A Mammogram Saved Her Life—by Finding Heart Disease
Nancy Preston was a healthy 65-year-old yoga instructor with no sign of heart trouble. At her annual mammogram in October 2024, she wasn’t thinking about her heart at all. But the imaging test suggested signs of coronary artery disease—and led to quintuple bypass surgery. “The mammogram saved my life,” Nancy says. But in an unexpected way.
The radiologist found breast arterial calcifications (BAC). These are little white lines that appear on the mammogram along the breast’s blood vessels. They can indicate coronary artery disease. Doctors don’t typically tell patients about BAC when providing mammography results, though Mount Sinai has long provided that information in radiological reports.
Mount Sinai was conducting a study on patients’ responses to hearing about BACs, and the research staff asked if Nancy would be interested in joining it. The psychological study, headed by clinical psychologist Guy H. Montgomery, PhD, Chief of the Division of Health and Behavior at the Icahn School of Medicine at Mount Sinai, is looking at whether finding out they have BAC affects women's health care choices and lifestyle.
What Is Breast Arterial Calcification?
BACs occur when calcium builds up in the breast blood vessels. Mammograms are low-dose X-rays designed to look for tumors and calcium build-up or other findings in the breast. The goal of mammography is to identify any calcium build-ups that suggest cancer. But the imaging test highlights all calcifications in the breast, including BAC.
“Discovering breast arterial calcifications is a bonus finding,” explains Laurie Margolies, MD, Vice Chair for Breast Imaging at the Department of Radiology at Mount Sinai and a co-investigator on the study. “The best part of this bonus finding is that mammograms target the population most likely to benefit from care—women in their 40s, 50s, and 60s.”
At this point, women are old enough to be at higher risk of heart disease yet young enough to be more easily treated. “At Mount Sinai, we see breast arterial calcifications on about 13 percent of mammograms. That doesn’t mean 13 percent of women have heart problems, but it does mean that they should consider taking preventive measures and talking to a cardiologist if they are not already,” Dr. Margolies says.
The following spring, Nancy received a letter inviting her to join the study. Nancy sought a meeting with Mary Ann McLaughlin, MD, Associate Professor of Medicine (Cardiology) at the Icahn School of Medicine and co-investigator on the study. Dr. McLaughlin had Nancy do bloodwork and then had her take a stress test, an imaging study that assesses how well the heart works during exercise. “The reason I had Nancy take the stress test was because she was a participant in the study,” Dr. McLaughlin says. “If she had come to me with what she had, which was well-controlled high blood pressure and cholesterol and no symptoms, and was not part of the study, I likely would not have referred her for the stress test.” To everyone’s surprise, the stress test came back positive.
Dr. McLaughlin then brought Nancy to the Cardiac Catheterization Laboratory (also known as the Cath Lab) for a diagnostic procedure to see how her heart muscle and blood vessels were working. Dr. McLaughlin warned Nancy that there was a possibility she would wake up with a stent in one of her arteries. Instead, Nancy came out of anesthesia to the news that she had multiple artery blockages and would need open-heart surgery.
The Cath Lab test identified three severely blocked coronary arteries and two smaller blockages. “Due to the number of abnormalities,” Dr. McLaughlin says, “she needed bypass surgery, not just stents.” Within two weeks of the test, by the end of July 2025, Nancy was scheduled for open heart surgery. Her surgeon, Anelechi Anyanwu, MD, Vice Chair of Cardiovascular Surgery for the Mount Sinai Health System, performed a quintuple bypass. To do so, he cut through Nancy’s breastbone and moved blood vessels to reroute the blood flow around the blockages. Nancy stayed in the hospital for a week after the six-hour procedure.
An Inspiring Outcome
While in the hospital, Nancy started physical rehabilitation to improve her mobility and help her perform tasks of daily living. After discharge, she stayed with her sister, a cardiac respiratory therapist, for three weeks. She continued physical rehab, meeting twice a week with an exercise physiologist to lift weights and do cardio exercises. Slowly, she began to return to her yoga practice. “I was really missing that,” she says.
Four months after the surgery, Nancy was able to return to her full yoga practice. She was doing well, though she still had low blood pressure, anemia, and deep breathing. “I am thrilled with the care I received,” Nancy says.
She will see Dr. McLaughlin every six months and have periodic stress tests for years to come. “Nancy has an excellent prognosis because they treated the blockages before they damaged her heart muscle and because she is conscientiously taking her medications, watching her diet, and exercising,” Dr. McLaughlin says.
While the study isn’t complete, Nancy’s experience and the preliminary results suggest that it can be very helpful to share BAC information with patients. Dr. Montgomery noted, “If we consider the number of women who have mammograms each year, we could easily improve the health of thousands of women with BAC information.” Dr. McLaughlin added, “Nancy’s experience is inspiring me, and others on the team, to really make sure that these breast calcifications are more widely acknowledged on the radiology reports,”. “Probably the biggest message from Nancy’s story is that women should ask if they have breast arterial calcifications on their mammograms. And then, if they do, they should follow up with their health care provider to see what preventive steps could help.”