Artificial intelligence for the real world of breast screening

Breast cancer screening with mammography reduces mortality in the women who attend by detecting high risk cancer early. It is far from perfect with variations in both sensitivity for the detection of cancer and very wide variations in specificity, leading to unnecessary recalls and biopsies. Over the last 12 months several papers have reported on AI algorithms that perform as well as human readers on large well curated population data sets. The nature of the test sets, the way the gold standard has been calculated, the definition of a positive call, and the statistics used all influence the results. Historically retrospective studies have not predicted the real-life performance of radiologist plus machine. So, it is important to perform prospective studies before introducing Artificial intelligence into real world breast screening.