Automated Software Evaluation in Screening Mammography: A Scoping Review of Image Quality and Technique Assessment

Standardised breast positioning and optimal compression are critical components of effective breast cancer screening. This scoping review aims to report the current landscape of automated software tools developed for image quality assessment and mammographic technique evaluation, and to examine their reported impact.

A scoping review was undertaken across PubMed (MEDLINE), Scopus, and Emcare. Eligible studies were published between January 2014 and March 2025 and investigated the use of automated software or artificial intelligence-based tools to assess image quality, breast positioning, or compression in mammography or digital breast tomosynthesis.

Automated software was predominantly utilised in high-resource settings, where it provided benchmarked feedback, reduced the subjectivity inherent in traditional visual grading systems, and supported radiographer learning and skill development with measurable improvements. However, radiographer training in these systems, the impact of software on clinical workflow, and barriers to implementation, particularly in low-resource settings, were insufficiently addressed in the literature. Furthermore, no studies reported on the relationship between software-generated metrics and breast cancer screening outcomes.

Automated software for image quality evaluation represents a significant advancement in breast screening, illustrating the potential of technology to strengthen the screening-to-treatment continuum in breast cancer care. Nonetheless, widespread adoption requires evidence that these tools directly contribute to improved cancer detection outcomes to justify their uptake.