Breast cancer detection could get a boost from artificial intelligence.
When AI helped examine mammograms, doctors caught one more cancer case per 1,000 screened individuals compared with when they didn’t use the technology, researchers report January 7 in Nature Medicine . The largest real-world study on AI’s potential for breast cancer screening, which included nearly 500,000 women in Germany, suggests that the software could streamline the screening process without affecting the rate of false alarms.
“AI in mammography screening is at least as good as a human reader, and our study shows it’s even better,” says cancer epidemiologist Alexander Katalinic of the University of Lübeck in Germany.
Germany’s breast cancer screening program requires two radiologists to independently assess each patient’s mammograms and look for spots, abnormal masses and other peculiarities. (U.S. clinics mostly rely on one physician.) If at least one doctor suspects cancer in the four X-ray images, which are compared with the patient’s previous screening, a third radiologist helps determine if the individual needs more tests.
“We have 3 million women participating each year in this project, and 24 million pictures have to be read every year,” Katalinic says. “That’s a big workload for the radiologists.”
In the new software, an AI-supported image viewer triggers a “safety net” alert if a radiologist deems a patient’s mammograms as cancer-free but the AI software suspects otherwise. The white square shows the suspicious region. Vara To see if AI could lighten the load , decision referral software was installed at 12 screening sites across the country. More than 460,000 women ages 50 to 69 took part in the study from July 2021 through late February 2023. AI tagged the mammograms as normal, suspicious or unclassified. The 119 participating radiologists chose to use an AI-supported image viewer, which revealed the software’s assessment, for roughly half of the women’s screenings.
Without AI’s assistance, clinicians identified about six breast cancer cases, confirmed via biopsy, per 1,000 patients during screening. Doctors found around seven cases with the software’s help, leading to a 17.6 percent higher breast cancer detection rate with AI. Compared with patients who received traditional screenings, the group checked with AI’s help had slightly fewer false positives — when a doctor suspects cancer, but further tests provide an all clear.
How the AI would best fit into radiologists’ workflow remains an open question, but it could replace one of the initial readers, says Stefan Bunk, chief technology officer and cofounder of Vara, the health care technology company in Berlin that developed the AI. “This discussion should now start.”
