44% of the women die when diagnosed with Breast Cancer
How Niramai is reducing it by early-stage breast cancer detection using its breakthrough technology.
Breast Cancer has emerged as the second most common cancer in women after cervical cancer in India. 1.5 lakh women are diagnosed with breast cancer per year, which accounts for 14% of all cancer among women. Today, 1 in 17 women is at risk of being diagnosed with breast cancer.
India is among the countries with the lowest survival rate of 66% for breast cancer as compared to other developed nations who have marked the survival rate of 90%. The major reason for the low survival rate in India is due to lack of awareness and the social stigma attached to it. The developed nations were able to improve on the survival rate primarily by raising awareness and encouraging the population for routine checkup.
In India, discussion of breast health openly in the community is itself taboo. They have fear of being rejected by their partner or by the community, especially in rural areas. Most of the time the disease at an early stage is asymptomatic or a painless lump. The lack of awareness of the symptoms of breast cancer keeps them from consulting a doctor and concluding that it is a natural occurrence
There is a notion that if we have to solve a problem, we need to first find the problem. The existence of Breast Cancer disease is such that it exists but does not have an expressed reality.
“The story of breast cancer in India is non-existing reality”
Another attribute that contributes to low survival rate is having an appropriate modality to diagnose breast cancer at an early stage. The modalities that are actively used by our clinical practitioners are Clinical Breast Examination(CBE) and Mammography. CBE is an examination where the clinicians touch and feel the breast and check if there is a lump on the breast. This examination is often uncomfortable for women and hence hesitate to get it done. Mammography test which is gold standard of all tests, which is often a painful test where 10KG of weight is pressed onto the breast while capturing an Xray image. The test is often not advised to take repeatedly as its pressure put on breast may increase the risk of cancer, but mammography has proven to be an appropriate and useful modality in the developed nations for early diagnosis of breast cancer. Mammography has certain limitations when it comes to sensitivity and specificity of the diagnosis. It works accurately with women over 40 and does not give good results on dense breasts.
According to study, the population age of women getting diagnosed with breast cancer in India is around the 30 years, which is comparatively a young population which has dense breasts and hence mammography might not be a reliable modality to diagnose breast cancer at an early stage.
In order to combat the issues that other modalities present, Niramai Health Analytix, a company based out of Bangalore has developed a novel solution that can diagnose breast cancer at an early stage. Non-contact, painless and radiation free solution which can detect 5 times smaller cancer tumour than traditional methods is an appropriate modality for Indian demographic.
Different Modalities when compared to Niramai Test
There are many different modalities available such as mammography, ultrasound, Breast Clinical Examination, etc.
Mammography test that is the golden standard for diagnosing breast cancer and commonly recommended by clinical practitioners. This test is said to have played a significant role in helping developed nations like Australia and USA to increase their mortality rate.
But Mammography has its own limitations which would make it not an appropriate modality for the Indian population.
Mammography test is used to diagnose breast cancer and is currently the golden standard of all tests. It’s a painful test as the breast is kept under a 10KG weight and scanned to get an x-ray image. This test may find tumors that are too small to feel but it is very less likely to find tumors in dense breast tissue. Younger women are more likely to have dense breast tissue. Hence this test is advisable for women with age about 45.
Apart from this test being very painful and uncomfortable, the doctors usually do not recommend it more than twice as the pressure that is enforced on the breast may increase the risk of getting breast cancer in the future.
Although it has played a significant role in increasing the survival rate in developed nations like the USA and Australia. Mammography test requires very high capital cost and highly experienced radiographers for its diagnosis.
Mammography is less likely to find breast tumors in women with dense breast tissue. Because both tumors and dense breast tissue appear white on a mammogram.
Given the capital intensive and limitations of the test, mammograms are not particularly helpful for early diagnosis of breast cancer for the Indian population.
Other modalities which exist such as MRI which are only recommended if the subject is at very high risk of breast cancer. Ultrasounds can also be used for diagnosing breast cancer but it needs further investigation as its clinical researchers have shown very less sensitivity and specificity. We don’t want our hospitals and doctors to over-burden themselves with false-positive cases.
There is no consensus on what screening modality would best serve the Indian population to the stage of diagnosis.
There is an increase in the trend of new cancer patients, and the age group of new patients coming annually have gradually dropped from <<55 years to under 40 years of age. Breast cancer in India is more often seen in a younger population when compared to western cohorts. Given the known limitations of mammography which is commonly used would not be optimal for screening particularly given the earlier age of onset in Indian women. There is no consensus on what screening modality would best serve the Indian population to the stage of diagnosis.
The value of ultrasound screening requires further investigation and there are concerns overwhelming the healthcare infrastructure with false positives.
It is unclear whether clinical breast examination alone is sufficient, and the challenge would be determining who should perform this and what training level is required to maximize benefit.
[Disparities with existing methods] Breast cancer is preventable if screening is done early by self-breast examination or mammography. Discussing self-breast examination or performing mammography is difficult in rural due cultural barriers. Performing mammography is also costly, which is why many rural women do not undergo this screening test resulting in increasing cancer burden in rural areas.
[Benefits of Niramai] Niramai’s Thermalytix can be used as a tool which can be effectively used for any women above 18 years of age. Thermalytix is also not painful and not harmful when used multiple times a year. It is convenient, comfortable and needs no intervention other people
What is the Niramai Test and how does the test Work?
Niramai test is a simple breast cancer screening solution that is radiation-free, privacy-aware, and highly accurate enough to consider it as an appropriate modality for women of all ages above 18. The Niramai Test is a very simple screening test. The patient enters the room and the instructions are given by the technicians outside who will be using thermalytix software which is used to capture thermal images of the breast region.
Niramai Test uses thermography as its fundamental modality which involves analysis of thermal heat pattern generated when captured using a high-resolution thermal camera. The infrared rays used by the thermal camera to capture the heat pattern of the breast region is completely harmless and the test can be repeated many times. The test is also comfortable as no other person is seeing or touching the breast in order to examine and identify whether the lump exists or not.