Enhancing detection of previously missed non-palpable breast carcinomas through artificial intelligence

To investigate the impact of artificial intelligence (AI) reading digital mammograms in increasing the chance of detecting missed breast cancer, by studying the AI- flagged early morphology indictors, overlooked by the radiologist, and correlating them with the missed cancer pathology types.

Mammograms done in 2020-2023, presenting breast carcinomas (n = 1998), were analyzed in concordance with the prior one year's result (2019-2022) assumed negative or benign. Present mammograms reviewed for the descriptors: asymmetry, distortion, mass, and microcalcifications. The AI presented abnormalities by overlaying color hue and scoring percentage for the degree of suspicion of malignancy.

Prior mammogram with AI marking compromised 54 % (n = 555), and in the present mammograms, AI targeted 904 (88 %) carcinomas. The descriptor proportion of "asymmetry" was the common presentation of missed breast carcinoma (64.1 %) in the prior mammograms and the highest detection rate for AI was presented by "distortion" (100 %) followed by "grouped microcalcifications" (80 %). AI performance to predict malignancy in previously assigned negative or benign mammograms showed sensitivity of 73.4 %, specificity of 89 %, and accuracy of 78.4 %.

Reading mammograms with AI significantly enhances the detection of early cancerous changes, particularly in dense breast tissues. The AI's detection rate does not correlate with specific pathological types of breast cancer, highlighting its broad utility. Subtle mammographic changes in postmenopausal women, not corroborated by ultrasound but marked by AI, warrant further evaluation by advanced applications of digital mammograms and close interval AI-reading mammogram follow up to minimize the potential for missed breast carcinoma.