Can Mammograms Help Your Heart?

Visible to the naked eye on mammograms by trained clinicians, breast arterial calcifications look like little white “tram track” lines. While they may seem insignificant, they hold clues about your heart health and in some cases could prompt dicussions that could save you from a future heart attack.

Breast arterial calcifications (BACs) are calcium deposits in the breast arteries that can be seen on mammogram. BACs, or calcifications in the vessels, are different than calcifications in the breast tissue, which can indicate breast cancer. BACs are unrelated to cancer but can signal risk for major cardiovascular events in women. 

A recent 2022 clinical study found an association between breast arterial calcification and heart disease in postmenopausal women ages 60 to 79, while 2024 research noted that BACs were “especially predictive” of heart disease in younger women ages 40 to 59. Experts at Lehigh Valley Health Network (LVHN), part of Jefferson Health, believe BACs are important.  

“BACs are linked to approximately a twofold increased risk for stroke and heart failure, with cardiovascular death risk potentially exceeding twofold,” says Deborah Sundlof, DO, Director, Regional Heart Center, Lehigh Valley Hospital (LVH)–Muhlenberg and Director, Women’s Heart and Vascular Center. “Different studies and parameters show mixed results, but more severe breast calcification clearly links to higher health risks."

Breast cancer screening guidelines vary across professional societies in regard to when to begin, how often to be screened and when to stop. LVHN recommends annual mammograms beginning at age 40 and most patients choose annual screening. Others may decide with their clinician that screening every two years is appropriate based on individual risk factors and preferences. 

While federal law requires information such as breast density be included in mammography reports, there is currently no such mandate for breast arterial calcifications. Regardless, LVHN began screening for BACs recently.

“Our radiologists now include a comment about whether BACs are present on the mammogram at no additional charge and with no additional radiation,” says diagnostic radiologist Martha Ksepka, MD, Co-Chief, Section of Mammography. 

Dr. Ksepka says routine reporting on BACs is not the current standard of practice but is becoming more common since we now know the association between BACs and cardiovascular disease. In the past, radiologists have not reported on BACs since the clinical implications of this finding were unknown. 

Since reporting of BACs is fairly new, a system for quantification is still under investigation. The degree of vascular calcifications can vary. Our reports comment only on whether BACs are present or absent. Patients are encouraged to speak with their clinicians regarding the clinical significance of BACs. It is also important to note that the absence of BACs on a mammogram does not exclude the possibility of cardiovascular disease.

Alongside clinical leaders and internationally recognized experts from the Bruce & Robbi Toll Heart and Vascular Institute, Jefferson Health hospitals in the Greater Philadelphia area began adding BAC information on their mammogram screening reports in 2025.

To begin with, women should make sure their mammogram report includes BAC status. You can do so by scheduling your mammogram with LVHN and Jefferson. If your mammogram report indicates BACs, there are a few steps you can take, starting with a visit to your primary care clinician to discuss your personal risk for heart and blood vessel disease and to develop a plan to support your long-term health.  

“Clinical action should include, at minimum, evaluation for 10-year risk using an accredited scoring system such as Predicting Risk of CVD Events (PREVENT), keeping in mind that BACs provide incremental predictive value beyond these scores,” Dr. Sundlof says. “The finding of BACs should prompt healthy cardiovascular lifestyle modifications and personalized patient-clinician discussions about cardiac risk management.” 

Dr. Ksepka agrees, adding women may want to consult either their primary care clinician or cardiologist, while striving for a healthier lifestyle. 

“We hope reporting on BAC status in mammogram reports will help clinicians identify patients at risk for cardiovascular disease,” she says. “Most importantly, it will empower patients to make lifestyle changes that will benefit their overall health, including decreasing their risk for heart disease and breast cancer.” 

Both clinicians note that LVHN and Jefferson offer cardiovascular specialty care for women, go to Jefferson’s capabilities and LVHN’s Women’s Heart and Vascular Center to learn more.