Breast cancer is the most common cancer among women in India and remains a major public-health challenge. October is recognised as International Breast cancer awareness month. With over 200,000 new cases every year and 100,000 deaths per annum, for every two women diagnosed with breast cancer, one dies of it in India. Due to lack of awareness and absence of a robust population-based screening programme, more than 60% present in the advanced stages. The burden underlines the urgent need to improve awareness, promote timely assessment and strengthen pathways to early diagnosis and treatment.Artificial intelligence (AI) is creating new possibilities in breast imaging. AI systems can analyse mammograms, flag subtle abnormalities and help radiologists prioritise suspicious studies. The challenge is to ensure that these advances benefit women not only in major cities but also in rural, remote and underserved communities.AI must support healthcare professionals, not replace them. Suspicious findings still require clinical assessment, appropriate imaging and, when indicated, tissue diagnosis. Its potential lies in strengthening different parts of the pathway—from reliable breast-health information to specialist-supported interpretation of imaging.Reaching every communityIn the North-East, as in other parts of India, geography, travel distances, uneven access to specialist services and language diversity can complicate timely healthcare. The challenge is to connect women wherever they live—to awareness, early assessment, diagnosis and treatment.Mammography can play an important role in early detection, particularly for women in appropriate age and risk groups. However, its benefits depend on access to quality imaging, reliable interpretation and follow-up. Where mammography is not readily accessible, trained healthcare workers can help identify breast changes through clinical breast examination (CBE) and refer women who require further assessment. CBE is included in India’s National Health Mission approach to population-based screening. Any abnormal finding must be linked to timely clinical assessment, diagnostic imaging and tissue diagnosis where indicated, followed by appropriate treatment.Our experience in Telangana and Andhra Pradesh demonstrated the potential of taking early detection into communities. Between 2012 and 2016, more than 200,000 underprivileged women across 4,000 villages underwent CBE delivered by 3,750 trained healthcare workers. This experience contributed to the wider adoption of CBE within National Health Mission’s screening strategy.The lesson is simple: health services must reach women in their communities, rather than relying only on women to travel to specialist centres.AI in breast imaging & careAI can support parts of the breast-imaging pathway, including analysing mammograms and helping triage studies that need closer review. In some settings, it is used as an additional reader alongside radiologists. Used responsibly, it may help manage workloads and support consistency; it cannot independently establish a cancer diagnosis or replace clinical judgement.Technology is useful only when the rest of the pathway works. Women with concerning findings need clear referral routes, access to diagnostic imaging and biopsy, and timely treatment—including surgery, systemic therapy and radiotherapy when required. Screening without diagnosis and treatment is not an effective cancer-control programme.AI-enabled breast-health educationAI-enabled educational platforms can make reliable breast-health information available in multiple languages and allow women to ask questions in a familiar format. This could be especially valuable where distance, stigma or limited awareness makes it difficult to seek information.This is the purpose of NARI—National Awareness & Resource Initiative for Breast Health, a non-profit public-health initiative of Ushalakshmi Breast Cancer Foundation. NARI uses an AI-enabled digital educator to explain benign breast conditions, breast cancer, warning signs, screening and prevention. It is an educational resource, not an AI doctor, and does not replace examination by a qualified healthcare professional or provide a diagnosis.Prevention still essentialEarly detection is only one part of the response. Maintaining a healthy weight, being physically active, avoiding tobacco, limiting alcohol, following healthy dietary patterns and breastfeeding can help reduce breast cancer risk. Prevention and early detection must go hand in hand.From innovation to an integrated systemIndia must harness AI as a complement to human expertise, integrating digital education with trained healthcare workers, primary care, appropriate imaging, pathology and specialist services.For the North-East and other underserved regions, multilingual education and community-based awareness can be linked to carefully planned referral networks. AI tools must be evaluated for accuracy, usefulness, privacy and suitability for the communities they serve, with local health systems and healthcare workers remaining central.Technology alone cannot save lives; its true value lies in reaching women who are otherwise left behind and ensuring that those who need care receive it in time. The ultimate measure of AI’s success will not be how advanced the technology becomes, but how many lives it helps save.(The author is a breast cancer specialist, Padma Shri awardee & Officer of the Most Excellent Order of British Empire. He is founder-chairman, Ushalakshmi Breast Cancer Foundation, Hyderabad & founding director: KIMS-Ushalakshmi Centre for Breast Diseases)
