How technology is changing the detection of breast cancer

Dr. Rachel Brem decided at age 12 that she wanted to cure cancer after her mom was diagnosed with breast cancer. It was early detection that led to her mother living way past her prognosis of six months. Now, Brem is working to improve breast cancer screening for all women.

Brem is a board-certified diagnostic radiologist and director of Breast Imaging and Intervention at George Washington University. She created the Brem Foundation to help prevent breast cancer from taking more lives. 

On this week's episode of "Healthful," she discussed the innovation that makes her hopeful.

Artificial intelligence and breast imaging

"AI is going to change everything in medicine, and certainly breast cancer detection," Brem said.

In addition to her work with George Washington University's Breast Imaging and Intervention unit, Brem collaborates with ScreenPoint Medical to develop Transpara, an AI breast cancer screening software.

Already there is significant scientific research showing mammograms paired with AI evaluations "can find cancer up to five years earlier," she said, by detecting warning signs in women that might be missed with just mammograms alone. The software can also predict future risk of breast cancer even when none is detected in a mammogram.

"Imagine what the impact of that is going to be on survival therapy," Brem said.

If women begin getting screened at age 35 with AI-enhanced readings, she noted the software will constantly teach itself how to improve in detecting breast cancer with each analysis. That's younger than the starting age recommended by several major medical organizations.

At George Washington University, Brem said, "we've been using AI for over four years in every mammogram," adding that using the software does not cost extra.

The FDA has cleared some AI technology to predict risk of or detect breast cancer. 

However, nationwide, just 20% of practices use AI with their mammogram procedures. Often, the AI readings cost extra, which may make the option inaccessible for some.

"There is nothing you can do to absolutely prevent breast cancer," Brem acknowledged.

But she said, "One of the things AI can do is really equalize the inequalities," referring to the racial disparities that affect diagnosis and treatment for many women.

"Black women die at a 40% higher rate [from breast cancer] than White women," Brem noted, and women with fewer resources have less access to mammograms.  

Brem wants to change this with her foundation, which for the past 20 years has championed early detection  through innovative screening, increased education and awareness, and equitable access.

"I look forward to the more wide-reaching implementation of AI to help not only find more cancers, but with healthcare," she said.

A breast cancer breath test?

Brem is helping to develop a breath test that could detect breast cancer. Diseased tissues give off a chemical compound that becomes gas and, scientists believe, could be used as a noninvasive way to assess who needs further screening. 

These tests are still in the experimental and clinical trial phases. They are not cleared by the FDA for screening.  

"It's not available yet, but I'm really excited about having no pain, no compression, and no injection way of diagnosing if you're accurately diagnosed," Brem said.  

And there's hope it could someday help beyond breast cancer. "The next step on our roadmap is not just breast cancer but a women's health panel where you could do one breath and get all these tests done," Brem said. 

The current state of breast cancer screening

The guidelines from the American College of Physicians stated in 2026 that women over the age of 50 should get a mammogram every other year. The United States Preventive Services Task Force recommends that women should start screening every other year at the age of 40. 

To Brem, "This is a travesty."

"Women will die if they listen to that."

From her research, women should get checked for breast cancer annually starting at the age of 40. For those with a history of breast cancer in their family, they should start at 35.

This is all easier said than done. Women often cite anxiety as a reason they delay or skip getting screened. The thought of receiving a positive test result understandably makes women nervous, but as Brem notes, "We don't get rid of the disease by not knowing we have it."

Early detection of breast cancer leads to significantly better outcomes compared to cases where breast cancer is found in its later stages. 

"Ninety-nine percent of women with early breast cancer survive and thrive," Brem said, but this outcome can only be possible if women screen for it early and regularly.

In addition to the recommended mammograms, Brem also believes "you absolutely, unequivocally definitely need more exams" if you have dense breasts. Half of women have dense breasts, and mammograms might not be able to pick up potentially deadly tumors hiding behind the tissue. Ultrasounds, MRIs or contrast-enhanced mammograms are necessary for those with dense breasts to get a complete view of their risks.

Supplemental screening isn't always standard with some doctors. Brem advised that it is "really important" for women to insist that their doctors order these extra exams. The mammograms are not enough.

Demand more, get educated, and "be badass"

Brem is adamant in her belief that women can be proactive now to better their health and improve their breast cancer outcomes. If you have dense breasts, demand additional screening. 

For those under 40 who think they have time until they need to start screening for breast cancer, think again.

"You're not too young to have breast cancer," Brem warns.

Having the conversation now about your plan for breast cancer screenings and seeking out additional exams is essential in early detection and better prognosis. "If you find it early, even if you're young, it's curable," Brem said.

Rates of cancer are rising in younger women and awareness is the first step to being proactive about your health. Her foundation provides resources to educate women. 

But what do you do with this information? Brem urges you to advocate for yourself at the doctor's office.

"We tell women to be badass," she said. "You need to advocate for yourself. It is a fundamental principle. It's your right. It's what you deserve, and it's not a maybe."