{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T20:06:11Z","timestamp":1793217971691,"version":"4.5.0"},"reference-count":92,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health Ricerca Corrente 5x1000 funds"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Conventional breast cancer screening programs are predominantly age-based, applying uniform intervals and modalities across broad populations. While this model has reduced mortality, it entails harms\u2014including overdiagnosis, false positives, and missed interval cancers\u2014prompting interest in risk-stratified approaches. In recent years, artificial intelligence (AI) has emerged as a critical enabler of this paradigm shift. This narrative review examines how AI-driven tools are advancing breast cancer screening toward personalization, with a focus on mammographic risk models, multimodal risk prediction, and AI-enabled clinical decision support. We reviewed studies published from 2015 to 2025, prioritizing large cohorts, randomized trials, and prospective validations. AI-based mammographic risk models generally improve discrimination versus classical models and are being externally validated; however, evidence remains heterogeneous across subtypes and populations. Emerging multimodal models integrate genetics, clinical data, and imaging; AI is also being evaluated for triage and personalized intervals within clinical workflows. Barriers remain\u2014explainability, regulatory validation, and equity. Widespread adoption will depend on prospective clinical benefit, regulatory alignment, and careful integration. Overall, AI-based mammographic risk models generally improve discrimination versus classical models and are being externally validated; however, evidence remains heterogeneous across molecular subtypes, with signals strongest for ER-positive disease and limited data for fast-growing and interval cancers. Prospective trials demonstrating outcome benefit and safe interval modification are still pending. Accordingly, adoption should proceed with safeguards, equity monitoring, and clear separation between risk prediction, lesion detection, triage, and decision-support roles<\/jats:p>","DOI":"10.3390\/cancers17172901","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T09:18:57Z","timestamp":1756977537000},"page":"2901","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Artificial Intelligence-Driven Personalization in Breast Cancer Screening: From Population Models to Individualized Protocols"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0374-5054","authenticated-orcid":false,"given":"Filippo","family":"Pesapane","sequence":"first","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3979-8075","authenticated-orcid":false,"given":"Luca","family":"Nicosia","sequence":"additional","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucrezia","family":"D\u2019Amelio","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Radiology Department, SC Radiologia, IRCCS C\u00e0 Granda Fondazione Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Radiology Unit, Sant\u2019Andrea University Hospital, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Quercioli","sequence":"additional","affiliation":[{"name":"Postgraduate School in Radiodiagnostics, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariassunta Roberta","family":"Pannarale","sequence":"additional","affiliation":[{"name":"Postgraduate School in Radiodiagnostics, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Priolo","sequence":"additional","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Marinucci","sequence":"additional","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Giorgia","family":"Farina","sequence":"additional","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Penco","sequence":"additional","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Dominelli","sequence":"additional","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9439-9275","authenticated-orcid":false,"given":"Anna","family":"Rotili","sequence":"additional","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenza","family":"Meneghetti","sequence":"additional","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Carla","family":"Bozzini","sequence":"additional","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Santicchia","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Radiology Department, SC Radiologia, IRCCS C\u00e0 Granda Fondazione Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3437-8939","authenticated-orcid":false,"given":"Enrico","family":"Cassano","sequence":"additional","affiliation":[{"name":"Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1001\/jamainternmed.2023.3798","article-title":"Estimated Lifetime Gained with Cancer Screening Tests: A Meta-Analysis of Randomized Clinical Trials","volume":"183","author":"Bretthauer","year":"2023","journal-title":"JAMA Intern. 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