New artificial intelligence finds breast tumours that doctors miss

By | January 3, 2020

New artificial intelligence spots breast tumours that trained doctors miss in ‘huge advance’ for cancer patients

  • Computer algorithm could now help diagnose breast cancer more accurately 
  • Found reduction in the number of false positives and reduction in false negatives
  • Study co author Dr Mozziyar Etemadi said the new tool was ‘a huge advance’

Artificial intelligence that can help diagnose breast cancer more accurately than trained doctors could save thousands of lives, according to new research.

A computer algorithm developed by British and US scientists has found AI was able to display a 1.2 per cent reduction in the number of false positives and a 2.7 per cent reduction in false negatives.  

The breakthrough has been likened to ‘a spell-check for writing email’ and could reduce the number of ‘false negatives’ that can lead to life threatening delays in treatment.    

It will also prevent ‘false positives’ during routine screening – sparing women unnecessary surgery and great stress.

A computer algorithm (left and right) developed by British and U.S. scientists can help diagnose breast cancer more accurately than trained doctors, according to new research

A computer algorithm (left and right) developed by British and U.S. scientists can help diagnose breast cancer more accurately than trained doctors, according to new research

Study co author Dr Mozziyar Etemadi, an assistant professor of anaesthesiology at Northwestern University, Chicago, said: ‘This is a huge advance in the potential for early cancer detection.

‘Breast cancer is one of the highest causes of cancer mortality in women. Finding cancer earlier means it can be smaller and easier to treat. We hope this will ultimately save a lot of lives.’

The machine learning device was designed and trained using mammography images mostly from women in the UK and correctly identified cancers better than experts.

When tested on 25,856 unidentified women screened on the NHS at three hospital trusts and 3,097 at Northwestern Medicine, there were far fewer cases of cancer incorrectly identified – or missed.

The results published in Nature demonstrates how AI could ‘potentially be applied in clinical settings around the world,’ said the researchers.

Compared to actual clinical practice and the opinions of six independent radiologists, missed tumours plunged from 9.4 to 2.7 per cent with AI and incorrect identification of cancer also fell from 5.7 to 1.2 per cent.

Study co author Dr Mozziyar Etemadi (pictured), an assistant professor of anaesthesiology at Northwestern University, Chicago, said the tool was a 'huge advance in the potential for early cancer detection'

Study co author Dr Mozziyar Etemadi (pictured), an assistant professor of anaesthesiology at Northwestern University, Chicago, said the tool was a ‘huge advance in the potential for early cancer detection’

The software also correctly picked up cancers in the screening images with a similar degree of accuracy as the experts.

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Currently, two experts review breast screening scans but the system is not perfect, as it can miss some cases and pick up ones that would not have gone on to cause problems.

Breast cancer is the most common type of cancer in women globally, occurring in about one in eight women.

At present, mammography is the most widely used breast cancer screening tool, but diagnosing cancer from these images is a challenge and one in five cases are missed by radiologists – twice the rate of that in the study.

What is more, about half of women who undergo screening over a ten year period will experience a false positive in which cancer is wrongly suspected.

Co-lead author Scott McKinney, a software engineer at Google Health in California, said: ‘Computers are really good at these tasks. We hope someday this tool for radiologists becomes as ubiquitous as spell-check for writing e-mail.’ 

Breast cancer affects more than 55,000 UK women each year - killing more than 11,000.(Stock image)

Breast cancer affects more than 55,000 UK women each year – killing more than 11,000.(Stock image)

AI tools could now support clinical decision-making in the future and relieve pressure on healthcare systems by reducing workload.

Dominic King, UK lead at Google Health, London, said: ‘Our team is really proud of these research findings, which suggest we are on our way to developing a tool that can help clinicians spot breast cancer with greater accuracy.

‘Further testing, clinical validation and regulatory approvals are required before this could start making a difference for patients, but we’re committed to working with our partners towards this goal.’

Women aged between 50 and 71 are invited to receive a mammogram on the NHS every three years, where an x-ray of the breast tissue is used to look for abnormal growths or changes which may be cancerous.

While screening is highly effective and the majority of cancers are picked up during the process, even with significant clinical expertise human interpretation of the x-rays is open to errors.

Co-author Professor the Lord Ara Darzi of Denham, of Imperial College London, said: ‘Screening programmes remain one of the best tools at our disposal for catching cancer early and improving outcomes for patients, but many challenges remain – not least the current volume of images radiologists must review.

‘While these findings are not directly from the clinic, they are very encouraging, and they offer clear insights into how this valuable technology could be used in real life.

‘There will of course a number of challenges to address before AI could be implemented in mammography screening programmes around the world, but the potential for improving healthcare and helping patients is enormous.’

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Breast cancer currently affects more than 55,000 UK women each year – killing more than 11,000.

It is estimated more than two million women across the world developed the disease last year – with more than 600,000 deaths.

In the U.S. there will be an estimated 268,600 women diagnosed with breast cancer this year – and around 41,760 deaths from the disease.

Dr Etemadi said: ‘While this is exciting, early-stage research, validation in future trials is needed to better understand how models like these can be effectively integrated into clinical practice.

‘In some examples, the human outperforms the AI and in others, it’s the opposite.

‘But the ultimate goal will be to find the best way to combine the two – the magic of the human brain isn’t going anywhere any time soon.’ 

WHAT IS BREAST CANCER, HOW MANY PEOPLE DOES IT STRIKE AND WHAT ARE THE SYMPTOMS?

Breast cancer is one of the most common cancers in the world. Each year in the UK there are more than 55,000 new cases, and the disease claims the lives of 11,500 women. In the US, it strikes 266,000 each year and kills 40,000. But what causes it and how can it be treated?

What is breast cancer?

Breast cancer develops from a cancerous cell which develops in the lining of a duct or lobule in one of the breasts.

When the breast cancer has spread into surrounding breast tissue it is called an ‘invasive’ breast cancer. Some people are diagnosed with ‘carcinoma in situ’, where no cancer cells have grown beyond the duct or lobule.

Most cases develop in women over the age of 50 but younger women are sometimes affected. Breast cancer can develop in men though this is rare.

Staging means how big the cancer is and whether it has spread. Stage 1 is the earliest stage and stage 4 means the cancer has spread to another part of the body.

The cancerous cells are graded from low, which means a slow growth, to high, which is fast growing. High grade cancers are more likely to come back after they have first been treated.

What causes breast cancer?

A cancerous tumour starts from one abnormal cell. The exact reason why a cell becomes cancerous is unclear. It is thought that something damages or alters certain genes in the cell. This makes the cell abnormal and multiply ‘out of control’.

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Although breast cancer can develop for no apparent reason, there are some risk factors that can increase the chance of developing breast cancer, such as genetics.

What are the symptoms of breast cancer?

The usual first symptom is a painless lump in the breast, although most breast lumps are not cancerous and are fluid filled cysts, which are benign. 

The first place that breast cancer usually spreads to is the lymph nodes in the armpit. If this occurs you will develop a swelling or lump in an armpit.

How is breast cancer diagnosed?

  • Initial assessment: A doctor examines the breasts and armpits. They may do tests such as a mammography, a special x-ray of the breast tissue which can indicate the possibility of tumours.
  • Biopsy: A biopsy is when a small sample of tissue is removed from a part of the body. The sample is then examined under the microscope to look for abnormal cells. The sample can confirm or rule out cancer.

If you are confirmed to have breast cancer, further tests may be needed to assess if it has spread. For example, blood tests, an ultrasound scan of the liver or a chest x-ray.

How is breast cancer treated?

Treatment options which may be considered include surgery, chemotherapy, radiotherapy and hormone treatment. Often a combination of two or more of these treatments are used.

  • Surgery: Breast-conserving surgery or the removal of the affected breast depending on the size of the tumour.
  • Radiotherapy: A treatment which uses high energy beams of radiation focussed on cancerous tissue. This kills cancer cells, or stops cancer cells from multiplying. It is mainly used in addition to surgery.
  • Chemotherapy: A treatment of cancer by using anti-cancer drugs which kill cancer cells, or stop them from multiplying
  • Hormone treatments: Some types of breast cancer are affected by the ‘female’ hormone oestrogen, which can stimulate the cancer cells to divide and multiply. Treatments which reduce the level of these hormones, or prevent them from working, are commonly used in people with breast cancer.

How successful is treatment?

The outlook is best in those who are diagnosed when the cancer is still small, and has not spread. Surgical removal of a tumour in an early stage may then give a good chance of cure.

The routine mammography offered to women between the ages of 50 and 70 mean more breast cancers are being diagnosed and treated at an early stage.

For more information visit breastcancercare.org.uk or www.cancerhelp.org.uk


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