AI Is Catching Breast Cancer Years Earlier, but Access Remains Uneven, Doctor Says

With Breast Cancer Awareness Month entering its final weeks, a George Washington University radiologist says artificial intelligence is already reading mammograms years before a tumor becomes visible to the human eye, even as access to the technology and official screening guidance remain uneven across the country.

Dr. Rachel Brem, director of Breast Imaging and Intervention at George Washington University, told CBS News that she has spent more than two decades pushing for earlier breast cancer detection, a mission she traces to her own mother's early-stage diagnosis decades ago. Her hospital has run artificial intelligence over every mammogram performed there for more than four years, at no added cost to patients, using Transpara, software built by the Dutch company ScreenPoint Medical. The tool scans 2D and 3D mammograms as a "second pair of eyes" for radiologists, flagging subtle patterns and estimating a patient's future cancer risk even when no mass is visible yet.

Brem says the technology, which continues to improve as it analyzes more scans, can identify cancer risk markers roughly five years before a tumor would otherwise appear on a standard mammogram, a gap that can be the difference between a routine excision and advanced-stage treatment.

Access remains limited

Despite that promise, only about one in five U.S. mammography practices currently uses AI alongside screening, according to Brem, largely because many clinics charge patients an extra fee for the AI reading. That unevenness compounds existing disparities: Black women die of breast cancer at a rate roughly 40% higher than white women, Brem said, a gap tied to later-stage diagnoses and unequal access to supplemental imaging. Dense breast tissue, which affects roughly half of all women and can hide tumors on a standard mammogram, is a related blind spot; Brem urges women with dense breasts to ask their doctors for added imaging such as ultrasound, MRI or contrast-enhanced mammography.

Guidance on when to start screening remains split. The U.S. Preventive Services Task Force recommends mammograms every other year beginning at age 40, while the American College of Physicians updated its own guidance this year to recommend biennial screening starting at 50 for average-risk women. Brem said she advises patients to start annual mammograms at 40, or at 35 for those with a family history of the disease, calling the later timelines a risk she is not willing to recommend to her own patients.

"We don't get rid of the disease by not knowing we have it," Brem said. "Women will die if they listen to that."

A noninvasive test in development

Brem is also helping develop a breath test that would screen for breast cancer without compression, pain or injection, by measuring chemical compounds released into exhaled air by diseased tissue. The test, run through her nonprofit, the Brem Foundation to Defeat Breast Cancer, is still in development and is not yet available to patients. Brem's longer-term goal is a single breath sample that could screen for several women's health conditions at once.

For now, she says, the message is a simple one: caught early, breast cancer is rarely a death sentence. "Ninety-nine percent of women with early breast cancer survive and thrive," Brem said, arguing that the real-world gap in outcomes has less to do with the disease itself than with how late, and how unevenly, it tends to be found.