June 9, 2015
Breast Cancer is a leading cause of female cancer mortality worldwide. According to the Globocan 2014 report, about 23% of all cancer cases are due to Breast Cancer and nearly 14% of all cancer deaths are related to it. Additionally today there are more than 1.38 Million new cases of cancer diagnosed globally each year and over 458,000 deaths result from it annually. Although these numbers may seem staggering at first, the interesting thing to note here is that these statistics are only derived from the women who have been screened i.e. according to WHO, only 60 million (which is less than 4%) of the total women population in the world today (which is about 1.6 billion) have been screened out of which 25 million have been from the United States. Therefore the problem might be much larger than we realize at this moment. In fact in countries like China where there are about 350 million women who are above the age of 40, only a small portion of them (7.5 million) has been screened. A similar story is reflected in India where out of the total of 250 million women over the age of 40 only 7 million are screened. Hence, if the data is to extrapolated from the WHO statistics, the reality may in fact be more like over 16 million women who have breast cancer and over 4.5 million women may actually die due to Breast cancer alone. Thus it is vitally important to come up with an inexpensive and easy-to-use technology which can used to screen this vast population as early detection and treatment have been found to be the best way to decrease deaths due to breast cancer.
The current techniques used for screening breast cancer are mammography and laboratory ELISA-based screening test. Although they have been around for quite some time, they haven’t been able reach out to the masses for various reasons. These machines are extreamly expensive and require specialized environments to be placed in, i.e. clean rooms, temperature controls and continuous clean water supply etc. A Mammography machine can cost anywhere over a $100K and a ELIZA machine can cost over $30K in the US. The issue become even more significant for emerging economies like India, China and other underdeveloped nations where one has to add shipping costs and duties resulting in very high costs. Further, there are issues with constant Electrical supplies in these countries and no clean water etc. Hence, these tests tend to be very expensive and rely heavily on trained personnel. Additionally the enormous size of the machines and their high maintenance requirement prevent them from being accessible by people in rural areas.
In regards to Mammography which is the primary technique used for breast cancer screening, while it can be highly accurate, the problem arises due to exposure to radiation which can further trigger certain genes like the BRACA1 and BRACA 2 in women to result in possible tumor formation in the breast. Hence patients tend to avoid getting screened. Further, the accuracy really depends on the reading ability of the radiologist which varies from 45 to 95% depending on the radiologists experience, fatigue, eye site, frame of mind etc. According to American Cancer Society, the average Mammographers’ reading ability is around 76% and the false positive rate is approximately 3 to 4 per mammogram. This implies high rates of misses and cost increase due to unnecessary biopsies. Basically the analogy we can draw is that of someone looking for a needle in a haystack when in fact there may not be any such needle in the hay stack. So while Mammography is a standard and accepted screening technique, less than 4% of the world population is being screened and hence millions of women dies every day due to Breast Cancer.