International – Use of artificial intelligence for image analysis in breast cancer screening programmes: systematic review of test accuracy

Breast cancer is a leading cause of death among women worldwide. Approximately 2.4 million women were diagnosed with breast cancer in 2015, and 523 000 women died. Breast cancer is more amenable to treatment when detected early, so many countries have introduced screening programmes. Breast cancer screening requires one or two radiologists to examine women’s mammograms for signs of presymptomatic cancer, with the aim of reducing breast cancer related morbidity and mortality. Such screening is also associated with harms, such as overdiagnosis and overtreatment of cancer that would not have become symptomatic within the woman’s lifetime. Disagreement exists about the extent of overdiagnosis, from 1% to 54% of screen detected cancers, and about the balance of benefits and harms of screening. The spectrum of disease detected at screening is associated with outcomes. For example, detection of low grade ductal carcinoma in situ is more associated with overdiagnosis, whereas detection of grade 3 cancer is more likely to be associated with fewer deaths. Cancer is detected in between 0.6% and 0.8% of women during screening…