Breast arterial calcification linked to increased cardiovascular mortality risk

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Journal of breast imaging Published May 26, 2026 Medically reviewed May 26, 2026 Study authors: Nandurkar Rhea, Vasanthakumar Sheran, Stewart Jack, Aldous Emma, Tu Huong, Goel Vinay, Scanlon Liam,… PubMed ↗ DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Consider breast arterial calcification as an incidental marker of increased cardiovascular risk in women.

A systematic review and meta-analysis investigated the association between breast arterial calcification (BAC) and cardiovascular outcomes. The analysis included a large cohort of participants and found that the presence of BAC was associated with an increased risk of all-cause mortality, cardiovascular mortality, heart failure, stroke, and myocardial infarction. These associations remained significant in subgroups from screening mammography cohorts and in studies using quantitative BAC assessment.

The authors noted that associations with incident outcomes were observed only in studies using quantitative BAC assessment, which may limit the generalizability of findings from qualitative assessments. The study did not report on safety outcomes, as BAC is an imaging finding rather than a therapeutic intervention.

Clinically, recognition of BAC as an incidental finding on mammography may enable timely identification of individuals at elevated cardiovascular risk. However, the authors emphasize that BAC is described as a surrogate marker of cardiovascular disease, not a direct cause. The findings support considering BAC in the context of overall cardiovascular risk assessment, but should not be overstated as a standalone diagnostic tool.

Study Details

Study typeMeta analysis

Sample sizen = 85

EvidenceLevel 1

Follow-up702.0 mo

PublishedMay 2026

PMID42185878

View Original Abstract ↓

OBJECTIVE: Breast arterial calcification (BAC) is a surrogate marker of cardiovascular disease (CVD); however, its associations with incident mortality and major adverse cardiovascular events (MACEs) have not been systematically evaluated. The association between BAC and incident MACE and whether this is influenced by the method of BAC assessment was examined. METHODS: PubMed, MEDLINE, and EMBASE were reviewed to June 2025 for studies comparing BAC status with incident MACE (composite of death, myocardial infarction [MI], stroke, heart failure). The primary outcome was all-cause mortality. Random-effects meta-analysis was performed using hazard ratios (HRs) with 95% CIs. Subgroup analysis was conducted by method of BAC measurement and restricted to screening mammography cohorts, PROSPERO registration (CRD42020202612). RESULTS: Of 1118 studies screened, 24 were included (236 475 participants; mean age 58.5 years). Breast arterial calcification presence associated with all-cause mortality (HR, 1.32; 95% CI, 1.20-1.45; P <.0001) (follow-up 0.55-26 years). Increased risk was observed for cardiovascular mortality (HR, 1.38; 95% CI, 1.14-1.66; P = .0009), heart failure (HR, 1.29; 95% CI, 1.20-1.37; P <.0001), stroke (HR, 1.2; 95% CI, 1.11-1.30; P <.0001), and MI (HR, 1.2; 95% CI, 1.15-1.26; P <.0001). When restricted to screening mammography cohorts without concurrent indications for cardiovascular investigation (5 studies, n = 85 647), associations remained significant for all-cause mortality (HR, 1.34; 95% CI, 1.14-1.58; P = .0004), cardiovascular mortality (HR, 1.38; 95% CI, 1.14-1.66; P = .0009), heart failure (HR, 1.48; 95% CI, 1.19-1.86; P = .0005), and stroke (HR, 1.34; 95% CI, 1.08-1.67; P = .008). Associations with incident outcomes were observed only in studies using quantitative BAC assessment (HR, 1.31; 95% CI, 1.19-1.44; P = .002). CONCLUSION: Breast arterial calcification is a promising prognostic marker of mortality and CVD risk. Recognition of this incidental finding may enable timely identification of at-risk individuals.