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AI-supported breast screening improves cancer detection rate
New research shows using AI for mammograms improves early detection of breast cancers but warns this ‘must be done cautiously’.
Women who had received an AI-assisted mammogram were also 12% less likely to be diagnosed with breast cancer in the years after their screen.
The use of artificial intelligence (AI) for routine mammograms is helping detect more cancers and leading to fewer diagnoses being made between screens, according to international research.
Published in The Lancet, the study involved 100,000 women in Sweden undergoing routine mammograms from 2021–22.
Women were recruited across four sites and were randomly assigned to either AI-supported mammography screening (intervention arm) or to standard double reading by radiologists without AI (control arm).
Double reading, where two radiologists read each mammogram, is standard practice in European screening programmes.
In the intervention arm, a specialist AI system analysed the mammograms and triaged low-risk cases to single reading and high-risk cases to double reading performed by radiologists. AI was also used as detection support to the radiologists, in which it highlighted suspicious findings in the image.
Results showed that AI-assisted mammograms picked up more cancers without increasing false positives.
Women who had received an AI-assisted mammogram were also 12% less likely to be diagnosed with breast cancer in the years after their screen, which the researchers describe as an important indicator that the mammograms were not missing anything.
At the two-year follow up, there were 1.55 interval cancers per 1000 women in the AI-supported mammography group, compared to 1.76 interval cancers per 1000 women in the control group.
Additionally, there were 16% fewer invasive, 21% fewer large, and 27% fewer aggressive sub-type cancers in the AI group compared to the control arm.
In the AI-supported mammography group, 81% of cancer cases were detected at screening, compared to 74% of cancer cases in the control group.
The rate of false positives was similar for both groups, at 1.5% in the intervention group and 1.4% in the control group.
Lead author Dr Kristina Lång said the study is the first randomised controlled trial investigating the use of AI in breast cancer screening and the largest to date looking at AI use in cancer screening in general.
‘It finds that AI-supported screening improves the early detection of clinically relevant breast cancers which led to fewer aggressive or advanced cancers diagnosed in between screenings,’ she said.
‘However, introducing AI in healthcare must be done cautiously, using tested AI tools and with continuous monitoring in place to ensure we have good data on how AI influences different regional and national screening programmes and how that might vary over time.’
Researchers emphasised that their study does not support replacing healthcare professionals with AI, as the AI-supported mammography screening still requires at least one human radiologist to perform the screen reading with support from AI.
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