Routine mammograms primarily detect breast cancer early; however, doctors now highlight their potential to uncover hidden cardiovascular risks. Specifically, mammograms can identify breast arterial calcifications (BAC)—calcium deposits in breast arteries—which experts increasingly recognise as markers of underlying vascular damage linked to heart disease.
A Routine Scan That Triggered Cardiac Evaluation
A 52-year-old woman from Mumbai underwent a routine screening mammogram. Although her breast tissue appeared normal, the radiologist detected clear BAC. According to Dr Brajesh Kumar Kunwar, the patient had no prior history of heart disease but had lived with diabetes for nearly seven years.
Consequently, doctors conducted a cardiac evaluation, which revealed abnormal cholesterol levels and early signs of coronary artery narrowing. This timely intervention allowed clinicians to initiate treatment before symptoms developed.
BAC as a Surrogate Marker of Atherosclerosis
Doctors now consider BAC a surrogate marker of Atherosclerosis—a condition characterised by plaque buildup in artery walls. In this case, the patient had never experienced chest pain or warning signs. Nevertheless, the mammogram finding prompted early intervention, including medication, lifestyle changes, and stricter diabetes control. As a result, doctors potentially prevented a future cardiac event.
Moreover, these calcium deposits reflect vascular changes associated with ageing, diabetes, hypertension, and metabolic disorders. While BAC does not increase breast cancer risk or require breast-specific treatment, it serves as an important indicator for cardiovascular evaluation.
Rising Detection with Increased Screening
The Indian Council of Medical Research recommends mammography for women aged 40 and above every two years, or earlier for high-risk individuals. As more women in India undergo screening, doctors are detecting BAC more frequently.
Dr Tushar Jadhav notes that BAC appears in approximately 10–20% of women undergoing mammography. Furthermore, its prevalence increases with age—from about 9–16% in women aged 40–65 to nearly 50% in those above 65. It is particularly common among post-menopausal women and those with diabetes, hypertension, or chronic kidney disease.
Global Research Strengthens the Link
Emerging global research supports these clinical observations. Studies at the Mount Sinai Health System involving 15,000 women have linked BAC on mammograms to increased heart disease risk. In one notable case, a 67-year-old woman with no symptoms underwent a mammogram that revealed BAC, which later led to the diagnosis of severe Coronary Artery Disease. She subsequently underwent life-saving bypass surgery.
Additionally, a 2025 study published in the Heart analysed over 49,000 mammograms using artificial intelligence (AI). The algorithm accurately predicted major cardiovascular events—including heart attacks, strokes, and heart failure—at a level comparable to leading clinical risk models.
Role of AI in Advancing Risk Prediction
Advanced AI tools now enable more precise analysis of mammograms by detecting subtle vascular patterns that may not be visible to the human eye. According to Dr Ashutosh Kothari, this technology could support large-scale population studies in India to better understand the link between BAC and cardiovascular risk. However, he emphasises the need for clinical validation in collaboration with cardiologists.
BAC as a Risk Indicator, Not a Diagnosis
Dr Rahul Gupta clarifies that while BAC and coronary artery disease share common risk factors, their underlying mechanisms differ. Therefore, clinicians should treat BAC as a marker of systemic vascular ageing and cardiovascular risk—not as a definitive diagnosis. Importantly, not every woman with BAC requires advanced cardiac testing.
Need for Individualised Assessment
Finally, doctors stress the importance of a personalised approach. Dr Kothari advises clinicians to evaluate BAC findings alongside existing conditions such as diabetes, hypertension, and lifestyle factors. Additionally, symptoms like fatigue, breathlessness, and reduced exercise tolerance should guide further assessment.
Overall, by integrating mammography findings with cardiovascular screening, clinicians can identify risks earlier and implement preventive strategies more effectively.