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Unfortunately AI models like this one often never make it to the clinic. The model could be impressive enough to identify 100% of cases that will develop breast cancer. However if it has a false positive rate of say 5% it’s use may actually create more harm than it intends to prevent.
Not at all, in this case.
A false positive of even 50% can mean telling the patient “they are at a higher risk of developing breast cancer and should get screened every 6 months instead of every year for the next 5 years”.
Keep in mind that women have about a 12% chance of getting breast cancer at some point in their lives. During the highest risk years its a 2 percent chamce per year, so a machine with a 50% false positive for a 5 year prediction would still only be telling like 15% of women to be screened more often.
That’s why these systems should never be used as the sole decision makers, but instead work as a tool to help the professionals make better decisions.
Keep the human in the loop!
Breast imaging already relys on a high false positive rate. False positives are way better than false negatives in this case.
That’s just not generally true. Mammograms are usually only recommended to women over 40. That’s because the rates of breast cancer in women under 40 are low enough that testing them would cause more harm than good thanks in part to the problem of false positives.
Nearly 4 out of 5 that progress to biopsy are benign. Nearly 4 times that are called for additional evaluation. The false positives are quite high compared to other imaging. It is designed that way, to decrease the chances of a false negative.
The false negative rate is also quite high. It will miss about 1 in 5 women with cancer. The reality is mammography is just not all that powerful as a screening tool. That’s why the criteria for who gets screened and how often has been tailored to try and ensure the benefits outweigh the risks. Although it is an ongoing debate in the medical community to determine just exactly what those criteria should be.
How would a false positive create more harm? Isn’t it better to cast a wide net and detect more possible cases? Then false negatives are the ones that worry me the most.
It’s a common problem in diagnostics and it’s why mammograms aren’t recommended to women under 40.
Let’s say you have 10,000 patients. 10 have cancer or a precancerous lesion. Your test may be able to identify all 10 of those patients. However, if it has a false positive rate of 5% that’s around 500 patients who will now get biopsies and potentially surgery that they don’t actually need. Those follow up procedures carry their own risks and harms for those 500 patients. In total, that harm may outweigh the benefit of an earlier diagnosis in those 10 patients who have cancer.
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