Maryland has enacted a first-of-its-kind state law requiring mammography centers to notify patients whether routine breast scans show evidence of breast arterial calcification (BAC), linking routine cancer screening to information about cardiovascular risk.
In Plain English: The Clinical Takeaway
- What it is: Breast arterial calcification (BAC) involves calcium deposits within breast arteries, causing them to become stiff.
- Why it matters: While there is no known tie to breast cancer, these calcium deposits are linked to an elevated risk for heart disease, including heart failure, heart attack, and stroke.
- What patients should do: If a mammogram report notes BAC, patients should consult their doctor to review their cardiovascular risk profile using established predictive tools.
Maryland Mandate Changes Routine Mammogram Reports
On Oct. 1, a first-of-its-kind law went into effect in Maryland requiring mammography centers to notify patients if their scans show evidence of breast arterial calcification (BAC) on all routine mammograms at no additional cost. These calcium-laden arteries have always appeared on mammograms, but they have long been considered an incidental finding of little, if any, significance.
Larger studies using artificial intelligence have linked BAC to increased risk for cardiovascular events such as heart failure, heart attack and stroke. The Maryland law mandates notification of BAC — whether it’s present or absent — on all routine mammograms at no additional cost.
Pathophysiology of Breast Arterial Calcification Versus Coronary Plaque
| Vascular Marker | Anatomical Location | Primary Pathological Mechanism | Associated Clinical Risk |
|---|---|---|---|
| Breast Arterial Calcification (BAC) | Deeper layer of the arteries in the breasts | Arterial stiffening | Cardiovascular events such as heart failure, heart attack and stroke |
| Coronary Artery Calcification (CAC) | Arteries leading to the heart | Atherosclerosis (plaque buildup) | Higher risk of heart disease |
Contraindications & When to Consult a Doctor
Experts are still determining the best way to act on a BAC finding.
If it’s elevated, they may recommend starting a statin to reduce your risk, Nudy said.
References
- American Heart Association.
- Penn State College of Medicine.
