SBI 2026: A Disciplined Approach to the Future
As I sit at the airport in Seattle waiting for my flight home, my thoughts turn to the overarching themes of the first two days of the 2026 Society of Breast Imaging (SBI) Symposium. Compared to last year’s gathering in Colorado Springs, this conference felt fundamentally different. It wasn’t just the shift from the Rockies to the humid, forested terrain of the Pacific Northwest, nor the move to a larger metropolitan venue; rather, the energy of the meeting itself felt more grounded.
The Maturation of AI
After SBI 2025, I reflected on a wonderful sea change as the SBI finally seemed to embrace supplemental screening. However, that progress was nearly drowned out by the ridiculous hype surrounding Artificial Intelligence—specifically the blatant over-marketing from vendors.
This year, the vendor stalls told a different story. The overblown banners and loud claims had vanished, replaced by an honest, down-to-earth approach regarding what AI actually offers. There was a visible, increased recognition that no system is perfect. I couldn't help but smile at one particular vendor; last year, I had chastised them for lacking research materials and employing salespeople who were unversed in the research foundations of their products. This year, those same representatives wore buttons that read: “Ask me about our prospective clinical trials.” Even more encouraging was the presence of scientists from these companies, prepared to discuss the nuances of research and explain how their algorithms differ under the hood. On the user-end, I was pleased to see cleaner AI interfaces for mammography detection. We are seeing fewer distracting circles, more cases with no marks at all, and higher confidence in flagged positives. It is a shift toward reducing mental exhaustion for the radiologist rather than increasing it.
BI-RADS 2025 and the Cost of Education
In the lecture hall, two highlights stood out from the first two days. The first was the standing-room-only crowd for the update on BI-RADS 2025. The second was the ensuing Q&A session, where the audience used the SBI app to upvote questions.
The top-voted question asked why the new atlas is priced to the point of "extortion." The audience broke into widespread applause when the question was read. While the committee acknowledged the price hike, they simply stated it was an ACR decision, not theirs. Personally, I would have liked to see SBI leadership vigorously push back at the ACR for their pricing decision, but I am nonetheless encouraged by the audience’s challenge. The world is a better place when the BI-RADS manual is accessible; we want every resident and fellow—not just in the U.S., but across the globe—to have this essential resource in their hands.
Honoring the Advocates
The SBI Gold Medal was deservedly awarded to Dr. Wendie Berg, a true star in breast imaging. For years, Dr. Berg has bucked the status quo, pushing back against the initial reluctance of the ACR and SBI to strongly endorse supplemental screening for women with dense breasts.
Dr. Berg is a preeminent example of an objective physician-scientist who pushes bias aside to follow the data. Long before it was popular, she helped launch densebreast-info.org and led head-to-head trials comparing technologies like Contrast-Enhanced Mammography (CEM) and the often-maligned Molecular Breast Imaging (MBI). In her acceptance speech, she reminded us: “Always challenge the status quo and do not just believe that what we are doing today is the best that we can do... we have so much more to learn.”
Additionally, the SBI Honorary Fellowship was awarded to Congresswoman Debbie Wasserman Schultz. As a breast cancer survivor and advocate, her example served as a reminder that our field is as much political as it is scientific. “Be prepared to overcome obstacles,” she urged, “and never stop pushing forward.”
The Shift in the Job Market
Between sessions, I visited the Career Fair. The consensus among recruiters is clear: it has become significantly harder to hire breast imagers compared to even one year ago. Interestingly, most practices now offer remote or hybrid options, noting that many job seekers today specifically demand them. This is a meaningful shift from only a few years ago. Both the willingness of practices to offer remote diagnostics and the comfort level of radiologists in accepting this work mark a new era for our workflow.
A Personal Milestone
Finally, I was truly honored to be inducted as a Fellow of the Society of Breast Imaging. I am grateful for the opportunity to work alongside the society to advance our specialty and effect meaningful change. I leave Seattle feeling optimistic about what lies ahead and our shared capacity to meet the challenges of the future.
