From personalized screening to artificial intelligence, leading experts explore how breast cancer detection is becoming more precise and what those changes mean for patients today.
“One of the most common questions I get is, ‘When should I get screened?’ Which is closely followed by, ‘Why can’t I get screened sooner?'”
That’s Dr. Seema Venkatachalam Malkani, a physician and Lynn Sage Breast Cancer Foundation Board Chair, describing the two questions that arrive together in exam rooms every week. For decades, the answer was relatively straightforward: begin mammograms in middle age, repeat them at regular intervals, and hope that cancer, if present, would be found early.
Today, that approach is changing.
Breast cancer screening is entering a new era. As researchers learn more about individual risk, new technologies emerge, and our understanding of the disease evolves, screening is becoming increasingly personalized.
At the same time, breast cancer incidence is rising among younger women and women of color, raising important questions about when screening should begin, who may need additional screening, and how to ensure every person has access to lifesaving care. These trends reinforce why a one-size-fits-all approach is no longer enough, and why the future of screening must be built around an individual’s unique risk.
For many people, this changing landscape can feel confusing. When recommendations differ, which guidance should you follow? How do you know what’s right for you? And how can new technologies help detect breast cancer earlier?
To help answer those questions, the Lynn Sage Breast Cancer Foundation hosted “Caught Early,” a panel discussion moderated by Dr. Seema Venkatachalam Malkani, featuring Dr. Sonya Bhole, a breast imaging specialist and former Lynn Sage Breast Imaging Fellow; Dr. Dezheng Huo, an epidemiologist and current Lynn Sage Scholar Award recipient; and Dr. Yamilé Molina, a leading public health researcher focused on health equity and access to breast cancer care.
A New Era of Breast Cancer Screening
For years, screening recommendations have evolved as new evidence has emerged. Different organizations have issued different recommendations about when screening should begin and how often it should occur, leaving many people uncertain about what guidance applies to them.
Those changes aren’t a sign of uncertainty; they reflect scientific progress and different approaches to balancing the benefits and risks of screening. As researchers learn more about breast cancer biology and individual risk, recommendations continue to evolve, helping physicians make more informed decisions while minimizing unnecessary testing and procedures.
As Dr. Huo noted,”Everybody agrees that mammography saves lives. The debate is really between the benefit and the harm.”
Those potential harms can include false positives, unnecessary biopsies, additional imaging, and the anxiety that often accompanies them. The differences between screening recommendations largely come down to how experts weigh these benefits and risks, not a disagreement about whether mammography saves lives. While organizations are drawing from the same body of evidence, some place greater emphasis on reducing unnecessary testing, while others prioritize detecting cancer as early as possible.
The challenge isn’t determining whether screening works—it’s determining who benefits most, when they should begin, and how often they should be screened.
Screening Is Moving Beyond a One-Size-Fits-All Approach
One of the strongest messages from the discussion was that the future of breast cancer screening will not be based on age alone.
While age remains an important factor, clinicians are increasingly looking at a broader picture that includes family history, breast density, genetics, reproductive history, prior biopsies, and other individual risk factors.
As Dr. Huo emphasized, “The debate on when to start and how often to screen should not be based just on age. Age itself is not sufficient.”
He continued, “We should think about how to screen individuals. Different people need different ways of screening.”
This shift toward personalized screening has the potential to identify higher-risk individuals earlier while reducing unnecessary testing for others. For patients, that means understanding your own risk factors and having conversations with your healthcare provider are becoming just as important as the mammogram itself.
Breast density is one example of how personalized screening works, and one that many people can learn about today. Dense breast tissue makes cancers more difficult to detect on a mammogram and is also associated with a higher risk of breast cancer. Depending on an individual’s overall risk, providers may recommend supplemental screening, such as an MRI or ultrasound.
Dr. Bhole noted that mammograms categorize breast density into four groups, with about half of women over 40 falling into one of the two categories considered “dense.” Because density information is included in mammogram results and radiology reports, patients can review their results and bring questions to their next appointment.
Understanding your breast density, family history, and other personal risk factors can help ensure screening recommendations are tailored to you, not just your age. As Dr. Bhole encouraged, the goal is not to make screening more complicated. It is to make it more precise.
Technology Is Changing What’s Possible
The future of breast cancer screening is not simply about finding more cancers. It is about finding the right cancers, in the right people, at the right time, while reducing unnecessary testing and procedures for those who do not need them.
Artificial intelligence is one of the technologies helping make that future possible. Rather than replacing today’s screening tools or physicians, AI is helping researchers and clinicians better understand risk and make more informed decisions about who may benefit from earlier or additional screening. This is the type of innovation Lynn Sage is proud to support. Through a Lynn Sage Scholar Award, Dr. Huo is leading research exploring how artificial intelligence can combine information from mammograms, genetic markers, and clinical history to create individualized breast cancer risk predictions. This work could help physicians identify who may benefit from earlier screening or additional imaging, moving the field closer to truly personalized care.
Advances in imaging and AI are also improving how radiologists detect abnormalities, particularly for people with dense breast tissue.
But the panelists emphasized that technology is a tool to enhance, not replace, physician expertise. As Dr. Bhole noted, AI can support radiologists by helping identify areas for closer review and improving efficiency, but the final decisions remain with the physicians caring for patients.
The future of screening will be defined by how effectively innovation helps physicians deliver more personalized, precise, and informed care.
Innovation Only Matters If Everyone Can Access It
Scientific advances alone will not improve outcomes if people cannot access them. As screening becomes more personalized, ensuring equitable access becomes even more important.
Dr. Molina highlighted the many factors that influence whether someone receives timely breast cancer screening—from insurance coverage and transportation to awareness, trust, and access to healthcare resources.
“The key disparity in terms of time to diagnosis is access to a breast imaging center of excellence, usually hampered by access to Medicaid insurance,” she said.
A breast imaging center of excellence provides specialized expertise, advanced imaging, and a coordinated path from an abnormal screening result to diagnosis and treatment. But not everyone has access to these resources, and where someone receives care can affect how quickly they receive answers.
Dr. Molina challenged that screening innovations and guidelines alone aren’t enough. Expanding screening recommendations only works when healthcare systems have the resources, staffing, and infrastructure needed to meet increased demand.
“As we think about these policies and these guidelines, let’s think about the resources afforded to centers and institutions that want to do better,” she said.
The future of breast cancer screening cannot only be about creating better tools. It must also be about removing the barriers that prevent people from benefiting from them. That requires continued investment in equitable research, thoughtful implementation of new guidelines, community partnerships, and healthcare systems committed to reaching every population.
Knowledge Is One of the Most Powerful Tools We Have
Perhaps the most empowering takeaway from the discussion wasn’t about technology or guidelines—it was about understanding your own health.
As Dr. Venkatachalam Malkani emphasized, “Personalized care begins with asking the right questions.”
Conversations about breast cancer risk should begin long before a first mammogram is scheduled. Understanding your personal and family history—and discussing those factors with your healthcare provider—can help ensure that screening recommendations reflect your individual risk rather than a single age-based guideline.
Dr. Bhole echoed that message: “If we can break these guidelines down in a really conversational way, then we can teach women—and men—to advocate for themselves.”
Age still matters and remains the foundation of today’s screening recommendations. But it is no longer the only factor. The panelists emphasized the importance of beginning conversations with healthcare providers early, around age 25, to understand personal risk factors and develop a screening plan tailored to each individual. For women at average risk, they continue to recommend starting annual mammograms at age 40. Personalized screening is not about replacing that baseline; it is about identifying who may benefit from beginning earlier, receiving additional imaging, or taking a different approach based on their unique risk profile.
“Mammography is still the gold standard,” said Dr. Bhole. “It is the only modality that has been proven to save lives for breast cancer screening.”
That spirit of education and empowerment is exactly why Lynn Sage hosted “Caught Early.” It also reflects another important part of the Foundation’s mission: investing in the researchers and physicians shaping the future of breast cancer care. Dr. Sonya Bhole is a graduate of the Lynn Sage Breast Imaging Fellowship Program, and Dr. Dezheng Huo’s groundbreaking research is supported through a Lynn Sage Scholar Award. Their work is a powerful example of how investing in promising physicians and researchers today leads to better science, more personalized care, and better outcomes for patients tomorrow.
Breast cancer screening is entering a new era—one shaped by better science, more personalized care, and technologies that have the potential to detect cancer earlier than ever before. At Lynn Sage, we’re proud to support the researchers, physicians, and collaborations helping make sense of this rapidly changing landscape. Together, we’re working toward a future where every person has access to the advances and care they need, and where breast cancer is caught earlier, treated more effectively, and ultimately eradicated.
Learn more about Lynn Sage’s work at www.lynnsage.org, and take one important question with you to your next healthcare appointment: What is my personal risk, and what should my screening plan look like?