A Mammogram’s Silent Clue: Identifying Hidden Heart Risks

By Nina Vincoff, MD

Most people would agree that mammograms are a critical component of women’s health, a vital tool in the fight against breast cancer. Annual mammograms can reduce a woman’s chance of dying from breast cancer by up to 40 percent.

But what if I told you that these routine scans could also hold a silent clue about a different, yet equally serious threat – heart disease?

Hidden within the images of breast tissue, tiny calcium deposits line the arteries in some women. Radiologists call this finding breast arterial calcification (BAC), and while harmless on its own, it can be a red flag for cardiovascular disease. Think of it as a warning sign, or an alarm bell, because it is signaling potential trouble brewing in your blood vessels.

The implications are significant. Heart disease is the leading cause of death for women in the United States, often sneaking up silently without obvious symptoms, and many women are unaware that they are at risk. BAC offers a unique opportunity for early intervention.

Imagine this: a woman goes in for her annual mammogram, a routine part of her healthcare regimen. The scan reveals a clean bill of health for her breasts but identifies the presence BAC. Armed with this knowledge, she can work with her doctor to assess her overall cardiovascular risk and take proactive steps to protect her heart.

The next step might be an evaluation of her other risk factors for heart disease, including blood pressure, cholesterol, smoking or diabetes. Depending on her risk, other testing might be recommended such as an EKG, echocardiogram or other imaging tests. She might be advised to make simple yet powerful lifestyle changes like adopting a heart-healthy diet, incorporating regular exercise, and managing stress. Or she might need treatment with medications, or even a procedure to treat blockages of the arteries of the heart.

Some might argue that adding heart health to the already emotionally charged experience of a mammogram could cause unnecessary anxiety. However, I believe that knowledge is power. Ignoring a potential risk doesn't make it disappear. Instead, it allows it to fester in the shadows. Mammograms help women take action by finding early breast cancers with best chance for cure. By adding information about BAC, we can help women also take charge of their heart health before it becomes a crisis.

In our practice, we include information about the presence of BAC on every mammogram. I recently met a woman who was informed she had BAC. She wasn’t aware that she had heart disease, so she consulted with her doctor. This led to the discovery of a significant blockage requiring immediate intervention. The woman underwent a successful stent placement and attributes the early detection and treatment of her heart condition to the information she received from her mammogram results.

Breast cancer screening has been a remarkable public health success story. Today, most women that aware that early detection with mammography saves lives. But unfortunately, other women’s health issues have not received the same attention – and that includes heart disease. BAC presents a unique opportunity to leverage mammograms – a test many women are already having - for a broader purpose, potentially saving lives from a silent killer.

Let's not ignore this valuable clue hidden in plain sight. Let's empower women with knowledge and early intervention strategies to protect their hearts and live longer, healthier lives.

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Dr. Nina Vincoff is the medical director at Northwell Health’s Katz Institute for Women’s Health.