sciences at Penn State College of Medicine who presented the findings. Yet, it’s rarely reported.
Radiologists don’t typically flag these calcifications “because there’s no known association between this breast arterial calcification and breast cancer,” Nudy explained. This oversight, he argues, could be a missed opportunity, especially considering women often experience delays in cardiovascular diagnosis.
More than 60 million U.S. women—about 44%—have some form of heart disease, according to the U.S. Centers for Disease Control and Prevention. Heart disease affects women of all ages and was responsible for nearly 305,000 female deaths in the U.S. in 2023, the CDC reports.
How the Study Worked
In the new Penn State study, researchers analyzed data from 10,348 women who had undergone at least two mammograms at a U.S. academic medical center, with an average of 4.1 years between scans. They used an artificial intelligence tool to measure the severity and progression of calcification in breast arteries over time.
The results were striking. Women with worsening calcium buildup faced significantly higher risks of major cardiovascular events—up to double the risk for those with the most severe scores, Nudy explained. Nearly one in five women had detectable vascular calcification at baseline.
“We saw progression of this BAC, or breast arterial calcification, in as little as one year,” Nudy said. “So I think it just goes to show that cardiovascular risk is something that changes all the time.”
Women who initially showed no calcification but developed it later had a 41% higher risk of cardiovascular events and death over an average 5.6 years of follow-up. The risk increased even further for women whose calcification advanced from mild to moderate or severe levels.
Why This Matters for Women
Unlike coronary artery calcium scoring—which involves a CT scan to assess heart disease risk—identifying BAC doesn’t require additional testing, radiation, or cost. The data already exists on routine mammograms.
If breast arterial calcification were routinely reported, Nudy said, the next step wouldn’t be panic, but evaluation. “At the very least, these patients should have a cardiovascular disease risk assessment,” he said, which typically includes blood pressure and cholesterol checks, risk calculators, and potentially preventive therapies like statins and lifestyle changes.
This research is particularly relevant given the disparities in women’s heart health. “We know that women face a lot of disparities when it comes to cardiovascular care, compared to men,” Nudy said. “They’re more likely to be diagnosed at later stages of cardiovascular disease… and we also know that women are less likely to get” treatment for the condition. Breast arterial calcification, he believes, “could be something that we use to improve that.”
Currently, there’s no standardized system for documenting BAC in radiology reports, although Canada has proposed a grading framework. In this study, researchers used AI to efficiently quantify calcification across thousands of images. “If we were to run a research study where we had to have multiple radiologists analyze multiple mammogram images from over 10,000 participants, that would take a lot of time and a lot of money,” Nudy said. AI, he added, made the process scalable and standardized.
Further research is needed to determine if identifying BAC leads to meaningful changes in patient care and outcomes. Nudy is currently leading additional research using mammograms from the federally funded Women’s Health Initiative, a large and long-running study of chronic disease in menopausal women.
For now, the findings highlight a potentially groundbreaking way clinicians may one day use a familiar test—not just to detect cancer, but to help prevent heart disease before symptoms even appear.
2025 the Pittsburgh Post-Gazette. Distributed by Tribune Content Agency, LLC.
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