A routine mammogram is primarily designed to detect breast cancer, but a new Maryland law is giving the screening test another important role: helping women recognize potential warning signs of cardiovascular disease. Beginning October 1, 2026, mammography providers in Maryland are required to notify patients when breast arterial calcifications, commonly known as BAC, are identified during a mammogram.
The new law could change how women and their doctors approach preventive health care. Breast arterial calcifications are deposits of calcium in the walls of arteries within the breast. Although these findings are not breast cancer, research has linked them to an increased risk of cardiovascular problems, including heart attacks, strokes, and other serious complications.
The legislation does not mean mammograms can diagnose heart disease or replace dedicated cardiovascular testing. Instead, it creates an opportunity to identify a potential risk marker during an examination women may already receive as part of their routine health care.
According to NBC4 Washington, Maryland is the first state to enact a law requiring patients to be notified when breast arterial calcifications are observed on their mammograms. Supporters believe this additional information could encourage women to discuss their cardiovascular health with their doctors before a serious problem develops.
The new requirement also raises important questions about how the finding should be interpreted, what patients should do when it appears in their results, and whether similar legislation could eventually be adopted in other states.
What Is Maryland’s New Mammogram Law?
Maryland’s new law, known as House Bill 1364, requires certain mammography facilities to include a notice about arterial calcification when the finding is observed during a mammogram. The legislation was approved by Governor Wes Moore and took effect on October 1, 2026.
The purpose is to make sure patients receive information about a potential cardiovascular risk marker that may otherwise go unmentioned in a report focused on breast cancer screening.
Under the law, the notification encourages patients to discuss the finding with their health care providers and consider appropriate next steps based on their individual circumstances.
The legislation does not require every woman with breast arterial calcifications to undergo a particular heart test or begin medication. Instead, it aims to connect information already visible on a mammogram with a broader conversation about cardiovascular risk.
The distinction matters because BAC is not a diagnosis of heart disease. Its presence may indicate a higher risk, but a clinician must consider the patient’s overall health, medical history, blood pressure, cholesterol, blood sugar, and other relevant factors before recommending further evaluation.
The official details of the legislation are available through the Maryland General Assembly’s House Bill 1364 page.
What Are Breast Arterial Calcifications?
Breast arterial calcifications occur when calcium deposits build up in the walls of arteries within breast tissue. These deposits can sometimes be seen on routine mammograms as distinctive white, line-like markings along blood vessels.
Radiologists may notice these findings while examining images for signs of breast cancer. Unlike suspicious breast calcifications that may require additional investigation for possible malignancy, breast arterial calcifications are a vascular finding.
However, the fact that BAC is not breast cancer does not mean it should automatically be ignored.
Researchers have found associations between breast arterial calcifications and cardiovascular conditions. The finding may provide additional information about a woman’s long-term heart health, particularly when considered alongside other risk factors.
It is important to understand that BAC and the calcification commonly discussed in coronary artery disease are not identical. They can develop through different biological processes. Even so, studies have found that BAC may be associated with a higher likelihood of future cardiovascular events.
The finding is therefore best understood as a potential warning signal rather than proof that a person currently has blocked heart arteries.
According to the University of Maryland Medical System, identifying BAC during a mammogram can provide an opportunity for earlier cardiovascular risk assessment without requiring an additional imaging procedure solely to look for the breast artery finding.
Can Mammograms Really Help Prevent Heart Disease?
Mammograms do not directly prevent heart disease, but they may help identify women who could benefit from a closer look at their cardiovascular health.
The difference is important. A mammogram is an imaging test used primarily to screen for breast cancer. When breast arterial calcifications are visible, the finding may offer additional information that prompts a patient and her doctor to evaluate cardiovascular risk factors.
For example, a woman may receive regular mammograms but have limited awareness of her blood pressure, cholesterol levels, or blood sugar. If BAC appears in her results, it may create an opportunity to review those measurements and discuss whether further testing is appropriate.
Depending on the individual’s medical history and risk profile, a doctor may recommend cholesterol testing, diabetes screening, lifestyle changes, or a more detailed cardiovascular assessment. Some patients may benefit from consultation with a cardiologist, while others may need routine monitoring and preventive care.
The potential benefit is earlier awareness. Cardiovascular disease can develop over time, and some people do not recognize their risk until they experience symptoms or a major health event.
However, researchers are still studying how BAC should be incorporated into standard cardiovascular risk assessment. An association between BAC and cardiovascular disease does not prove that notifying patients about the finding will automatically reduce heart attacks or deaths.
The Maryland law is intended to make relevant information available so patients and clinicians can decide what action, if any, is appropriate.
What Does Research Say About BAC and Cardiovascular Risk?
Scientific research has increasingly examined whether breast arterial calcifications can provide useful information about cardiovascular health.
A study published in JACC: Advances in 2025 examined 1,216 women and found that 19% had breast arterial calcifications. Among women with BAC, 21% experienced major adverse cardiovascular events, compared with 11% of women without the finding, according to the reporting by NBC4 Washington.
These results suggest that BAC may help identify women who have an elevated risk of cardiovascular complications. However, the figures describe the outcomes observed in that particular study population. They should not be interpreted as the personal probability that every woman with BAC will develop heart disease.
A separate 2026 meta-analysis published in the American Journal of Cardiology reviewed research on breast arterial calcifications and cardiovascular outcomes. The analysis found an association between BAC and an increased incidence of future cardiovascular events across the studies examined.
Together, these findings support growing interest in using mammography as an additional opportunity to identify possible cardiovascular risk.
Nevertheless, there are important limitations. Much of the available evidence comes from observational studies, which can identify associations but cannot establish that BAC directly causes cardiovascular disease. Researchers are also continuing to investigate how the finding should be graded, which patients benefit most from follow-up, and how doctors should incorporate it into existing prevention guidelines.
The American College of Cardiology has discussed both the potential of BAC as a cardiovascular risk marker and the remaining questions about its routine clinical use.
The evidence is promising, but further research is needed to establish the most effective approach to follow-up and prevention.
Why Is This Law Particularly Important for Women?
Cardiovascular disease is the leading cause of death among women in the United States, according to the Centers for Disease Control and Prevention. Despite its significant impact, heart disease is sometimes associated more strongly with men in the public imagination.
That perception can contribute to women overlooking their own cardiovascular risk or failing to recognize symptoms that deserve medical attention.
Women can experience familiar heart attack symptoms, such as chest discomfort, but they may also experience shortness of breath, unusual fatigue, nausea, or pain in the jaw, back, or arm. Symptoms vary, and not every person experiences the same warning signs.
Another challenge is that cardiovascular risk can be influenced by factors beyond the measurements traditionally emphasized in routine checkups. Pregnancy-related complications, menopause, and certain reproductive health conditions can affect a woman’s long-term cardiovascular profile.
Identifying breast arterial calcifications during a mammogram may help bring heart health into a conversation that otherwise focuses on breast cancer screening.
This does not mean that women without BAC are free from cardiovascular risk. A mammogram is not a comprehensive heart assessment, and many women who have cardiovascular disease or significant risk factors will not necessarily have visible BAC.
Instead, the notification requirement provides another potential opportunity to identify risk and encourage preventive care.
What Should You Do If Your Mammogram Shows Breast Arterial Calcifications?
A BAC finding can be concerning, especially when a patient first learns that a breast cancer screening test has revealed something related to heart health. However, the finding alone does not mean a person has heart disease or is about to experience a heart attack.
The appropriate response is to discuss the result with a qualified health care professional.
A primary care clinician can review the mammogram report alongside the patient’s personal and family medical history, blood pressure, cholesterol levels, blood sugar, smoking history, physical activity, and other relevant risk factors.
Based on that assessment, the clinician may recommend additional testing or preventive measures. Not every patient will require the same evaluation, and treatment should not be started solely because BAC was mentioned in a mammogram report.
Women can also use the conversation as an opportunity to review their existing heart health habits. Regular physical activity, a balanced eating pattern, avoiding tobacco, adequate sleep, and managing blood pressure and cholesterol can help reduce cardiovascular risk.
The American Heart Association provides general information about cardiovascular disease and prevention. Individual recommendations, however, should be tailored to a person’s health needs by their clinician.
Patients should also continue recommended breast cancer screening. A BAC notification is additional information, not a replacement for the original purpose of the mammogram.
If someone experiences symptoms that could indicate a heart attack, such as chest pressure, shortness of breath, faintness, or sudden discomfort in the arm, back, jaw, or upper body, they should seek emergency medical care rather than wait for a routine appointment.
Why Some Doctors Have Raised Concerns About the New Law
Although supporters see the Maryland legislation as an opportunity to improve women’s health, some medical professionals have raised questions about whether BAC notification should become mandatory before standardized follow-up recommendations are established.
When the bill was being considered, two radiologists at Johns Hopkins University reportedly argued that the legislation was premature and that the evidence did not yet establish a consistent clinical pathway for every patient with BAC.
Their concerns included the possibility that patients could become alarmed by a finding whose significance may vary from person to person. They also questioned whether the notification could create confusion if clinicians lacked clear guidance about which tests or referrals should follow.
These concerns reflect a wider debate in medicine: how should health care systems communicate emerging risk markers when the evidence suggests a meaningful association but the ideal response is still being studied?
Supporters argue that patients should be informed when potentially useful health information is already visible on an imaging study. They also point out that a notification can encourage a conversation with a physician without automatically triggering expensive tests or treatment.
The law’s approach is to inform patients and encourage individualized medical discussion rather than prescribe one universal course of action.
As researchers gather more evidence, clinical organizations may be able to develop clearer recommendations about how BAC should influence cardiovascular risk assessment. Until then, clinicians must interpret the finding within the broader context of each patient’s health.
Could Other States Follow Maryland’s Example?
Maryland’s new law may encourage other states to examine whether patients should routinely be informed about breast arterial calcifications detected during mammography.
The policy is attractive in part because the information can be obtained from an imaging test that many women already undergo. Detecting BAC does not require a separate mammogram or an additional radiation exposure beyond the original screening examination.
If more health systems adopt consistent reporting practices, researchers may also be able to collect better information about how often BAC occurs, which groups are most likely to have it, and what happens when patients receive follow-up care.
However, other states would need to consider their own legislation, medical reporting practices, and standards for communicating findings to patients.
A notification requirement alone will not eliminate cardiovascular disease. Its effectiveness will depend on whether patients understand the information, have access to follow-up care, and receive appropriate assessment and treatment when necessary.
The larger opportunity is to improve communication between breast imaging specialists, primary care clinicians, and cardiovascular specialists. Better coordination could help ensure that relevant findings do not disappear into a report that patients may never fully discuss with their doctors.
What Maryland’s New Law Means for the Future of Preventive Health Care
Maryland’s breast arterial calcification notification law represents a shift toward making more use of information already available through routine medical testing.
Mammograms will continue to play an essential role in breast cancer screening. But when BAC is visible, the finding may provide another opportunity to discuss a woman’s cardiovascular health.
The legislation does not transform mammography into a heart scan, nor does it establish that every patient with BAC has cardiovascular disease. Instead, it encourages patients and doctors to consider whether the finding signals a need for a more complete assessment.
As research develops, BAC reporting may become a more integrated part of preventive health care. The key will be ensuring that the information is accurate, clearly explained, and connected to evidence-based follow-up.
For patients, the message is straightforward: learn what your mammogram report says, ask questions when you do not understand a finding, and discuss any potential cardiovascular risk with your health care provider.
The Maryland law cannot guarantee that heart disease will be prevented, but it may help more women recognize the importance of heart health before a medical emergency occurs.
Frequently Asked Questions About Mammograms and Heart Disease
Can a mammogram detect heart disease?
A mammogram cannot diagnose heart disease, but it can reveal breast arterial calcifications, which have been associated with a higher risk of cardiovascular problems. If BAC is found, a clinician can assess the patient’s overall heart health and decide whether further evaluation is appropriate.
What is breast arterial calcification?
Breast arterial calcification is calcium buildup in the walls of arteries within breast tissue. It is not breast cancer, but research suggests that its presence may provide information about a person’s cardiovascular risk.
What does Maryland’s new mammogram law require?
Maryland House Bill 1364 requires certain mammography facilities to notify patients when arterial calcification is observed during their mammogram. The law took effect on October 1, 2026, and encourages patients to discuss the finding with their health care providers.
Does having BAC mean I will have a heart attack?
No. BAC is a potential risk marker, not a prediction that a heart attack will occur. Its significance depends on the patient’s overall health and other cardiovascular risk factors. A doctor can help determine whether additional assessment is needed.
What should I do if BAC appears in my mammogram results?
Contact your primary care provider or another qualified clinician to discuss the finding. Your provider may review your blood pressure, cholesterol, blood sugar, medical history, and other risk factors to determine whether further testing or preventive steps are appropriate.
Can women without BAC still develop heart disease?
Yes. The absence of BAC does not rule out cardiovascular disease or eliminate other risk factors. Women should continue routine preventive care and discuss their individual heart health with their clinicians.
Does a mammogram prevent heart disease?
No. A mammogram does not directly prevent heart disease. However, identifying BAC may prompt earlier risk assessment and encourage preventive steps that can help reduce cardiovascular risk.
Conclusion: A Mammogram Could Offer Women Another Opportunity to Protect Their Heart Health
Maryland’s new law is bringing attention to a potentially important connection between breast cancer screening and cardiovascular prevention. By requiring notification when breast arterial calcifications are identified, the state aims to ensure women receive information that could help them discuss their heart health with their doctors.
The research linking BAC with cardiovascular risk is encouraging, although more work is needed to determine how best to use the finding in routine clinical practice. BAC is not a diagnosis of heart disease, and not every patient with the finding will need the same follow-up.
For women, the law offers a reminder that preventive health care involves more than one condition or one test. Understanding mammogram results, monitoring cardiovascular risk factors, and maintaining regular medical care can all contribute to better long-term health.
The most important next step is not to panic over a report, but to understand it. A conversation with a health care professional can help turn a potentially concerning finding into an informed plan for protecting heart health.
Citation and Sources
- NBC4 Washington: Could Mammograms Help Prevent Heart Disease? A New Maryland Law Aims to Help
- Maryland General Assembly: House Bill 1364: Public Health – Mammograms – Arterial Calcification Notice
- University of Maryland Medical System: Can Mammograms Help Detect Heart Disease Risk?
- American College of Cardiology: Mammography as a Window Into Cardiovascular Health
- PubMed, American Journal of Cardiology: Breast Arterial Calcification on Mammography and Cardiovascular Outcomes in Women: A Meta-analysis
- American Heart Association: What Is Cardiovascular Disease?
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