Breast Arterial Calcification and Coronary Calcium: What Is the Difference?

Breast arterial calcification on a mammogram and coronary calcium on CT are different findings. Learn what each may mean for cardiovascular prevention.

Quick answer

Breast arterial calcification (BAC) is calcium visible in arteries within breast tissue on a mammogram. Coronary artery calcium (CAC) is calcified plaque in the arteries that supply the heart, usually measured on a noncontrast cardiac CT. These are different imaging findings with different clinical uses. A BAC finding can be an opportunity to revisit cardiovascular risk factors.

What does BAC mean?

BAC is generally seen in the walls of breast arteries and often becomes more common with age and certain health conditions. Research associates BAC with a higher likelihood of future cardiovascular events in some populations. The finding itself does not establish that an individual has a coronary blockage or needs a particular medication.

How does CAC differ?

CAC reflects coronary artery calcified atherosclerotic plaque and is used in selected primary prevention decisions. A CAC score considers coronary plaque burden, while a mammogram is primarily designed to evaluate breast health. Different tests, tissues and patterns of calcification are involved.

Does BAC indicate breast cancer?

BAC refers to vascular calcification and is distinct from the breast calcifications that may prompt cancer imaging follow-up. Mammogram findings should be interpreted by the breast imaging clinician, with any breast diagnostic follow-up handled through that pathway.

What should you ask after BAC is mentioned?

Ask whether blood pressure, LDL cholesterol, diabetes status, smoking history, family history and other cardiovascular risks have been reviewed recently. A clinician can decide whether further testing is indicated. Bringing the actual mammography report, existing laboratory results and medication list helps make the conversation specific.

FAQ: Should every woman with BAC have a coronary calcium scan?

The choice depends on overall risk, current preventive treatment decisions, symptoms and clinical judgment. BAC alone is not a universal order for CAC screening. Its best role in guiding future testing is still being studied.

Request an appropriate evaluation

A new cardiovascular risk conversation may merit a longer clinical visit. My Heart Spark P.C. lists a 45 minute Long Cardiology Visit ($150) with Dr. Brown’s Team, subject to clinical review and availability. https://myheartspark.clientsecure.me/request/service

Evidence perspective

Read peer reviewed BAC cardiovascular outcome research through PubMed: https://pubmed.ncbi.nlm.nih.gov/ . This is educational material; discuss individual findings and management with a qualified clinician.