Artificial Intelligence Brings Revolutionary Change to Breast Cancer Screening

Imagine scanning through tens of thousands of black-and-white images a day, hunting for a needle in a haystack. Your eyes are strained and fatigued, your concentration on the verge of cracking. Yet you persevere because as a breast radiologist, lives depend on your vigilance and precision, and you only get the opportunity once a year to say yes or no to the mammogram.  

That’s what it was like being a breast radiologist prior to artificial intelligence.  

But as early adopters of AI, today’s breast radiologists at Lynn Women’s Health & Wellness Institute and Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health, have already been transforming patient care for years.  

“Every single day, I am grateful that I am working with artificial intelligence to help me in assessing the findings on mammograms,” says breast radiologist Kathy Schilling, M.D., FACR, medical director of Lynn Women’s Health & Wellness Institute. “Not only are we finding more cancers, we are also finding them earlier and we are decreasing the number of false positives.” 

Getting More Out of Your Mammogram

AI flags subtle abnormalities that might otherwise escape even the most experienced eyes and prompts radiologists to investigate further. “When it identifies an abnormality on the mammogram, it will encircle it so that we know exactly where it’s located,” Dr. Schilling said. “Then we take a closer look.” 

Approximately 40 million screening mammograms are performed in the U.S. each year, according to the U.S. Food and Drug Administration. Mammography remains the gold standard screening technology for breast cancer, which is the second-most deadly cancer in women.  

As mammography technology has advanced over the last decade, it has created a tremendous demand on breast radiologists, who are in short supply. In 2014, for example, the move from 2D to 3D mammography increased the number of images for each patient from four to up to 300, Dr. Schilling said. Keeping up with the volume was nearly impossible. 

But when Dr. Schilling began using AI in 2020, she knew she’d found what she calls her “co-pilot.” 

It’s the partnership between human expertise and machine intelligence that has made a difference in care, she said. In addition to locating a suspicious lesion, AI also categorizes it, giving it a score from 1 to 100.  

“The higher the number, the more likely we’re dealing with a malignancy,” she explained. “But it’s up to the radiologist to bring the knowledge that we have about the specific patient. It’s not just black and white. The computer says yes, there’s something or no, there’s not, but the radiologist knows the patient — what her risks are, whether she’s had cancer before, her co-morbidities, her age, if she is frail. We bring the human aspect to care.” 

AI-Enhanced Mammograms Make a Real Difference

As a physician-scientist, Dr. Schilling always looks for scientific evidence to support the use of new technology. She began researching the Institute’s results while using AI. At the time of the study, the Institute had nine dedicated breast radiologists, with an average of 22 years of experience. With AI, the radiologists: 

• Increased cancer detection by 23 percent 

• Caught many small cancers — 3 or 4 mm  

• Found 33 percent more cancers in patients with dense breasts, which make it more difficult to identify abnormalities 

• Discovered 100 percent more invasive lobular cancers, which are difficult to detect because they do not form a typical discrete mass localized in the breast but infiltrate single file through the breast. “Finding these cancers early is important because when they present late, outcomes tend to be poor because they are much larger and more difficult to treat due to delay in diagnosis,” Dr. Schilling said.  

• Outcomes were realized without a change in recall rate 

“By adding this technology to our toolbox, we are making huge leaps. We are finding cancers years earlier than before. It’s a win-win for all of us,” Dr. Schilling said. 

Know Your Risk Factors for Breast Cancer

Every woman should have a conversation with her primary care physician or OB/GYN by age 30 about her risk factors for breast cancer. The talk should occur earlier for those with a family history, known genetic mutation or other concern that may predispose them to cancer, she said.  

For women at average risk of breast cancer, the current guidelines by the American College of Radiology and American Society of Breast Surgeons recommend that annual screening begin at age 40.

VisitBaptistHealth.net/Mammo to learn more or schedule your breast cancer screening this Breast Cancer Awareness Month.

Kathy Schilling, M.D., FACR, breast radiologist and medical director of Lynn Women’s Health & Wellness Institute at Boca Raton Regional Hospital, part of Baptist Health