Breast cancer – the burden and early diagnosis
Breast cancer is the most common cancer in women both in the developed and less developed world. It is estimated that worldwide over 508 000 women died in 2011 due to breast cancer (Global Health Estimates, WHO 2013). This represents about 12% of all new cancer cases and 25% of all cancers in women.
Incidence rates vary greatly worldwide from 19 per 100,000 women in Eastern Africa to 90 per 100,000 women in Western Europe per year. In most of the developing regions the incidence rates are below 40 per 100,000. However, the incidence of breast cancer is increasing in the developing world due to an increase in life expectancy, increase urbanization and the adoption of western lifestyles. Although some risk reduction might be achieved with prevention, these strategies cannot eliminate the majority of breast cancers that develop in low- and middle-income countries where breast cancer is diagnosed in very late stages.
Therefore, in all countries - early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control.
So far the only breast cancer screening method that has proven to be effective is mammography screening. However, mammography screening is very costly and is cost-effective and feasible in countries with good health infrastructure that can afford a long-term organized population-based screening programs. And even there screening is not available to everyone. For example in Germany, only women aged between 50 and 69 are entitled to a mammography screening every two years, even though around 20% of breast cancer is detected in women under the age of 50.
In health systems with developed infrastructure, physicians regularly examine the breast as part of a routine female check-up (usually once or twice a year) in addition to the mammography. However, there is no standardized or evaluated method for such breast examinations (for instance in Germany) and it’s provided at varying levels of time investment and care.
discovering hands® - idea and benefits
discovering hands® trains and deploys visually impaired women with their highly developed sensory skills to detect the early signs of breast cancer.
“Medical Tactile Examiners” (MTEs) are trained to deliver physical breast examinations at doctors’ practices. During a 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.
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.
Discovering hands® is planning to substantially increase the number of MTEs in the years to come, both in Germany and around the world. We are operating as a social business because we believe in the our value proposition (to the healthcare sector, and institutions supporting people with disabilities) and financial sustainability because of that.
We are committed to the social "win-win" of our model: offering meaningful employment to blind women, and creating an opportunity for them where they have competitive strength; and helping to improve the breast cancer early identification situation and awareness for the most common cancer among women.
discovering hands® currently operates in Germany and in Austria. In both India and Colombia we have pilot projects running with scale-up in planning. And we are interested in further country roll-out, which we operate through a social franchise. If you are an entrepreneur and would like to implement discovering hands in your country, contact us! We’d love to hear from you. Also, if you are an impact investor and are interested in collaborating with us to further roll-out the model, please contact us too. We are interested in hearing from you!
If you would like to find out more or support us in our efforts, do not hesitate to contact us.