Aim: To investigate the relationship between breast arterial calcifications (BACs) and systemic hypertension (HT) and diabetes mellitus (DM). Methods: Mammograms and patient records of 2406 women who were screened for breast cancer or had undergone diagnostic mammography were reviewed retrospectively. Mammograms were evaluated for the presence of arterial calcification and results were coded. Patients who had been using insulin or oral hypoglycemic agents were included in the diabetic group; patients who had been using antihypertensive agents were included in the hypertensive group. Diabetes was defined as use of oral hypoglycemic agents or insulin and hypertension was defined as use of anti hypertensive agents. Results: The prevalence of BACs among diabetics (25.4) was higher than among hypertensives (17.6%). The prevalence in the nondiabetic, nonhypertensive (NDNH) group was lowest (7.3%). The prevalence increased with age. BAC was seen almost four times more in diabetic patients and three times more in hypertensive patients than in NDNH controls. Conclusion: BACs are associated with diabetes and hypertension. BAC on a mammogram may indicate unsuspected diabetes or hypertension, especially after 59 years of age. (C) 2004 Elsevier Inc. All rights reserved.