Wednesday, August 29, 2018

iBreastExam - A Cheaper and Less Stressful Prescreening Tool for Breast Cancer

          Two researchers, Mihir Shah and Matthew Campisi have developed a new prescreening tool for breast cancer detection at Drexel University's School of Biomedical Engineering, Science and Health Systems in Philadelphia. This new tool is called the iBreastExam (iBE) and it uses a new ceramic sensor technology to detect subtle variations in breast tissue. It is a battery operated, hand-held machine that can provide results after only a few minutes via a mobile app. Other advantages of the iBE are that it's cheaper than a mammogram, painless, involves no radiation and can be done by a trained female health care worker in five minutes anywhere.  

          In 2016, a study [1] performed by a group of researchers at the Perelman School of Medicine at the University of Pennsylvania showed that iBE demonstrated acceptable sensitivity and specificity in a cohort of patients who had already had a positive breast exam or an abnormal screening mammogram. This was a study designed to validate the iBE's ability to detect lesions.  These researchers state that mammography and ultrasonography demonstrate sensitivity rates of 85-88% and 93-97% for a population of known detectable findings. The iBE in this population demonstrated a comparable sensitivity of 85.7%. Furthermore the iBE meets the threshold of a pre-screening device when compared to the current prescreening tool, i.e. a clinical breast exam, which has a sensitivity of only 50-60%. 

           In this study cohort, the iBE was able to detect all but two of the malignancies, both of which were less than 1 cm in size which is an important threshold for a prescreening device. Directly comparing the sensitivity of cancer detection demonstrates that both the iBE (83%) and the mammogram (91%) are reliable tools to identify patients with cancer. While the sensitivity of cancer detection is lower, the specificity of iBE (74%) surpasses that of mammography (51%) showing that the iBE is better than mammography at not falsely identifying patients with cancer ( i.e. false positives). For this reason and the fact that the iBE is painless, quick and easy to undergo, and doesn't involve radiation, it appears to be a screening tool that won't trigger undue anxiety and stress in patients. In addition its modest cost relative to other screening tests should make it very attractive to insurance companies and medical providers, especially those in economically deprived areas. 

1. Broach et al. World Journal of Surgical Oncology (2016) 14:277.

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