Dr. Rachel Brem decided at the age of 12 that she wanted to cure cancer after her mother was diagnosed with breast cancer. It was thanks to early detection that his mother survived well beyond her six-month prognosis. Today, Brem works to improve breast cancer screening for all women.
Brem is a board-certified diagnostic radiologist and director of breast imaging and intervention at George Washington University. She created the Brem Foundation to help prevent more deaths from breast cancer.
On this week’s episode of “Healthful,” she discussed the innovation that gives her hope.
Artificial intelligence and breast imaging
“AI is going to change everything in medicine, and certainly in breast cancer detection,” Brem said.
In addition to her work with George Washington University’s Breast Imaging and Intervention Unit, Brem is collaborating with ScreenPoint Medical to develop Transpara, an AI breast cancer screening software.
There is already significant scientific research showing that mammograms combined with AI assessments “can detect cancer up to five years earlier,” she said, by detecting warning signs in women that might go unnoticed with mammograms alone. The software can also predict future risk of breast cancer even if none is detected during a mammogram.
“Imagine what impact this will have on survivorship therapy,” Brem said.
If women start getting screened at age 35 with AI-enhanced readings, she noted that the software will constantly learn how to improve breast cancer detection with each scan. This is younger than the starting age recommended by several major medical organizations.
At George Washington University, Brem said, “we’ve been using AI for over four years in every mammogram,” adding that it doesn’t cost more to use the software.
However, nationally, only 20% of practices use AI for their mammography procedures. Often, AI readings cost more, which may make the option inaccessible for some.
“There’s nothing you can do to absolutely prevent breast cancer,” Brem acknowledged.
But she said: “One of the things AI can do is actually equalize inequality,” referring to the racial disparities which affect the diagnosis and treatment of many women.
“Black women die at a 40 percent higher rate (from breast cancer) than white women,” Brem noted, and women with fewer resources have less access to mammograms.
Brem wants to change that with his foundation, which has championed early detection for 20 years through innovative screening, increased education and awareness, and equitable access.
“I look forward to broader implementation of AI to help not only detect more cancers, but also improve healthcare,” she said.
A breathalyzer for breast cancer?
Brem is participating in the development of a breathalyzer capable of detecting breast cancer. Diseased tissue gives off a chemical compound that turns into a gas and, scientists say, could be used as a non-invasive way to assess who needs further screening.
“It’s not available yet, but I’m really excited to have no pain, no compression and no way of injection to diagnose if you’re accurately diagnosed,” Brem said.
And we hope it can one day help beyond breast cancer. “The next step on our roadmap is not just breast cancer, but a women’s health panel where you could take one breath and do all these tests,” Brem said.
The current state of breast cancer screening
Guidelines from the American College of Physicians stipulated in 2026 that women over 50 should have a mammogram every two years. The U.S. Preventive Services Task Force recommends that women begin screening every two years at age 40.
For Brem, “It’s a parody.”
“Women will die if they listen to this.”
According to her research, women should be screened for breast cancer annually from 40 years old. For those with a history of breast cancer in their family, it should start at age 35.
All this is easier said than done. Women often cite anxiety as the reason they delay or avoid getting tested. The idea of receiving a positive test result understandably makes women nervous, but as Brem notes, “you don’t get rid of the disease by not knowing you have it.”
Early detection of breast cancer leads to significantly better outcomes compared to cases where breast cancer is detected at a later stage.
“Ninety-nine percent of women with early breast cancer survive and thrive,” Brem said, but this result can only be possible if women are screened early and regularly.
In addition to the recommended mammograms, Brem also believes that “you absolutely, unequivocally, absolutely need more tests” if you have dense breasts. Half of women have dense breasts, and mammograms may fail to detect potentially deadly tumors hidden behind the tissue. Ultrasounds, MRIs or mammograms with contrast are necessary for women with dense breasts to get a complete picture of their risks.
Additional screening is not always the norm among some doctors. Brem said it is “very important” that women insist that their doctors order these additional tests. Mammograms are not enough.
Demand more, educate yourself and “be badass”
Brem is adamant in her belief that women can be proactive now to improve their health and improve their breast cancer outcomes. If you have dense breasts, request additional screening.
For those under 40 who think they have time to start breast cancer screening, think again.
“You’re not too young to get breast cancer,” Brem warns.
Discussing your breast cancer screening plans now and seeking additional tests is essential for early detection and a better prognosis. “If you find it early, even if you’re young, it’s curable,” Brem said.
Cancer rates are increasing among younger women and awareness is the first step to being proactive about your health. Her foundation provides resources to educate women.
But what do you do with this information? Brem invites you to defend your interests with the doctor’s office.
“We tell women to be badass,” she said. “You have to defend your interests. It’s a fundamental principle. It’s your right. It’s what you deserve, and it’s not a maybe.”
Gn Health
