Radiologist Demand and Supply: Securing the Future of Breast Imaging

Recent projections from peer-reviewed studies indicate that U.S. imaging utilization is expected to grow modestly, by roughly 16.9% to 26.9% by 2055 relative to 2023 levels, primarily driven by population growth and an aging demographic (Christensen et al.^a, 2025).

Although these figures encompass multiple modalities, similar principles apply to mammography. In fact, as more women enter and remain in the screening age range, the total number of mammograms is anticipated to increase by approximately 20-30% over the next 30 years. This forecast assumes that per-capita screening rates remain constant; however, if new guidelines (i.e. expanding recommended screening from age 40 to 74) are widely adopted, actual demand could exceed these baseline estimates.

A key factor is the impact of insurance mix. Although the shift from Medicare fee-for-service to Medicare Advantage tends to dampen per-person imaging rates, mammography is considered a preventive service and is broadly covered across plans. So, as older women increasingly enroll in Medicare Advantage, the overall demand for breast imaging is expected to rise steadily.

On the workforce side, projections indicate that the overall radiologist supply is expected to grow by approximately 25.7% to 40.3% by 2055 relative to 2023, depending on whether residency slots continue to expand (Christensen et al.^b, 2025). Under current training levels (without additional slots), the workforce would grow only modestly, roughly 25% over 32 years. This slow growth is compounded by post-COVID-19 attrition rates, now averaging around 3% annually (up from 1.9% pre-pandemic), which could result in thousands fewer radiologists over time.

While overall supply and demand projections appear roughly balanced, the subset of breast imaging specialists may face an even tighter squeeze due to increasing mammography volumes, subspecialty preferences, and higher burnout in this field.

To secure the future of breast imaging, imaging center executives must plan for increased volumes by expanding mammography unit capacity, extending operating hours, and leveraging teleradiology. Equally critical is the integration of AI systems that may offer a promising path to handling scale efficiently. The application of AI has the potential to transform healthcare and ensure its long-term sustainability by improving operational efficiency by reducing repetitive administrative tasks and instead allowing healthcare providers to focus more on patient care (Topol, 2019^c). Yet, technology without establishing new processes is no panacea. Ensuring robust workflow integration and high user acceptance remains essential.

Additionally, policy-makers will need to prioritize expanding radiology training programs, with a specific focus on breast imaging fellowships, and implement effective retention strategies to reduce burnout. Legislative initiatives to support Graduate Medical Education (GME) funding and ensure adequate reimbursement for preventive services will also be needed to maintain access to appropriate imaging services to women.

By aligning operational improvements, technological innovation, and supportive policies, the radiology community can meet the gradual, but significant, increase in mammography demand, ultimately enhancing early detection and improving patient outcomes for decades to come.

^a. Christensen, E. W., Drake, A. R., Parikh, J. R., Rubin, E. M., & Rula, E. Y. (2025). Projected US Imaging Utilization, 2025 to 2055.  Journal of the American College of Radiology (JACR), Volume 22, Issue 2, February 2025.

^b. Christensen, E. W., Parikh, J. R., Drake, A. R., Rubin, E. M., & Rula, E. Y. (2025). Projected US Radiologist Supply, 2025 to 2055.  Journal of the American College of Radiology, Volume 22, Issue 2, February 2025.

^c. Topol, E. (2019). Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. Basic Books.