Significance of Breast Arterial Calcification on Mammography
- Category: Medical Staff Briefs Newsletter, Heart & Vascular, Medical Staff, St. Joseph Hospital, Women’s Health
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Cardiovascular disease (CVD) remains the leading cause of death among women. Breast arterial calcifications (BAC), identified on mammography, are associated with significantly increased risks of cardiovascular outcomes, including stroke (relative risk 2.05), heart failure (2.14), cardiac death (2.94), and atherosclerotic CVD (1.58) 1
As of 2025, BAC reporting has been designated a high-priority MIPS Quality Measure (QMM28) by CMS. Additionally, reporting of BAC on mammography is recommended by the Society of Breast Imaging subsection of the American College of Radiology, as well as the Canadian Society of Breast Imaging, recognizing BAC as a readily available, no-cost biomarker for cardiovascular risk.2
Accordingly, beginning in May 2026, MRD radiologists will include documentation of BAC presence or absence in all mammography reports, along with a qualitative grading scale (mild, moderate, severe). For patients with identified BAC, comprehensive cardiovascular risk assessment is recommended. When clinically appropriate, this may include specialty referral, lipid panel testing, and/or additional imaging such as CT coronary artery calcium scoring.
Given that CVD remains under-diagnosed and undertreated in women compared to men3, routine BAC reporting represents an important opportunity to enhance cardiovascular risk awareness and improve preventive care in this population.
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