Professor Fiona Gilbert discussed the challenges of breast cancer screening and how major medical advances in technology could save the lives of more women in the 502nd Linacre Lecture at St John’s College.
An audio recording of the annual lecture, titled Should we move to personalised screening for breast cancer?, has been published online following Professor Gilbert’s talk on Tuesday 10 February 2026.
The Professor of Radiology and Head of the Department of Radiology at the University of Cambridge has spent her career assessing breast imaging techniques to improve patient care and outcomes and led many major studies.
These include the BRAID trial, which last year showed that extra scans could treble cancer detection for higher risk women.
Founded in 1524 by Thomas Linacre (1460-1524), the physician to Henry VIII and founding president of the Royal College of Physicians, the Linacre Lecture is given annually by a leading academic in Medical Sciences.
It is the oldest medical endowment in the University, and its purpose is to discuss relevant topics in medical practice, the development of medicine, and new research insights.
In her lecture, Professor Gilbert discussed the evolution of breast screening programmes and the need to make use of the latest technologies to find and treat breast cancer much earlier.
She explained the limitations of mammography – particularly in women with dense breasts, which make it more difficult to detect cancers – and the potential of modern technology to improve survival rates for these women and others at higher risk of the disease.
“We know that 30 per cent of women who attend for screening are diagnosed with cancer between the three-yearly screening rounds. It’s a real problem”
Denser breasts look whiter on mammograms, which makes it harder to spot small early-stage cancers that also appear white.
“The NHS breast screening programme has been running for 40 years but has remained largely unchanged, which is disappointing because there have been massive developments in imaging over that time,” said Professor Gilbert.
Breast cancer gene carriers and those at 50 per cent risk of carrying a mutation are offered annual MRI with mammography.
Women at moderate risk are offered annual mammography between the ages of 40 and 50, while those up to 70 years of age are invited every three years for mammography.
“We know that 30 per cent of women who attend for screening are diagnosed with cancer between the three-yearly screening rounds. It’s a real problem,” said Professor Gilbert.
Advanced modern imaging techniques show promising results in detecting more cancers. These include ultrasound, digital breast tomosynthesis (DBT) – which take multiple images from different angles – and contrast-mammography, which uses iodine to highlight cancers.
Professor Gilbert said artificial intelligence can also be used to improve screening accuracy for early detection, as well as personalised screening based on risk prediction tools.
