Harnessing artificial intelligence, researchers have created a risk model for breast cancer based on digital mammogram images that aims to identify people with the highest 10-year risk. The model outperformed the current standard clinical risk tool for 10-year risk and could identify 40% of breast cancers using clinical guidelines, suggesting it could be integrated into existing screening protocols to enhance primary prevention efforts. As the incidence of breast cancer rises worldwide, clinicians have leaned heavily on prevention through lifestyle modifications and screening tools such as mammograms. Known as primary prevention, these tactics work best when targeted towards women with the highest risk of developing tumors. Clinicians typically use lifestyle models such as the Tyrer-Cuzick-v8 model to identify these patients, but newer AI-based models have emerged that could surpass their performance. However, these AI models are primarily designed to predict short-term risk. To meet the need for a long-term risk assessment tool, Mikael Eriksson and colleagues created a 10-year, AI-based risk model for invasive and in situ breast cancer. They gathered digital mammogram data from a total of 8,696 people across two large cohorts in the US and Sweden from 2010 to 2020, including 1,633 patients with breast cancer. The model calculated overall 10-year risks of 3.83% and 3.14% for each cohort, respectively, and yielded promising performance while estimating the 10-year risk of invasive tumors. Furthermore, it outperformed both Tyrer-Cuzick-v8 and a 5-year AI risk model named Mirai at predicting cancers in the top 10% of high-risk people. Eriksson et al. caution that most of their study participants were of European ancestry. “This stresses the need for further evaluating the model in diverse populations and for its intended use before considering its clinical use,” they write. For reporters interested in trends, a May 20 study in Science Advances presents an AI-based mammogram risk score for breast cancer trained on data from more than 226,000 women of diverse ancestries that can overcome biases based on race or ethnicity. Please see this week’s VancePak for embargoed release information; when published, the paper will be available here: https://www.science.org/doi/10.1126/sciadv.ady3905 Also, an April 30 study in Science showed that the large language model OpenAI o1 could exceed a large group of human physicians at clinical reasoning and tasks such as diagnosis and evaluation of emergency room patients: https://www.science.org/doi/10.1126/science.adz4433