Breast cancer – the burden and early diagnosis
In Germany, breast cancer is the most common cause of death for women between 40 and 44 years of age. Roughly 60,000 women are newly diagnosed with breast cancer every year; for 18,000 of these cases the illness is fatal. Early detection and treatment significantly increases women’s chance of survival, and quality of life for those on treatment.
The available prevention and early detection methods for breast cancer in Germany are not optimal. The standard method used today is mammogram screening. However, routine mammograms in the German healthcare system are only offered to women aged between 50 and 69, even though around 20% of breast cancer is detected in women under the age of 50. In addition (and for younger women this is the only method of screening), physicians regularly examine the breast as part of a routine female check-up (usually once or twice a year). However, there is no standardized or evaluated method for such breast examinations in Germany and it’s provided at varying levels of time investment and care.
discovering hands® - idea and benefits
discovering hands® addresses some of these shortcomings by training and deploying visually impaired women with their highly developed sensory skills to detect the early signs of breast cancer.
“Medical Tactile Examiners” (MTEs) are trained at vocational training centers for people with disabilities (Berufsförderungswerke) across Germany and deliver breast examinations at doctors’ practices. During the 9-month training period, they learn how to use a standardized diagnostic method for examining the female breast. Additionally, all MTEs are trained in communication skills and breast-specific psychology, as well as administrative tasks typically carried out by a doctor’s assistant MTEs are either directly employed by resident doctors or hospitals, or they work for different practices and/or hospitals on a freelance basis.
The examination is either paid by health insurances (so far we have contracts with 4 health insurances in Germany) or out of the patient’s own pocket.
Discovering hands® has a number of benefits:
- Perceived disability is leveraged as a talent: By using the extraordinary sensory capabilities of visually impaired women, a perceived “disability” is transformed into a capability. A completely new field of meaningful employment is created
- Standardized method: MTEs use a standardized examination method that has been developed specifically for the purpose of their work
- More time for prevention and early detection: Typically, a regular breast examination carried out by a gynecologist takes between 1 and 3 minutes. The MTE invests at least 30 minutes for each session, not only examining the breast, but also educating patients on how to cope with the risk of breast cancer. Patients feel that they are well taken care of and receive the best possible preventive examination in a pleasant environment
Preliminary qualitative results show that MTEs detect ~30% more and ~50% smaller tissue alterations in the breast than doctors (5-8mm vs. 10-15mm). A clinical, peer reviewed study is currently being conducted at the University of Erlangen under the supervision of Prof. Beckmann.
As of today, ~20 blind women are part of the discovering hands® network, working in 17 gynecologist’s practices and hospitals across Germany. You can find a list here. More than 10,000 examinations have been carried out to date.
Discovering hands® is planning to substantially increase the number of MTEs in the years to come, aiming at employing roughly 70 blind women in Germany alone.
So far, there has been no expansion or adoption of the discovering hands® approach (or any similar use of blind women in early breast cancer detection) beyond Germany. However, discovering hands® intends to expand the system to at least 3-4 countries in the next 5 years via a social franchise system: we will expand to Austria in 2014, we are in negotiations with representatives from possible partner organizations in three countries from Europe and the Middle East and there is concrete interest from 5 countries across three continents. For more information, you can download a short description of the idea here, a detailed Exposé here and an impact report (in German) here .
Discovering hands® is a social enterprise. All benefits are reinvested in improving our services and scaling up the reach of MTEs across Germany and beyond.
Success thus far
The idea and current status of discovering hands® has received a lot of positive feedback and support. We have won numerous awards, among them the prize for innovation in the German healthcare system in 2011. As a social entrepreneur, Dr. Frank Hoffmann – the CEO and founder of discovering hands®– has been awarded an Ashoka Fellowship for the development of the discovering hands® model. Furthermore, discovering hands® has been selected to become part of the Ashoka Globalizer Program as well as the Making More Health Initiative and in 2013, the Ruderman Family Foundation has decided to support discovering hands® as the first non-profit organization outside the US and Israel. To date, 6 public and all private health care funds cover the cost for the examination in Germany. This makes the MTE’s service available free of charge for roughly 5.5 million women in this country. Also, there has been widespread national and international news coverage on discovering hands®. Please find a selection of press clippings here.
If you would like to find out more or support us in our efforts, do not hesitate to contact us.