Each year, millions of women complete a routine mammogram as a regular part of their wellness routine. For most, it's a breast health checkpoint, but emerging research is revealing that the same scan may hold a powerful clue about a woman's heart.
Cardiovascular disease is the leading cause of death for women, yet it remains dramatically underdiagnosed and underdiscussed in the context of women's health, which has historically focused more on cancers and reproductive issues. Unlike mammography, there is no widely used, sex‑specific “heart screening” built into women’s preventive visits, and many women—and clinicians—still do not fully recognize cardiovascular risk.
That’s where breast arterial calcification (BAC) comes in. BAC is a calcium buildup that occurs in the arterial walls of the breast and is visible on a mammogram. Although BAC itself doesn’t cause heart disease, it is strongly associated with cardiovascular disease and traditional risk factors, and may serve as an early warning sign of increased risk. In a large study of postmenopausal women, those with BAC on their mammograms were 51 percent more likely to develop heart disease or have a stroke compared to women without it.
Here is what makes this research so compelling: nearly 65% of women age 40 and older in the U.S. report having a mammogram in the past two years (current national guidelines recommend starting screening at age 40). That means a significant portion of American women are already receiving the screening where BAC could be identified. Perhaps most striking: BAC can already be found in up to 10% of women by age 40, potentially surfacing cardiovascular risk earlier than traditional markers.
Research led by Retu Saxena, MD at the Minneapolis Heart Institute Foundation Penny Anderson Women’s Cardiovascular Center aims to gather evidence around sharing BAC results with women as a regular part of their mammograms. Over a three-month period, participating sites will systematically report BAC findings if it is identified. Women with positive BAC findings will also receive educational materials explaining what it means and what actions they can take to further understand their risk. This includes a conversation with their primary care provider that may include preventive cardiovascular therapies or pursuing additional testing, such as a coronary calcium scan.
The potential impact is significant. If incorporating BAC reporting into routine mammograms proves successful in the pilot, it could be become a standard part of improving early detection and generating new knowledge about the role of BAC in guiding preventive care. BAC screening could start important conversations about traditional cardiovascular risk factors, including cholesterol, blood pressure, lifestyle behaviors, and family history. For women, it could mean earlier awareness and action to mitigate risk.
