Breast Arterial Calcification: A Radiological Marker for Cardiovascular Risk?

Breast arterial calcification on screening mammography predicts higher rates of major cardiovascular events and could change how mammograms inform cardiovascular risk in women. Noting arterial calcification on routine screening offers an accessible way to identify women at elevated cardiovascular risk earlier.

A recent observational analysis noted a graded relationship between the severity of breast arterial calcification and incidence of major cardiovascular events (myocardial infarction, stroke, heart failure).

Standard risk calculators can underestimate cardiovascular risk in some women, creating prevention gaps. Imaging biomarkers like mammographic calcification may provide complementary information to improve risk stratification and identify patients who warrant closer evaluation.

Routine notation of arterial calcification presence and severity could be added to reporting templates and linked to primary-care notification pathways. Embedding standardized descriptors in reports and issuing alerts when calcification is moderate or severe would prompt appropriate cardiovascular assessment after screening mammograms.

Prospective validation, workflow testing, and multidisciplinary collaboration are needed to define actionable thresholds and confirm clinical utility.

Key Takeaways:

• Breast arterial calcification on mammograms is associated with increased major cardiovascular events and may serve as an opportunistic biomarker.
• Reporting presence and severity can add complementary risk information, particularly for women under-recognized by standard calculators.
• Implementation requires prospective validation, reporting standards, and coordinated pathways between radiology and primary care.