- Objectives: Some studies have found correlations between the presence of breast artery calcium (BAC) observed on routine mammograms and risk factors for coronary artery disease (CAD). The aim of this study was to investigate whether such calcifications could predict the presence of coronary athero sclerosis. Methods: A total of 319 female patients between 50 and 70 years of age, 187 with significant CAD and 132 with angiographically normal coronary arteries, were randomly selected from a computerised database of our central catheterisation laboratory. The patients' mammograms were evaluated independently for the presence of BAC in a blinded fashion by an experienced breast radiologist, and additional clinical data were extracted from clinical charts. Results: The women in the CAD group were older (62.5 vs 60.7 years, p=0.05) and had a higher prevalence of hypertension, diabetes mellitus and dyslipidaemia. Although the prevalence of BAC was marginally higher in the CAD group (43.9% vs 37.1 %, p=0.138), this tendency was eliminated after controlling for confounders. Multiple regression analyses indicated that only age above 63 years (odds ratio [OR]=3.0, 95% confidence interval [CI]= 1.8-4.9) and hypertension (OR=2.2, 95% CI=1.2-4.1), but not angiographic evidence of CAD (OR=1.0,95% CI=0.6-1.6), predict with BAC on mammography. Conclusions: Despite correlation with some risk factors For CAD, the presence of BAC does not differentiate between patients with angiographic evidence of CAD and those with angiographically normal coronary arteries.