At a Glance
- 67-year-old woman avoided heart attack thanks to breast arterial calcifications found on routine mammogram.
- The calcifications prompted a cardiac stress test revealing multivessel coronary artery disease.
- Mount Sinai’s study will analyze how women react to BAC notifications and its impact on heart care.
- Why it matters: Early detection of BAC could save lives by prompting heart evaluation in asymptomatic patients.
A routine mammogram in October 2024 uncovered a silent threat in Nancy Preston, a 67-year-old New York City resident, leading to a life-saving bypass surgery and sparking a study on breast arterial calcifications.
What Are Breast Arterial Calcifications?
Breast arterial calcifications (BAC) are calcium deposits within the breast arteries. They are linked to heart disease but are distinct from the benign macro- or micro-calcifications that often appear on mammograms.
- Macro-calcifications appear as white dots and are usually benign.
- Micro-calcifications are white specks and can indicate cancer.
- About half of women develop benign breast calcifications.
Mount Sinai is studying how women react when BAC is reported in their mammogram results.
How BAC Led to a Life-Saving Bypass
After Preston was notified of her BAC, she underwent a cardiac stress test. Dr. Mary Ann McLaughlin explained:
> “In [Preston’s] case, her heart function was very strong at rest, but during the stress portion, part of her heart muscle was not squeezing appropriately.”
Mary Ann McLaughlin added:
> “If she had come to me with what she had, which was well-controlled risk factors and no symptoms, I likely would not have referred her for the stress test.”
The test revealed multivessel coronary artery disease, prompting quintuple bypass surgery. Preston said:
> “Thank God this BAC was shared with me.”
She is now recovering from the major surgery performed in July.
Mount Sinai’s Study Design
The study began recruiting patients 40 and older in 2021 and will analyze BAC rates in 14,875 women. Dr. Laurie Margolies estimates that 12.5% of women in the health system have BAC, including those with known heart conditions.
| Group | Notification Timing | Follow-Up Action |
|---|---|---|
| 1 | Immediately after mammogram | Educated, encouraged to consult preventive cardiologist |
| 2 | Standard mammogram letter, then BAC results after 6 months | Standard care |
The second part of the study randomly splits 1,888 patients with BAC into the two groups. Results are expected in early 2027.
Broader Implications for Heart Health
Research from 2018 to 2024 has linked BAC to heart disease across age groups. Dr. Naomi Ko noted:
> “Give me an opportunity to counsel my patients toward better lifestyle choices, and I’ll take it.”
She cautioned:
> “It’s not a slam dunk… We know these calcifications are associated with cardiovascular challenges, but we’re not 100% certain about what that could mean for every single individual patient.”
Dr. Melanie Chellman said:
> “The great thing about mammograms is that we’re already doing them on the particular women who are at the highest risk for heart disease: ages 40 and older.”
Dr. Steven Isakoff highlighted a provider-education gap:
> “Most of my colleagues, I would bet, are not aware of the association between breast arterial calcifications and heart disease.”
>
> “Without more specific guidance in the report about what steps to take, I would think it might not get acted upon.”
Key Takeaways
- BAC can signal hidden coronary artery disease even in asymptomatic patients.
- Early notification and follow-up may lead to life-saving interventions.
- Mount Sinai’s study will help determine the best way to communicate BAC findings.
The findings underscore how a routine breast exam can uncover crucial heart health information, offering a new avenue for early detection and prevention.
