At a Glance
- A routine mammogram uncovered arterial calcifications that led to lifesaving bypass surgery for a 67-year-old woman.
- The Mount Sinai study follows 14,875 women and finds 12.5 % have breast arterial calcifications.
- Women with BAC may have hidden coronary artery disease even when symptoms are absent.
- Why it matters: Detecting BAC in mammograms could spot heart disease early.
Nancy Preston, 67-year-old, had no heart symptoms when she got her annual mammogram in October 2024 at Mount Sinai. Doctors found breast arterial calcifications (BAC) and notified her, prompting a cardiac stress test that revealed multivessel coronary artery disease. The test led to quintuple bypass surgery last summer, and doctors credit BAC detection as life-saving.
Preston’s case illustrates that heart disease can be silent. She has a family history of heart attacks and controlled hypertension and Type 2 diabetes, yet she felt only mild fatigue. The stress test showed her heart function was strong at rest but impaired under exertion, a finding only uncovered because she was part of the study.
- BAC can appear in over 10 % of mammograms.
- Women with BAC may have hidden coronary artery disease.
- Early notification can lead to timely cardiac evaluation.
Mount Sinai’s Large-Scale BAC Study
The study began recruiting women 40+ in 2021 and now includes 14,875 participants. Roughly 12.5 % of these women have BAC, including those with known heart conditions. One arm of the study randomly assigns 1,888 BAC patients to immediate notification and counseling, while the other receives a standard letter and delayed BAC results six months later; results are expected early 2027.
| Metric | Value |
|---|---|
| Total participants | 14,875 |
| BAC prevalence | 12.5 % |
| Notified group | 944 |
| Delayed group | 944 |
The study aims to determine whether early awareness changes health behavior and outcomes.
Expert Voices on the Significance
Mary Ann McLaughlin said:
> “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.”
> “The only reason that Nancy went ahead with a stress test was because she was a participant in the study.”
> “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.”
Laurie Margolies explained:
> “In over 10 % of mammograms, you will see calcified arteries, and people are always surprised.”
> “When the arteries are calcified in a woman’s breast, it only makes logical sense that vessels might be calcified elsewhere.”
Naomi Ko added:
> “Give me an opportunity to counsel my patients toward better lifestyle choices, and I’ll take it.”
> “If it triggers and influences improved health behaviors and engagement positively in your health care, awesome.”
> “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.”
> “This is one data point about your body.”
Melanie Chellman noted:
> “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.”
> “We can use those same pictures to look for calcifications that are vascular.”
Steven Isakoff said:
> “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.”
> “More research is needed to define how much arterial calcification in the breast may be cause for concern.”
> “Meanwhile, he praised Mount Sinai’s efforts to fill in gaps in the data.”
> “There’s a lot of information buried in mammograms.”
Key Takeaways
- A routine mammogram can reveal BAC, a marker linked to hidden coronary artery disease.
- Mount Sinai’s study of 14,875 patients will test if detection changes outcomes.
- Experts agree that BAC detection offers a new avenue to prompt heart evaluation, but more data are needed to guide action.
Nancy Preston’s recovery underscores how a simple screening test can uncover life-threatening heart disease. The Mount Sinai study may soon provide the evidence needed to make BAC reporting a standard part of mammography.
