Mammography Symposium 2025

Artificial intelligence (AI) is rapidly transforming breast imaging, offering significant advancements across various modalities and stages of patient care. Its integration aims to enhance diagnostic accuracy, improve workflow efficiency, personalize patient management, and ultimately lead to better outcomes in breast cancer detection and treatment.

How AI is Transforming Breast Imaging

AI, particularly through machine learning and deep learning algorithms, analyzes complex patterns in large datasets of medical images. This capability allows AI to assist human readers and even perform certain tasks with high accuracy, often beyond the capabilities of the unaided human eye.

Here's a breakdown of AI's impact across different aspects of breast imaging:

• Enhanced Cancer Detection and Diagnosis:

  • What it does: AI algorithms are trained on vast numbers of mammograms, ultrasounds, and MRIs to identify subtle lesions, microcalcifications, masses, and architectural distortions that might be missed by human readers, especially in dense breast tissue. AI tools can act as a "second reader" or triage system, highlighting suspicious areas for radiologists to review more closely.

  • Impact: Increased sensitivity for breast cancer detection, particularly for subtle and interval cancers (cancers detected between screenings). Studies show AI can improve radiologists' performance by guiding their attention to relevant regions and potentially reducing recall rates.

  • URLs:

    • AI Helps Radiologists Spot More Lesions in Mammograms - RSNA

    • AI-Supported Mammography Screening Leads to Increased Breast Cancer Detection Rate - Cancer Network

    • AI could help improve early detection of breast cancers between screenings, UCLA-led study shows

• Improved Workflow Efficiency and Reduced Radiologist Workload:

  • What it does: AI can rapidly analyze studies, identify "normal" exams with high confidence, and prioritize suspicious cases for immediate radiologist review. This can significantly reduce the workload for radiologists, allowing them to focus on more complex cases.

  • Impact: Faster interpretation times, increased screening capacity, and optimized use of radiologist expertise, especially beneficial in areas with a shortage of trained breast radiologists.

  • URL:

    • AI successfully helps detecting more breast cancers around Danish capital - Københavns Universitet

    • New Frontiers in Breast Cancer Imaging: The Rise of AI - MDPI

• Automated Breast Density Assessment:

  • What it does: AI algorithms can accurately and consistently assess breast density from mammograms, an important risk factor and factor affecting mammogram sensitivity. This automates a previously subjective human assessment.

  • Impact: More consistent and reproducible breast density reporting, which is now a mandated element of MQSA. This facilitates more precise risk assessment and personalized screening recommendations.

  • URL:

    • New Study Explores the Role of AI in Tracking Breast Density - Mallinckrodt Institute of Radiology - WashU Medicine

    • Artificial Intelligence (AI) for Screening Mammography, From the AJR Special Series on AI Applications - American Journal of Roentgenology (Includes a section on Breast Density Assessment).

• Breast Cancer Risk Assessment:

  • What it does: AI can analyze imaging features (e.g., breast tissue patterns, density, subtle asymmetries) along with clinical data to predict a woman's short-term or lifetime risk of developing breast cancer more accurately than traditional models.

  • Impact: Enables truly personalized, risk-adapted screening strategies, allowing for targeted supplemental imaging (like MRI) for high-risk individuals and potentially reducing unnecessary screening for low-risk individuals.

  • URLs:

    • AI Risk Assessment for Breast Cancer - iCAD, Inc.

    • FDA approves first AI tool to predict breast cancer risk | FOX 13 Seattle

• Applications Across Modalities (Mammography, Ultrasound, MRI):

  • Mammography (2D and DBT): AI tools are widely used for computer-aided detection (CADe) and diagnosis (CADx), improving lesion detection and characterization.

  • Ultrasound: AI can assist in lesion detection, classification (benign vs. malignant), and reducing inter-operator variability in ultrasound exams.

  • MRI: AI accelerates image processing, helps with lesion segmentation, reduces interpretation times, and enhances confidence in differentiating lesions. Emerging AI tools can also identify women who might benefit from supplemental breast MRI after a negative mammogram.

  • URLs:

    • New Frontiers in Breast Cancer Imaging: The Rise of AI - MDPI

    • Using AI to Select Women with Intermediate Breast Cancer Risk for Breast Screening with MRI | Radiology - RSNA Journals

    • AI-Assisted Technique Offers Safe, Effective, Painless Breast Imaging Alternative - Caltech (Discusses PACT, a novel imaging technique using AI).

• Beyond Imaging Interpretation (Pathology and Treatment Planning):

  • Pathology: AI can analyze digital pathology slides to assist in tumor grading, classification of breast cancer subtypes, detection of lymph node metastases, and quantification of biomarkers (e.g., HER2, Ki-67), improving diagnostic accuracy and precision.

  • Treatment Planning: AI can help predict patient response to neoadjuvant chemotherapy, identify the risk of upstaging from DCIS to invasive carcinoma, and assist in preoperative 3D modeling for surgical planning and reconstructive techniques.

  • URLs:

    • Advances in Breast Cancer Care: The Role of Artificial Intelligence and Digital Pathology in Precision Medicine - European Journal of Breast Health

    • Artificial intelligence in breast pathology: overview and recent updates - PubMed

    • Artificial intelligence for cancer detection and treatment planning | St. David's HealthCare

Key Considerations and Future Directions:

While AI offers immense potential, ongoing research focuses on:

• Validation: Rigorous validation of AI models in diverse, real-world clinical settings to ensure generalizability and prevent biases.

• Explainable AI (XAI): Developing AI models that can explain their decisions to foster trust and facilitate human oversight.

• Integration into Workflow: Seamless integration of AI tools into existing clinical workflows to maximize efficiency without disrupting practice.

• Regulatory Approval: Navigating the regulatory landscape for AI-driven medical devices (like FDA approvals in the US).

The synergistic effect between human radiologists and AI systems holds the most promise, leading to improved patient care and potentially transforming the future of breast cancer management.

Source: Google Gemini

Research from PubMed:

Items 1-10 of 10 (Display the 10 citations in PubMed)

Presenting a mammography case effectively is crucial for clinical decision-making, peer review, and educational purposes. It requires a structured approach to convey all pertinent information concisely.

Here's a breakdown of case presentation fundamentals in mammography, with relevant links and URLs:

Case Presentation Fundamentals in Mammography

A strong mammography case presentation typically follows a logical flow, ensuring all critical information is covered for accurate assessment and recommendations.

1. Patient Demographics and Clinical Context:

   • What to include: Patient's age, relevant medical history (e.g., personal or family history of breast cancer, prior biopsies, surgeries, hormone replacement therapy, breast symptoms).

   • Why it's important: Provides context for interpreting the images and assessing risk.

   • URL (General Patient History Relevance): While no single URL dictates "how to present patient demographics," the importance of clinical history is emphasized in practice guidelines.

     • ACR Practice Parameter for the Performance of Screening and Diagnostic Mammography (Section on Clinical Information/Patient History)

2. Reason for Examination:

   • What to include: Was it a screening mammogram (routine check-up for asymptomatic women) or a diagnostic mammogram (investigating symptoms like a palpable lump, pain, nipple discharge, or follow-up from an abnormal screening)?

   • Why it's important: Guides the extent of the examination and subsequent work-up.

3. Prior Imaging Comparison:

   • What to include: Always compare with prior mammograms, and if available, prior ultrasound or MRI studies. Note the date of the most recent comparison.

   • Why it's important: Crucial for assessing stability, growth, or new findings. Changes are often the most significant indicator of pathology.

   • URL (Importance of Prior Imaging):

     • ACR Practice Parameter for the Performance of Screening and Diagnostic Mammography (Section on Comparison with Prior Mammograms)

4. Imaging Findings - Description:

   • What to include: Systematically describe any findings using standard mammographic terminology, often following the ACR BI-RADS lexicon.

     • Location: Quadrant (e.g., Upper Outer Quadrant - UOQ, Lower Inner Quadrant - LIQ), clock face position (e.g., 2 o'clock), and depth (anterior, middle, posterior).

     • Views: Specify the views on which the finding is seen (e.g., seen on MLO and CC views).

     • Masses: Shape (round, oval, irregular), Margin (circumscribed, microlobulated, obscured, indistinct, spiculated), Density (high, equal, low, fat-containing).

• Calcifications: Type (pleomorphic, amorphous, fine linear branching, punctate, coarse), Distribution (diffuse, regional, clustered, segmental, linear).

• Architectural Distortion: Description of any distortion without an associated mass.

• Asymmetry: Description of focal, global, or developing asymmetry.

• Associated Features: Skin retraction, nipple retraction, skin thickening, trabecular thickening, lymphadenopathy.

  • Why it's important: Provides a clear and consistent description of abnormalities.

  • URL (ACR BI-RADS Atlas – Lexicon):

    • ACR BI-RADS® Atlas - American College of Radiology

    • ACR BI-RADS® Atlas, 5th Edition – Mammography Lexicon (PDF link usually available via Google search for "ACR BI-RADS Atlas 5th Edition pdf") (Direct PDF link to the lexicon summary for quick reference)

1. Assessment (BI-RADS Category):

   • What to include: Assign the appropriate BI-RADS assessment category based on the likelihood of malignancy.

     • BI-RADS 0: Incomplete

     • BI-RADS 1: Negative

     • BI-RADS 2: Benign

     • BI-RADS 3: Probably Benign

     • BI-RADS 4: Suspicious (A, B, C subcategories)

     • BI-RADS 5: Highly Suggestive of Malignancy
     • BI-RADS 6: Known Biopsy-Proven Malignancy

   • Why it's important: Standardizes the interpretation and guides management recommendations.

   • URL (ACR BI-RADS Categories):

     • ACR BI-RADS® Atlas - American College of Radiology

2. Recommendations:

   • What to include: Clear recommendations for next steps, based on the BI-RADS assessment.

     • For BI-RADS 0: Recommend additional imaging (e.g., spot compression, magnification views, ultrasound) or comparison with prior studies.

     • For BI-RADS 3: Recommend short-interval follow-up (e.g., 6 months).

     • For BI-RADS 4/5: Recommend biopsy (e.g., core needle biopsy, excisional biopsy).

     • For BI-RADS 1/2: Recommend routine screening.

     • For BI-RADS 6: Recommend appropriate definitive treatment (e.g., surgical excision).

   • Why it's important: Provides actionable guidance for patient management.

   • URL (General Mammography Guidelines and Recommendations):

     • American Cancer Society Recommendations for Breast Cancer Screening

     • Society of Breast Imaging (SBI) - Guidelines and Statements

3. Summary/Impression:

   • What to include: A concise summary of the most significant findings and the final BI-RADS assessment.

   • Why it's important: Offers a quick overview of the case for other clinicians.

Additional Resources for Mammography Professionals:

• Society of Breast Imaging (SBI): Offers numerous educational resources, webinars, and guidelines for breast imaging professionals.

  • Society of Breast Imaging | SBI

• RadiologyInfo.org: Patient-friendly information on mammography, often useful for explaining procedures to patients.

  • Mammography (Mammogram): Early detection of breast disease. - Radiologyinfo.org

• FDA Mammography Quality Standards Act (MQSA): Essential for understanding regulatory compliance in mammography.

  • Mammography Quality Standards Act (MQSA) - FDA

Source: Google Gemini

• What are the essential components of a mammography case presentation?
• What are the best practices for structuring a mammography case presentation for peer review?
• Mammography case presentation guidelines ACR
• SBI mammography case presentation resources
• BI-RADS lexicon official guide
• Mammography reporting standards
• Breast imaging clinical history importance

Presenting a mammography case effectively is crucial for clinical decision-making, peer review, and educational purposes. It requires a structured approach to convey all pertinent information concisely.

Case Presentation Fundamentals in Mammography

A strong mammography case presentation typically follows a logical flow, ensuring all critical information is covered for accurate assessment and recommendations, often adhering to standards like those set by the American College of Radiology (ACR) and utilizing the Breast Imaging-Reporting and Data System (BI-RADS) lexicon.

1. Patient Demographics and Clinical Context:
   • What to include: Patient's age, relevant medical history (e.g., personal or family history of breast cancer, prior biopsies, surgeries, hormone replacement therapy, specific breast symptoms like a palpable lump, pain, or nipple discharge).
   • Why it's important: Provides context for interpreting the images, assessing individual risk factors, and guiding further management. For symptomatic patients, the exact location and duration of symptoms are critical.
   • URL (General Patient History Relevance):
     • ACR Practice Parameter for the Performance of Screening and Diagnostic Mammography (Refer to sections on clinical information and patient history, emphasizing its role in the diagnostic process).
     • TECHNOLOGISTS' COLUMN - Patient History: Details, Documentation, and Delivery - Mammography Educators (Discusses the importance of detailed patient history for technologists and radiologists).
2. Reason for Examination:
   • What to include: Clearly state whether it's a screening mammogram (routine check-up for asymptomatic women) or a diagnostic mammogram (investigating symptoms, abnormal screening findings, or follow-up of a known lesion).
   • Why it's important: Dictates the appropriate imaging protocol and the urgency of the assessment.
3. Prior Imaging Comparison:
   • What to include: Always compare with prior mammograms, and if available, prior ultrasound or MRI studies. Specify the dates and locations of these prior studies.
   • Why it's important: Crucial for assessing stability, growth, or the appearance of new findings, which are often the most significant indicators of malignancy.
   • URL (Importance of Prior Imaging):
     • ACR Practice Parameter for the Performance of Screening and Diagnostic Mammography (Emphasizes the necessity of comparison with prior relevant examinations).
4. Imaging Findings - Description:
   • What to include: Systematically describe any findings using standard mammographic terminology from the ACR BI-RADS lexicon.
     • Breast Composition/Density: Report the BI-RADS density category (A: Almost entirely fatty, B: Scattered fibroglandular density, C: Heterogeneously dense, D: Extremely dense). This is a mandated reporting element.
     • Location: Specify the breast (right/left), quadrant (e.g., Upper Outer Quadrant - UOQ, Lower Inner Quadrant - LIQ), clock face position (e.g., 2 o'clock), and depth (anterior, middle, posterior).
     • Views: Indicate on which mammographic views the finding is seen (e.g., seen on MLO and CC views).
     • Masses: Describe Shape (round, oval, irregular), Margin (circumscribed, microlobulated, obscured, indistinct, spiculated), and Density (high, equal, low, fat-containing).
     • Calcifications: Describe Type (punctate, amorphous, pleomorphic, fine linear branching), and Distribution (diffuse, regional, clustered, segmental, linear).
     • Architectural Distortion: Description of any distortion without an associated mass.
     • Asymmetry: Description of focal, global, or developing asymmetry.
     • Associated Features: Skin retraction, nipple retraction, skin thickening, trabecular thickening, lymphadenopathy, edema.
   • Why it's important: Provides a clear, objective, and consistent description of abnormalities, ensuring reproducibility and understanding across different clinicians.
   • URL (ACR BI-RADS Atlas – Lexicon):
     • ACR BI-RADS® Atlas - American College of Radiology
     • Breast Imaging Reporting and Data System - StatPearls - NCBI Bookshelf (Provides an overview of BI-RADS, including the lexicon categories).
5. Assessment (BI-RADS Category):
   • What to include: Assign the overall BI-RADS assessment category, which reflects the likelihood of malignancy based on all findings.
     • BI-RADS 0: Incomplete
     • BI-RADS 1: Negative¹
     • BI-RADS 2: Benign
     • BI-RADS 3: Probably Benign
     • BI-RADS 4: Suspicious (subdivided into 4A, 4B, 4C for increasing suspicion)²
     • BI-RADS 5: Highly Suggestive of Malignancy³
     • BI-RADS 6: Known Biopsy-Proven Malignancy⁴
   • Why it's important: Standardizes the final interpretation and directly guides management recommendations.
   • URL (ACR BI-RADS Categories):
     • ACR BI-RADS® Atlas - American College of Radiology
     • Breast Imaging Reporting and Data System - StatPearls - NCBI Bookshelf
6. Recommendations:
   • What to include: Clear, actionable recommendations for next steps, directly corresponding to the BI-RADS assessment.
     • For BI-RADS 0: Recommend additional imaging (e.g., spot compression, magnification views, ultrasound) or comparison with prior studies.⁵
     • For BI-RADS 3: Recommend short-interval follow-up (e.g., 6 months).
     • For BI-RADS 4/5: Recommend biopsy (e.g., core needle biopsy, excisional biopsy), specifying the imaging guidance.⁶
     • For BI-RADS 1/2: Recommend routine screening.
     • For BI-RADS 6: Recommend appropriate definitive treatment (e.g., surgical excision, as diagnosis is already confirmed).
   • Why it's important: Provides concrete guidance for the referring clinician and patient, ensuring timely and appropriate follow-up.
   • URL (General Mammography Guidelines and Recommendations):
     • American Cancer Society Recommendations for Breast Cancer Screening
     • Society of Breast Imaging (SBI) - Guidelines and Statements
7. Summary/Impression:
   • What to include: A concise concluding statement that summarizes the most significant findings, the overall BI-RADS assessment, and the final recommendation.
   • Why it's important: Offers a quick, comprehensive overview of the case for other clinicians who may not read the full detailed report.

Additional Resources for Mammography Professionals:

• Society of Breast Imaging (SBI): A leading resource for breast imaging professionals, offering educational content, guidelines, and case studies.⁷
  • Society of Breast Imaging | SBI
  • SBI Case of the Month (Provides examples of structured case presentations).
• American College of Radiology (ACR): Beyond BI-RADS, the ACR offers extensive resources for breast imaging quality and practice.⁸

Mammography and Breast Imaging Resources - American College of Radiology

• • Mammography Sample Lay Report Letters - American College of Radiology (Important for patient communication).
• RadiologyInfo.org: A public information website produced by radiologists that explains radiology procedures to patients, which can be useful for patient education.⁹
  • Mammography (Mammogram): Early detection of breast disease. - Radiologyinfo.org
• FDA Mammography Quality Standards Act (MQSA): Essential for understanding the regulatory framework and quality control requirements in mammography.
  • Mammography Quality Standards Act (MQSA) - FDA

Source: Google Gemini