Maryland Leads the Way: Empowering Women to Protect Their Heart Health through Mammograms

What you know can save your life.

Yet many women may not know that their annual mammogram can tell if they are at risk for heart disease.

Yes, you read that right.

In addition to detecting breast cancer, routine mammograms can also detect breast arterial calcifications (BAC), visible deposits which are often a marker for heart disease in women. 

A growing body of research links the presence of BAC to a substantially higher risk of heart disease and stroke — the leading causes of death for women. The American Heart Association reports a sharp increase in heart disease in women, even as awareness of the risk among women is declining. By 2050, a third of U.S. women between the ages of 20 and 44 will have some form of heart disease.

Today, Maryland became the first state in the country to require that providers notify women if BAC is detected through their mammograms. When it comes to early detection, knowledge is power. The public health opportunity to flag hidden risks for heart disease holds enormous potential, as more than 40 million people get mammograms in the U.S. each year. 

For years, Brem Foundation has worked alongside partners to advocate for women to be notified if dense breast tissue was detected through their mammogram. Because of coordinated advocacy, dense breast tissue notification became federal law in 2023. Women can now take the knowledge from their mammogram to their provider and have an informed conversation about the value of additional screening, including ultrasound and MRI. This knowledge can lead more women to identify their breast cancer at earlier stages, when survival rates are higher, and health outcomes are best. Said in another way - it will save lives. Now we are taking that same approach to cardiovascular disease.

Today, Mount Sinai Hospital System in New York is conducting a behavioral study to understand how women react to being notified about the arterial calcifications with their mammogram results. The study, which began recruiting patients 40 and older in 2021, aims to analyze BAC rates in a diverse sample of 14,875 women. Dr. Laurie Margolies estimates 12.5% of women in the health system have breast arterial calcifications, including those with known heart conditions. In addition, a 2018 review published in the Journal of Cardiovascular Imaging advocated for mammography as a screening tool for heart disease. And research published in 2024 in the journal JACC: Advances noted that BAC was “especially predictive” of heart disease in younger women ages 40 to 59. 

In March, Maryland House Speaker Joseline Pena Melnyk introduced this groundbreaking legislation that would require all mammogram reports to include whether breast arterial calcifications are present. Armed with this knowledge, women can now talk with their providers about the best plan of action to protect their heart health. Although BAC frequently appears on routine mammograms, there is currently no standardized protocol for reporting this information to a patient. This bill will ensure uniformity and knowledge transfer to the patient.

A strong advocate for the legislation, Brem Foundation’s Chief Medical Officer Dr. Rachel Brem offered her expert testimony before the Maryland House Committee on Health. “The path forward is clear: we must empower women with timely, actionable information about their cardiovascular health. When women understand their risks, when they have access to the right screening at the right time, and when they are equipped to advocate for themselves, we save lives. It is that simple, and that profound.”

Maryland’s new law provides women with simple, highly actionable information about their potential risk for heart disease, along with a path to determine a course of action with their provider. By becoming the first state to require BAC documentation in mammography reports, Maryland is setting a new standard in preventive care and women’s health — saving lives and serving as a model for other states and the country.

Knowledge is power — and women deserve ready access to it. Brem Foundation will continue advocating for transparency, education, and better care. Withholding information from women about their health is not protection — it’s a disservice. Women deserve a healthcare system that does better by them.

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