Maryland Requires Mammogram Reports to Flag Heart Risk Finding

Maryland became the first state in the country this month to require that mammogram results tell a patient when her images show breast arterial calcification, a finding that has long been visible on those films but rarely communicated to the women they belong to.

The law, House Bill 1364, took effect October 1. As reported by The Washington Post, mammography centers must now include information about breast arterial calcification, or BAC, in the results letter sent to a patient whenever it appears on a routine scan. The notification comes at no extra charge, and it directs patients to follow up with their physician to review their cardiovascular risk.

BAC is exactly what it sounds like: calcium deposits that accumulate in the muscular walls of breast arteries. It has nothing to do with breast cancer. But it's visible on standard mammography images, and researchers have spent years building the case that its presence is a meaningful signal about what's happening in a woman's vascular system more broadly.

A 2026 meta-analysis that pooled data from four cohort studies found that women with BAC had roughly an 82 percent higher rate of future cardiovascular events than women without it, after accounting for other risk factors. Separate work using AI-assisted image review has linked the finding to coronary artery disease, heart attack, and stroke.

The clinical nuance matters here. Radiologists have long noted BAC as an incidental finding, but as the University of Maryland Medical System noted in guidance to patients, the presence of calcification doesn't mean a woman has coronary artery disease, and its absence doesn't mean she's free of cardiovascular risk. It's a data point, not a verdict.

Gov. Wes Moore signed HB 1364 in May after it passed both chambers of the Maryland General Assembly without a single dissenting vote, according to reporting reviewed by telehealth.org. The law expressly states that the notification requirement does not create a new standard of care or form the basis of a lawsuit, a provision that addressed liability concerns from imaging centers during the legislative process.

What made the bill possible is that BAC reporting costs essentially nothing extra. The information is already sitting in those images. The problem, as the bill's sponsor, Maryland House Speaker Joseline Pena-Melnyk, put it during a February committee hearing, is that "even when the presence is documented, reporting practices lack uniformity." The law standardizes what was previously left to individual radiology departments to decide.

For clinicians outside radiology, the practical effect is a likely uptick in patients arriving at primary care or cardiology appointments with a BAC notation in hand and questions about what it means. A coronary artery calcium score, done by CT scan, is a related but distinct measurement and may be an appropriate next step for some patients, though that conversation belongs with their physician and depends on their overall risk profile.

Other states are watching. The Washington Post reported that Maryland's move could prompt similar legislation elsewhere, following the same path that breast density notification laws traveled: one state acts, clinical evidence builds, and other states follow.

For now, the law applies only to mammography centers operating in Maryland. Women in other states who want to know their BAC status can ask their radiologist or ordering physician whether that information is available in their imaging report, since some health systems already include it voluntarily.

Sources cited:
- The Washington Post (https://www.washingtonpost.com/wellness/2026/10/07/your-next-mammogram-results-could-reveal-bac-heart-disease-warning-sign/)
- telehealth.org (https://telehealth.org/news/maryland-law-requires-mammogram-patients-to-receive-breast-arterial-calcification-notice/)
- University of Maryland Medical System Health Hub (https://health.umms.org/womens-health/mammograms-and-heart-disease-risk/)
- The Queen Zone (https://www.thequeenzone.com/your-mammogram-may-reveal-a-warning-sign-about-your-heart-a-new-law-says-women-should-be-told/)
- AuntMinnie.com (https://www.auntminnie.com/clinical-news/womens-imaging/breast/news/15819599/maryland-first-state-to-consider-bac-notification-after-mammogram)