Mammograms can reveal risk for heart disease

A 50-year-old woman goes in for her annual mammogram, and it comes back showing she is clear of cancer. But the scan also catches signs of calcium build up in her breast tissue arteries, a risk factor for future heart attack or stroke. The radiologist isn’t required to look at this measure, so it passes unnoticed.

The woman goes home relieved, unaware of the early warning about a disease with an even greater chance of killing her.

That marker is breast arterial calcification, or BAC. It’s already visible on the tens of millions of mammograms performed on women in the U.S. each year, with no extra cost or time needed to read it. Heart disease kills more American women than all cancers combined. Yet the radiologist who could spot BAC, the primary care doctor who could act on it, and the cardiologist who could treat it rarely confer.

Currently, no country mandates the reporting of BAC, and there are no established clinical pathways for follow up once it’s found. That gap is a missed opportunity to advance personalized risk stratification and early cardiovascular disease prevention that can keep women healthy as they age. Unfortunately, a woman’s care in midlife depends on where she lives, who she sees, or how her provider was trained, rather than a consistent, evidence-based standard.

We need to fix this broken system; establishing standards around reporting BAC and protocols providers can follow when BAC is detected can help advance an integrated approach to midlife health in women.

Some health systems have already had success in making BAC reporting operationally possible. Northwell Health has been reporting BAC across its 21 hospitals since 2024. Mount Sinai’s departments of radiology and........

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