Mammogram That Sees the Future: AI Tool Now Officially Part of Breast Cancer Screening Standards and Experts Say Can Help Detect ‘the Likelihood of a Tumor In Five Years’

Now, the National Comprehensive Cancer Network (NCCN), which sets the standard of care in oncology, has formally incorporated this technology into its 2026 Breast Cancer Screening and Diagnosis Guidelines.

“We’re moving away from ‘one‑size‑fits‑all’ medicine to a model where every prevention, screening, and treatment plan is as unique as the individual person,” says Dr. Julie R. Gralow, Chief Medical Officer of the American Society of Clinical Oncology (ASCO).

WATCH: I Have Dense Breasts. Do I Need a 3D Mammogram?

NCCN’s New Direction: Predictive Screening, Not Just Detection

The NCCN guidelines include an AI-based mammogram risk assessment option. The update recommends that when AI identifies a patient as high risk, clinicians take direct action, such as offering supplemental imaging or discussing risk-reduction strategies.

“Historically, breast cancer risk assessment has relied on age, family history, genetics, and breast density,” explains Dr. Beth Mittendorf, Chief of Multidisciplinary Oncology at Dana‑Farber Cancer Institute and Chief of Breast Surgery at Beth Israel Deaconess Medical Center.

“AI‑based mammographic risk assessment creates an opportunity to identify women whose future risk may be higher even when traditional tools wouldn’t flag them,” Dr. Mittendorf adds.

How Clairity Breast Works

Clairity Breast evaluates mammogram features that aren’t visible to the human eye and integrates its five‑year risk score directly into clinical systems. While it does not replace mammography, experts say it strengthens early‑detection efforts.

“This new approach can enhance the current standard of care,” says Dr. Mary Newell, breast imaging specialist at Winship Cancer Institute of Emory University.

Dr. Basak Dogan, Director of Breast Imaging Research at UT Southwestern’s Simmons Cancer Center, notes that AI may reclassify many women previously considered average risk.

“Patients without a strong family history may now be identified as at increased risk based on their specific breast tissue patterns,” she says.

“That means more women could qualify for supplemental screening earlier—potentially catching cancers that would otherwise be missed,” Dr. Dogan continued.

What This Means for Physicians

The shift is significant: radiologists in centers using AI tools will begin incorporating risk scores directly into their reports.

“In practice, this moves us from purely diagnostic reporting—‘Is there a tumor today?’—to predictive reporting—‘What is the likelihood of a tumor in five years?’” Dr. Dogan explains.

“It will lead to more high‑risk referrals and a need for standardized templates to help clinicians explain these scores to patients,” Dr. Dogan added.

While many physicians are becoming more familiar with Clairity Breast, Dr. Gralow notes that adoption is still uneven because the technology has not yet rolled out to all 50 states.

WATCH: Reducing Anxiety About False Positive Mammogram Reports

What Patients Should Expect

Patients can ask whether their imaging center uses Clairity Breast and how AI might influence their five‑year risk assessment.

“In practical terms, some patients may be identified earlier for closer surveillance or supplemental imaging, while others can be reassured that their current plan remains appropriate,” Dr. Mittendorf says.

“A mammogram is no longer just a test to look for cancer today—it may also help us understand who is at higher risk over the next several years,” Dr. Mittendorf adds.

Cost and Coverage

Insurance coverage is still evolving.

Some centers currently offer AI analysis as an optional add‑on, typically for $40–$60.

Dr. Dogan notes that NCCN inclusion is a major step toward broader insurance adoption, though a dedicated billing code is still pending.

At Beth Israel Deaconess Medical Center in Boston, Clairity Breast is currently offered as a $199 self‑pay service.

AI’s Expanding Role in Cancer Care

AI is already used in radiology, pathology, treatment planning, and patient support. In 2024, ASCO released six guiding principles for AI in oncology—emphasizing transparency, equity, privacy, accountability, and the continued centrality of human clinical judgment.

• Transparency – AI tools should remain transparent throughout their entire lifecycle.
• Informed Stakeholders – Patients and clinicians must know when AI is used in care or decision‑making.
• Equity and Fairness – AI must be designed and used to minimize bias and ensure equitable access.
• Accountability – AI systems must meet legal, ethical, and regulatory standards, with developers responsible for their performance.
• Oversight and Privacy – Institutions should enforce policies that protect clinical autonomy and patient privacy when using AI.

WATCH: Cancer Still Hits Black Americans Hardest. The Urgent Need to Close the Cancer Care Gap

One of AI’s most promising advantages is its ability to reduce disparities in care, especially among ethnically diverse patients.

“Traditional models often perform poorly for patients from diverse backgrounds who may not know their full family history,” Dr. Dogan says.

“AI provides an objective assessment based on the individual’s biology, which can democratize access to high‑risk screening.”

Dr. Mittendorf underscores the balance ahead: “AI should help us identify risk earlier, tailor prevention more intelligently, and use specialist resources more effectively. The goal is not to replace clinical judgment, but to augment it.”

What To Know About Enhanced Mammograms

Enhanced mammograms are a helpful tool for women whose breast tissues obscure precise mammography readings. While implants often call for enhanced mammogram screening, women with dense breasts may also need enhanced screening. Dense breasts mean more fibroglandular tissue and less fatty breast tissue.

During mammograms, the tissue difference can make locating signs of cancer more difficult in women with dense breasts.

Additional testing can be considered for these women, depending on their personal history, preferences, and their physician’s guidance.

These tests include:

• 3-D Mammogram (Breast Tomosynthesis): This technology acquires breast imaging from multiple angles and digitally combines them into a 3D representation of the breast tissue. This allows physicians to see breast tissue architecture better, even in dense breasts. 3D mammograms are fast becoming the standard way of performing mammography.
• Breast Magnetic Resonance Imaging (MRI): An MRI machine uses magnets to create highly detailed, intricate images of the breast. These are mostly reserved for women with an extremely high breast cancer risk. Dense breasts alone may not be a valid reason to obtain a breast MRI. However, dense breasts in women with genetic mutations, like BRCA1 and BRCA2, or a strong family history of breast cancer, could justify obtaining breast MRIs.
• Molecular Breast Imaging (MBI): MBI is a newer imaging technique that uses a radioactive tracer to detect breast cancer. It is beneficial for women with dense breasts. However, MBI is not as widely available as other screening methods.

When you’re getting a mammogram, ask about dense breasts.

Understanding Your Mammogram Report

A radiologist reading mammograms categorizes breasts into four different categories using the Breast Imaging Reporting and Data System (BI-RADS), a classification system developed by the American College of Radiology (ACR).

These include:

• Fatty breast tissue: These breasts are mainly fat with very little dense tissue. Found in less than 10% of women, fatty breasts appear dark on mammograms.
• Scattered fibroglandular breast tissue: These breasts contain a mix of fatty and dense tissue (composed of glands and fibrous tissue). On a mammogram, they have dark areas (fatty tissue) intermixed with light areas (dense tissue). Around 40% of women have breasts that fall in this category.
• Heterogeneously dense breast tissue: This type of breast tissue has many areas of dense tissue and some areas of fat. Found in 40% of women, these breasts look mostly light, with some dark areas on a mammogram.
• Extremely dense breast tissue: Such breasts are almost entirely composed of dense glandular and fibrous connective tissues with very little fat. They are found in 10% of women and appear light on mammograms.

Your breasts are usually called dense on a mammogram report if they fall within the heterogeneously dense breast tissue or the extremely dense breast tissue categories.

When To Screen For Breast Cancer

Recently, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) upgraded its guidelines to suggest that women start getting mammograms every other year at the age of 40. The task force notes that this lowered the age (the previous recommendation was to begin screening at age 45) for breast cancer screening could save 19% more lives.

The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.

Mammograms are still the best tool for detecting breast cancer.

Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.

Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk of developing breast cancer, you should begin screening earlier.

Questions To Ask Your Doctor

If you have a breast cancer screening coming up or have recently had one, you may have questions you want answered. SurvivorNet’s proprietary AI tool “My Health Questions” is designed specifically for patients and caregivers.

WATCH: How One Cancer Survivor and Her Sister Used “My Health Questions” to Navigate Care

This powerful resource is embedded across the SurvivorNet website and delivers structured responses grounded in clinical guidelines and medically reviewed research to help people better understand their treatment options and feel more confident navigating care.

My Health Questions can also help patients come up with useful questions ahead of their next appointment.

Learn more about SurvivorNet's rigorous medical review process.

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