NEW DELHI: Breast cancer, the most common cancer in women globally, including in India, where it tops women-centric cancers, can now be predicted early after new global guidelines recommending integrating artificial intelligence into breast cancer screening.
The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 33 cancer treatment centers in the US, has recommended that women should be eligible for “AI-powered mammogram risk assessments” starting at age 35, instead at a later age.
The aim is to predict more accurately patients’ unique risk of breast cancer, and adjust their screening protocols accordingly.
According to Dr Raman Narang, MOC Cancer Care and Research Centre, New Delhi, the current change in breast cancer screening guidelines globally, especially the addition of artificial intelligence as an aid for risk prediction, marks a paradigm shift from a 'detection first' to a 'prediction first' approach.
He explained that historically, mammograms were used starting from the age of 40 years to detect existing cancers. “In contrast, modern guidelines recommend that women aged 35 years be screened using AI algorithms to predict their future risk.”
He said for India, this shift holds much significance.
Dr Narang said in India, breast cancer is the most prevalent cancer among women with delayed diagnosis being one of the leading causes of mortality in such cases.
“What makes breast cancer such a big problem here is the delay in diagnosis caused by low awareness, unavailability of screening facilities, and no risk stratification.”
He added that AI-powered screening has the potential to bridge this gap in several ways.
To start with, he said, it will facilitate the identification of high-risk patients regardless of whether there is any family history of the disease or the presence of genetic markers since most cases of breast cancer do not come with any of these features.
It will also provide for screening in a way that does not require universal testing, he added.
Dr Jyoti Arora, Principal Lead, Women's Imaging, Apollo Athenaa Women’s Cancer Centre, said breast cancer screening is entering a transformative phase with the inclusion of AI-based risk assessment in emerging guidelines.
“Traditionally, screening recommendations have relied heavily on age and family history. However, artificial intelligence can now analyze large volumes of imaging data, breast density, genetic factors, and clinical history to generate a more personalized risk profile for each individual.”
“The adoption of AI-driven risk assessment marks a significant step toward precision medicine in breast cancer care, promising earlier detection, optimized resource utilization, and ultimately, better patient outcomes,” she said.
She said this shift enables a move from a “one-size-fits-all” approach to personalized screening strategies.
“Women at higher risk may benefit from earlier and more frequent screening, including advanced modalities such as MRI, while those at lower risk can avoid unnecessary interventions and anxiety,” she added.
She cited an example of Mirai AI breast cancer risk model, developed at MIT, which predicts a woman’s risk of developing breast cancer up to five years in advance using mammographic data alone.
Unlike traditional models, it has shown consistent performance across diverse populations, addressing a key limitation of earlier risk tools, she said.
The use of AI-based breast cancer risk assessment from age 35 using mammograms was also recommended by global experts, who published the evidence in the Lancet journal. They said that it showed “consistently favourable outcomes.”