Dr. Rachel Brem on Advancements in Breast Cancer Detection

Dr. Rachel Brem’s passion for breast cancer research started at a young age when her mother was diagnosed with the disease. Early detection allowed her mother to outlive a six-month prognosis. Today, as a board-certified diagnostic radiologist and director of Breast Imaging and Intervention at George Washington University, Brem is dedicated to improving breast cancer screening.

Innovative AI in Breast Cancer Screening

Artificial intelligence (AI) is revolutionizing breast cancer detection. Brem collaborates with ScreenPoint Medical on Transpara, a software that pairs mammograms with AI assessments. Research shows this combination can detect cancer up to five years earlier by identifying warning signs that mammograms might miss alone. Notably, the software can assess future breast cancer risk.

Brem advocates for screening to start at age 35 with AI-enhanced readings, allowing the software to improve continuously. At George Washington University, they’ve used AI for over four years in every mammogram at no additional cost. Yet, nationwide AI use in mammograms remains low, often resulting in additional charges. This limits accessibility for some.

AI’s Role in Addressing Inequities

Brem acknowledges that absolute prevention of breast cancer isn’t possible. However, AI can help reduce racial disparities in diagnosis and treatment. African American women face a 40% higher mortality rate from breast cancer compared to White women. Brem’s foundation aims to change this through early detection initiatives, education, awareness, and equitable access.

A Potential Breath Test for Detection

Brem is involved in developing a breath test to detect breast cancer. Diseased tissues release a gas-forming compound, which could serve as a noninvasive diagnostic tool. While not yet available, Brem is optimistic about its potential to offer painless screenings and aid broader women’s health assessments. A single breath test could eventually offer multiple health insights.

Current Challenges in Screening Protocols

The American College of Physicians recommends biennial mammograms for women over 50, while the U.S. Preventive Services Task Force suggests starting at 40. Brem criticizes these guidelines, asserting that annual screenings should begin at 40, or even 35 for those with family history. Anxiety often leads women to delay screenings, but Brem emphasizes that early detection is crucial. Early-stage breast cancer has a 99% survival rate.

Brem highlights the importance of additional screenings for women with dense breasts, which affects half of women. Traditional mammograms might miss tumors obscured by dense tissue. MRIs, ultrasounds, or contrast-enhanced mammograms are necessary for these women. Not all doctors recommend these supplemental exams routinely, so Brem advises women to insist on them.

Empowerment Through Advocacy

Brem encourages women to take control of their health and demand appropriate screenings, especially if they have dense breasts. She dispels the misconception that young women are too young for breast cancer, stressing the importance of early and proactive measures. Her foundation provides educational resources, urging women to advocate for themselves in medical settings. Assertively seeking out necessary exams and discussing screening plans with doctors is fundamental.