Many women fear breast cancer screening due to the anxiety-inducing journey to the clinic and the cold metal bite of the mammography machine. In fact, some people find the process so unpleasant that they avoid it altogether.
For example, the 2023 Ontario Cancer Screening Performance Report found that between 2020 and 2021, 54.7 per cent of eligible women aged 50 to 74 participated in a regular mammogram. . This represents a decrease of more than 5 percent compared to pre-pandemic visit rates. Well below her program goal of at least 70%.
But what if there was a way to make that experience more comfortable? What if, for example, general practitioners could use a contactless detection tool in the relative comfort of their offices? – The promise of a new screening technology developed by Lifetech, which is scheduled to begin clinical trials this summer at Toronto's Princess Margaret Cancer Center (PMCC).
“We believe this tool has the potential to transform healthcare systems,” said Linda founder Rubens Fernando Mendrone. The phone-enabled device won't replace mammograms, but it could make routine testing more accessible, she said. Providing primary care physicians with simple proactive detection tools will also allow them to identify suspicious changes in breast tissue early, allowing patients to receive testing and treatment sooner, she said.
Medical experts agree that early detection is key for best results. If detected early, many breast cancers can be treated without radiation. Additionally, most provinces encourage women in their 40s to get breast cancer screenings, and starting this fall, Ontario will allow women in their 40s to be referred online for a mammogram. This comes after a recent study published by the University of Ottawa found that the incidence of breast cancer is increasing among young women in Canada.
Screening for breast cancer can be difficult for general practitioners, who are the first line of defense against the disease. Obvious symptoms such as lumps or lesions do not always appear, especially in the early stages of the disease. As a result, about 18 per cent of infections go undetected until they spread to other parts of the body, according to the Public Health Agency of Canada's website.
Mendrone, a tech entrepreneur who lost both her grandmother and godmother to breast cancer, says she understands how deadly the disease can be if intervention is unnecessarily delayed. He spent about two years researching breast cancer screening and came to the conclusion that primary health care professionals needed tools that could more easily detect potential indicators. A year later, he developed a prototype.
“We can give women another month, another year, a new life,” he says.
Searching for breast cancer using body temperature
Unlike mammography, which uses X-ray technology to detect cancer, the Linda Screening Tool employs thermography, which uses infrared sensors to detect heat patterns and blood flow within breast tissue. Although the tool itself is contactless, patients still need to remove their shirts and bras.
As cancer cells grow, they require more oxygen-rich blood to help them grow. This increases blood flow to the tumor and also increases the temperature around the tumor. Linda's sensors create a “heat map” of her breasts that highlights areas that appear suspicious. The device's AI-assisted smartphone app analyzes that data and estimates the likelihood of cancer within seconds.
Taking other details into account, such as your family history, your doctor can use that information to recommend you get a mammogram or see a specialist. Healthcare professionals can also use this assessment to triage cases more effectively. For example, a person who has a 97% chance of having cancer may be scheduled for a mammogram at the earliest, whereas a person whose mammogram shows no signs of cancer may be scheduled for a mammogram at the earliest. You may have to wait a long time to make a reservation.
This means moving from a first-come, first-serve model to what Mendrone calls a “first-come, first-served” approach that requires early treatment, which he says will save time and money for resource-strapped health systems. says. Most of the time it's more cost effective. According to a paper published in Current Oncology in 2023, treatment costs for late-stage breast cancer are often expensive.
“But at the end of the day, the doctor has the final say,” Mendrone said. “Linda doesn't tell them what to do. They're just told, 'This is questionable.'”
Thermography and breast cancer examination
Thermography technology is not new. Although it was first touted as a potential screening method in the 1950s, it has never been approved as a stand-alone tool in Canada. According to Health Canada's website, “claims that thermography helps diagnose breast cancer are unproven.”
Martin Yaffe, an imaging expert at the Ontario Cancer Institute, agrees there is a need for better ways to detect breast cancer. He points out that a variety of techniques are being investigated, including tomosynthesis, also known as 3D mammography, and the use of biomarkers that indicate breast cancer.
Yaffe, who is not familiar with the Linda device, cited concerns about the accuracy of the thermography. He says thermal imaging is not always a reliable predictor of cancer, since hot spots can occur in the body for other reasons, such as inflammation unrelated to tumors.
But Linda's device takes advantage of advances that make that possible, Mendrone said. High-resolution digital images can show suspicious tissue in more detail, and AI-powered analysis can make predictions more accurate, he says.
In addition, Yaffe said he welcomes innovative ideas to help doctors triage patients.
“AI-driven tools, perhaps using information from images, could also help prioritize the order in which patients should be seen in terms of urgency,” he says. “This will help us use resources more effectively in a health system that is under pressure.”
Connection with artificial intelligence
Linda Lifetech offers devices that medical professionals can use anywhere there is an internet connection. The AI tool was trained using a dataset of 3,000 patient records, including mammograms, ultrasounds, and biopsy results. By matching these records with the corresponding thermal images of the patient, Linda's algorithm can identify areas of potential cancer.
Mendrone aims to expand its dataset and further improve the tool's clinical outcomes through new partnerships across Canada, the United States, the United Kingdom, and Australia.
The simplicity of the tool is what makes it popular in Mendrone's home country of Brazil, he says. She said some doctors have started using the Linda machine for screening because mammograms are not easily available in most parts of the country. Each image costs about $10, including analysis features, so it's relatively inexpensive for clinics.
By comparison, the Ontario Ministry of Health's standard guidelines state that a unilateral mammogram performed on one breast costs $31.95, which is typically covered by the Ontario Health Insurance Plan (OHIP).
So far, the tool has been used to screen 45,000 women in Brazil, about 40% of whom have never had a mammogram, Mendrone said.
The value of technology-based solutions
A 2023 study co-authored by Mendrone and published in the British Journal of Cancer Research showed that the scans Linda performed had “similar trends to mammography in suspicious and non-suspicious cases.” .
While the study focused on improving Linda's AI algorithm, Princess Margaret's clinical trial over the next three years will be a double-blind study, with the results of Linda's scans and mammograms shared between raters and participants. This prevents bias and enables accurate evaluation. By comparison, says lead researcher Vivian Freitas.
Freitas, a radiologist with the University of Toronto Health Network and an assistant professor at the University of Toronto, says there is a “pressing need” for advances in imaging technology. She doesn't expect the Linda device to replace mammography, but it could “help streamline the diagnostic pathway, overcome barriers to mammography access, and reduce wait times.” .
Freitas also sees another potential benefit. If Linda's risk assessment proves accurate, it could help identify cancers in women with dense breast tissue, an important underserved cohort of mammograms. she says. Freitas says this tissue can be difficult to detect because its density is similar to that of a tumor. For this group of women, alternative imaging methods such as Linda's, which are unaffected by tissue density, may be more promising. According to health advocacy group Dense Breast Canada, 43 per cent of women between the ages of 40 and 74 fall into this category.
Mendrone said he hopes the device will help patients achieve better outcomes, which is why he named his company Linda, which means “beautiful” in Portuguese. Once the clinical trials are complete, Linda plans to apply for Health Canada approval. After that, Mendrone hopes PMCC and other hospitals will begin using the tool. But in the meantime, she plans to make the technology available to drugstore chains and clinics that want to offer early detection screening for breast cancer, at no cost to them.
“By putting Linda on the front lines of care, at the primary care level, we can catch it earlier,” he says. “And after that happens, everything can change.”
Carol Toller writes about MaRS technology. CTVNews.ca has partnered with her MaRS to showcase innovation in Canadian healthcare.