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Constance D. Lehman, MD, PhD
Professor of Radiology
Harvard Medical School
Chief of Breast Imaging and Co-Director of AVON Breast Center
Massachusetts General Hospital
Goal: To predict with precision and accuracy women at risk for developing breast cancer.
Impact: Dr. Lehman and her multidisciplinary team of scientists use advanced tools of artificial intelligence (AI) to extract complex information contained within a breast image—such as breast density—to develop risk models for breast cancer. This work will allow for the identification of women at risk for breast cancer, particularly aggressive subtypes of breast cancer and can be rapidly implemented to provide greater access.
What’s next: The research team will use artificial intelligence coupled with information included in the Nurses’ Health Studies to improve current risk assessment methods. Their work will improve the ability to predict an individual woman’s risk of breast cancer.
The first step in breast cancer prevention is an accurate assessment of individual risk so that personalized prevention strategies can be implemented. With the rapid advances in artificial intelligence, there is a great opportunity to improve upon current risk models, which are limited in their scope in both personalized risk assessment and in predicting risk of specific breast cancer subtypes. Dr. Lehman and her team are applying the power of artificial intelligence technology to improve breast cancer risk assessment, detection, diagnosis and treatment.
Full Research Summary
Research area: Predicting women at risk for breast cancer by applying advanced tools of artificial intelligence (AI) to extract complex mammographic image data.
Impact: Breast mammography has served as for the gold standard for breast cancer screening. However, mammography and other imaging technologies used in health care require highly-specialized training and are also subject to human interpretation. Furthermore, they each have limitations that can either result in false positives—reporting a cancer that is not there, or false negatives—reporting no cancer when, in fact, cancer is present. Dr. Lehman’s research will lead to more accurate risk-prediction tools that will facilitate personalized breast cancer prevention, screening and diagnosis.
Current investigation: Dr. Lehman’s collaborative research team has developed advanced computer algorithms that can extract complex patterns from mammographic images. They will combine this technology with information obtained from the Nurses’ Health Studies (with more than 20,000 diagnosed breast cancers)—including information about behavior, lifestyle, and reproductive history—to develop an artificial Intelligence-based risk assessment tool to predict a woman’s risk of aggressive breast cancers. These AI-based risk models will guide more effective targeted prevention strategies at the individual level. Their approach is designed to support rapid clinical implementation of personalized risk assessment both locally and globally with the potential application to different cancer types and patient populations.
Constance “Connie” Lehman, MD, PhD is a Professor of Radiology at Harvard Medical School, Chief of Breast Imaging, and co-Director of the Avon Comprehensive Breast Evaluation Center at the Massachusetts General Hospital. She is a physician scientist who received her MD and PhD from Yale University after graduating Phi Beta Kappa from Duke University. She is a change agent, innovator and pioneer in the domain of Artificial Intelligence implementation in clinical medical practice. Her current work applies artificial intelligence and advanced methods of deep learning to improve breast cancer detection, diagnosis and treatment. Her current efforts focus on applying AI to deliver higher-quality health outcomes at lower costs for the full diversity of patients at risk for and with cancer. This is a continuation of her career-long commitment to expand access for all patients globally to highest quality, patient-centered, affordable care.
With over 250 peer-reviewed scientific publications, she has led careful studies of advanced imaging tools to identify breast cancer at its earliest stages—when it can be cured. Collectively, her philosophy embodies the notion that we improve the health of our community by delivery the highest quality patient-centered care in a setting of active innovation and education.
In her prior leadership roles at the University of Washington and Seattle Cancer Care Alliance, she developed an internationally-recognized program of excellence in patient care, education and research. She collaborated with partners in industry, development, and multiple clinical and basic science disciplines to foster new opportunities for faculty to pursue their goals. As division chief of breast imaging and co-Director of the AVON Comprehensive Breast Center at MGH, she rebuilt the service care model as well as the education and clinical research programs to stimulate new growth and productivity in times of scarce resources.
In her career, Dr. Lehman has developed novel patient care pathways, which substantially improve efficiency and increase access for patients and increase satisfaction of patients, faculty and staff. Her methods are used widely by her former fellows and faculty, many who lead their own breast imaging programs.
Her research in clinical applications of breast MRI shaped the American Cancer Society and NCCN recommendations for screening MRI in high-risk patients. Dr. Lehman’s research on breast ultrasound updated the ACR appropriateness guidelines for women under 40, and this work continues to support best practices worldwide for women with palpable breast lumps.
Dr. Lehman has inspired many others to pursue careers in academic medicine and has served on a number of key national committees, including the National Cancer Institute’s Breast Cancer Steering Committee and the American College of Radiology’s (ACR) Committee on Breast Imaging for Appropriateness Criteria and Guidelines. She has given over 400 national and over 60 international invited talks spanning diverse topics in advanced imaging for more effective diagnosis and treatment of breast cancer.