A.I. Finds Cancer Doctors Don’t See
KECSKEMÉT, Hungary — Inside a dark room at Bács-Kiskun County Hospital near Budapest, Dr. Éva Ambrózay, a radiologist with more than two decades of experience, peered at a monitor showing a mammogram.
Two radiologists had previously said the X-ray did not show any signs that the patient had breast cancer. But Dr. Ambrózay was looking closely at several areas of the scan circled in red, which artificial intelligence software had flagged as potentially cancerous.
“This is something,” she said. She soon ordered the woman to be called back for a biopsy.
Advancements in A.I. are beginning to deliver breakthroughs in breast cancer screening by detecting the signs that doctors miss. The technology has shown an impressive ability to spot cancer at least as well as human radiologists, according to early results and radiologists, in what is one of the most tangible signs to date of how A.I. can improve public health.
Hungary, which has a robust breast cancer screening program, is one of the largest testing grounds for the technology on patients. At five hospitals and clinics that perform more than 35,000 screenings a year, A.I. systems were rolled out in 2021 and now check for signs of cancer that a radiologist may have overlooked. Clinics and hospitals in the United States, Britain and elsewhere in the European Union are also beginning to test or provide data to help develop the systems.
Widespread use of the technology faces many hurdles, doctors and A.I. developers said. Additional clinical trials are needed before the systems can be more widely adopted as an automated second or third reader of breast cancer screens. The tools must also show they can produce accurate results on women of all ages, ethnicities and body types. And the technology must
prove it can recognize more complex forms of breast cancer and cut down on false-positives, radiologists said.
The A.I. tools have also prompted a debate about whether they will replace human radiologists, with makers of the technology facing regulatory scrutiny and resistance from some doctors and health institutions. For now, those fears appear overblown, with many experts saying the technology will be effective and trusted by patients only if it is used in partnership with doctors.
And ultimately, A.I. could be lifesaving, said Dr. László Tabár, a mammography educator in Europe who was won over by the technology after reviewing its performance in breast cancer screening from several vendors.
“I’m dreaming about the day when women are going to a breast cancer center and they are asking, ‘Do you have A.I. or not?’ ” he said.
The U.S. National Cancer Institute has estimated that about 20 percent of breast cancers are missed during screening mammograms.
Peter Kecskemethy, a computer scientist who co-founded Kheiron Medical Technologies, a company that develops A.I. tools to help detect early signs of cancer, grew up in Hungary spending time at one of Budapest’s largest hospitals. His mother was a radiologist, often spending hours a day in a dark room looking at hundreds of images and making life-altering decisions for patients.
“It’s so easy to miss tiny lesions,” said Dr. Edith Karpati, Mr. Kecskemethy’s mother, now a director at Kheiron. “It’s not possible to stay focused.”
Mr. Kecskemethy, along with Kheiron’s co-founder, Tobias Rijken, an expert in machine learning, said A.I. should assist doctors. To train their A.I. systems, they collected more than five million mammograms of patients whose diagnoses were already known. The company, which is in London, also pays 12 radiologists to label images using special software that teaches the A.I. to spot a cancerous growth by its shape, density, location and other factors.
The technology then creates a mathematical representation of normal mammograms and those with cancers. With the ability to look at each image in a more granular way than the human eye, it compares that baseline to find abnormalities.
Last year, after testing more than 275,000 breast cancer cases, Kheiron reported that its A.I. software matched the performance of human radiologists when acting as the second reader of mammography scans. It also cut down on radiologists’ workloads by at least 30 percent because it reduced the number of X-rays they needed to read. In other results from a Hungarian clinic last year, the A.I. increased the cancer detection rate by 13 percent because more malignancies were identified.
Across five MaMMa Klinika clinic sites in Hungary, 22 cases have been documented since 2021 in which Kheiron’s technology identified a cancer missed by radiologists, with about 40 more under review.
“It’s a huge breakthrough,” said Dr. András Vadászy, the director of MaMMa Klinika. “If this process will save one or two lives, it will be worth it.”
Kheiron said the technology worked best alongside doctors, not in lieu of them. Scotland’s National Health Service will use it as an additional reader of mammography scans at six sites, and it will be in about 30 sites operated by England’s National Health Service by the end of the year. Oulu University Hospital in Finland plans to use the technology as well, and a bus will travel around Oman this year to perform breast cancer screenings using A.I.
“We are not irrelevant,” said Dr. Constance Lehman, a professor of radiology at Harvard Medical School and a breast imaging specialist at Massachusetts General Hospital, “but there are tasks that are better done with computers.”
In Hungary, Dr. Ambrózay said she had initially been skeptical of the technology, but was quickly won over. She pulled up the X-ray of a 58-year-old woman with a tiny tumor spotted by the A.I. that Dr. Ambrózay had a hard time seeing.
The A.I. saw something, she said, “that seemed to appear out of nowhere.”