Reflections on first 'self-screener' for breast cancer

The young American company EU LifeSciences is focusing on the early detection of cancer in women through systems they can use themselves at home. Together with Siemens, EU LifeSciences will soon launch the first device that allows you to screen your breasts yourself (1). It is the IBreastExam: a battery-operated device consisting of a handle and a cushion with sensors. With the IBreastExam, you have to scan the surface of your breasts with light pressure, while the sensors in the cushion can detect differences in breast tissue stiffness. That information is sent wirelessly to an app on your smartphone or tablet, where it is converted into a 3-D image showing the stiffness of the breast tissue. Differences in stiffness can indicate a lump in the breast, just as you can feel when you examine your breasts with your hands. However, the device, the IBreastExam, claims to be able to do this better than our fingers. Any abnormal hardening lights up red on your screen. It takes some practice to learn to use this IBreastExam properly. The device is not yet available, but is expected soon.

Third World Countries

The IBreastExam has been proving its worth for several years in third world countries where women do not have access to screening mammography. This is confirmed by a recent study (published April 2022) from Obafemi Awolowo University in Nigeria where, in 2019, 424 women at increased risk of breast cancer were either examined by an experienced surgeon or by a nurse trained to use the IBreastExam (2). The device found abnormalities in the breast more often than the experienced surgeon, but the surgeon was better able to distinguish between a benign or malignant lesion. Unfortunately, small lesions (smaller than 2 cm) were missed by both the surgeon and the IBreastExam. The study also examined women with ultrasound and mammography: both imaging techniques detected significantly more breast cancers than either the IBreastExam or the surgeon's hands. For countries, such as Nigeria, where women have little access to screening mammography, the IBreastExam does provide an excellent device to detect abnormalities in the breasts. Moreover, a nurse can learn to use this device, which is especially useful in regions where there are no or few physicians. Its ease of use and relatively low cost are additional reasons for making the IBreastExam available in third-world countries, where most breast cancers are detected at a later stage than in our countries, thus limiting survival. In Nigeria, for example, 80% of breast cancers are detected at stage 3 or 4 and the tumor has an average diameter of over 10 centimeters at the time of diagnosis.

False alarm

The IBreastExam will soon be launched as the world's first device that allows you to self-screen your breasts for cancer. The accuracy of this device can in no way surpass the accuracy of a screening mammogram. A negative result does not give complete certainty because very small tumors are missed. In addition, the device often gives false alarms. Of 50 cases of potentially suspicious lesions, five end up being breast cancer after further investigation. False alarms cause a lot of fear and anxiety and unnecessary investigations. It's quite possible that young women with breasts full of glandular tissue with such self-examination are even more likely to get false alarms. However, one advantage of the IBreastExam is that it is painless and even more accessible (you can do it at home), compared to a screening mammogram.

Pink Ribbon encourages women between the ages of 50 and 69 to accept the invitation of breast cancer screening by screening mammography, as organized in our country. Those at increased risk of breast cancer are best to consult with her (his) doctor about whether a mammogram at a younger age is desirable. Our organization does not consider the IBreastExam to be a good alternative to breast cancer screening as it is done today.

(1)https://www.uelifesciences.com/

(2)Mango V, Olasehinde O, Omisore A et al. The iBreastExam versus clinical examination for breast evaluation in high-risk and symptomatic Nigerian women: a prospective study. The Lancet Global 2022;10:E555-E563 (April 2022).