Today marks the 114th International Women’s Day celebration. In the United States and other developed countries, we no longer live in a society where women are explicitly held back. The Prime Minister of Italy, the CEO of the New York Times Company, four of nine U.S. Supreme Court justices, and the Vice President of the United States are all women. They occupy board seats, they innovate, and they run companies. But across the globe there are healthcare limitations that still prevent many women from reaching their full potential.
Women’s health is hungry for more innovation, investment, and advocacy. AI adoption holds promise for more and better healthcare. In the specialty of breast care, early detection and personalized risk stratification are helping move the needle for women to lead longer, healthier, and more productive lives.
Advances in breast care prevention, screening, and intervention may join the ranks of conditions like diabetes, heart disease, and stroke that often come to mind as “preventable” with lifestyle modifications and behaviors.
Breast cancer rates in women are rising at an alarming rate.1 The current “one size fits all” approach to screening and risk stratification is a vestige of a less sophisticated time. Personalized medicine and AI can no longer be relegated to drug therapy and diagnostics. We have gotten very good at treating cancer, but we are not nearly as sophisticated when it comes to early detection and prevention.2 Early detection and prevention for women must be our next frontier. Large scale studies, like WISDOM,3 present a cogent case for risk-based stratification and screening. But even these approaches only start to assess risk when a woman is in her late 30’s or early 40’s. It is time to change that approach.
The American College of Radiology and many experts from other specialties adamantly support breast cancer screening starting as early as age 25 for certain higher-risk women. We have sophisticated technologies that can be seamlessly integrated into each woman’s electronic health records (EHR), but providers and health systems are not widely adopting those technologies. This reticence is costing lives.
Volpara’s Risk Pathways4 allows providers to identify, manage, and track high-risk women through a wellness or annual exam before they reach the average age for mammography. Using an EHR to document and update risk status and personalized recommendations on a patient’s record helps ensure that her overall care includes consideration of her risk for breast and other cancers to ensure that she has, and adheres to, a personalized screening and prevention regimen. With visibility to all a woman’s providers it is far less likely that she will slip through the cracks or fall victim to a “one-size-fits-all” approach to cancer prevention. But this is not happening on a widespread scale.
Lunit’s AI-supported, image-based technology offers a second line of defense that can detect breast tissue patterns that are undetectable by the human eye. This extra layer of analysis on a screening mammogram offers radiologists deeper insights while offering patients invaluable peace of mind that each screening is thorough, accurate, and reliable. If we utilize two of the best available breast imaging technologies — Volpara’s Risk Pathways and Lunit’s AI for earlier cancer detection — we can create truly personalized screening and prophylactic care regimens that will save more and younger women’s lives across the globe.
For me, personally, this rings very true. In 1970 my maternal grandmother was 33 years old. She was diagnosed with late-stage breast cancer and given six months to live5. My mother was 12 at the time. My mother, Dr. Rachel Brem, became a zealous radiologist exclusively focused on breast cancer detection and improved patient outcomes. She diagnosed her own breast cancer at age 37 — I was 12. I was determined to do everything in my power to write a different story. I did not want to be the third generation of women in my family to get breast cancer in their 30’s. I had prophylactic mastectomies at age 30. For my four daughters, I want even better.
As a community of women, and men who care about them, let’s use this International Women’s Day and this Women’s History Month as an impetus to spur real change for women’s breast care. Early stage breast cancer has become a virtually curable disease. If more women can understand their risk, personalize their care, access the latest AI innovations for detection and ultimately, rise from their breast cancer diagnoses to live long, healthy lives — like my mother and grandmother — we will all benefit. The time is now to make change that will last a lifetime.
References:
1. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2814306
2. https://www.wsj.com/articles/whos-afraid-of-early-cancer-detection-grail-fda-approval-94f071a9
3. https://pubmed.ncbi.nlm.nih.gov/28130475/
4. https://www.volparahealth.com/news/volpara-health-receives-fda-clearance-for-next-generation-breast-density-algorithm-and-architecture/
5. She beat the odds and lived another 43 years and died in her 70’s cancer-free.
