Ensuring better breast examinations
A recent study carried out by the non-profit research organisation, the Mayo Clinic, showed a drop of roughly six percent in the number of mammograms among women in their 40s. The numbers might seem low but as the researchers warn, it is significant.
Lorraine G. Olson agrees. Professor of mechanical engineering at the Rose-Hulman Institute of Technology in Terre Haute, Indiana, she was diagnosed with breast cancer at age 45, which left her “stunned.”
When her husband’s prostate cancer was discovered a few months later, Dr Olson and he were inspired to change the way breast cancers are detected and therefore treated. Together they are working to create a robotic system that will make breast exams more accurate and comfortable.
Their device won’t replace mammograms but can be used in conjunction with them, allowing more frequent testing and enabling younger women to go in for testing earlier.
“Mammograms work by compressing breast tissue and passing x-rays through to get images which are then examined for abnormalities. They aren’t horribly painful. It’s just that they can be uncomfortable and most don’t do it until they absolutely have to” says Olson.
Mammograms also expose patients to radiation and are often not very accurate.
“There are lots of discussions centered on whether women in their 40s should go for regular mammograms. I would say 40 since I was diagnosed at 45 but ages to get tested are being pushed up because they want to limit patients’ exposure to radiation. Also since mammograms are not always correct they cause a lot of false alarms” she adds.
Women are usually advised to do self-breast exams or to have a physical exam by a hospital physician to ensure early detection and treatment.
Olson explains: “You know the drill. You go to your doctor and he or she does the exam. It’s here that our robotic structure comes in. The device will have a sensor which will press down gently and record the forces it feels.
“This way when you come back in a year there will be more than just a sketch of your records in your medical file. We are hoping to make this simple physical examination systematic, recordable and better equipped to make real predictions.”
Mammograms work by measuring tissue density or the weight of tissue and this is not always very precise. “Cancer tissue is usually very stiff so it is tissue stiffness, not density, that leads to a more accurate diagnosis” says Olson.
She uses the example of cream cheese and cheddar cheese to explain her point.
“Cream cheese and cheddar cheese weigh the same but if you push the cheddar cheese it doesn’t change very much inside, whereas the cream cheese can be squished all the way down. Our system works by pushing down on tissue and therefore is sensitive to stiffness. Cancerous tissue is believed to be up to 10 times stiffer than normal tissue” she says.
The sensor records the data for the breast tissue, and the computer is used to compare responses for cancerous tissue and healthy tissue and assesses the differences. “With the help of computer modeling we can draw up maps that will help us make more accurate diagnoses” says Olson.
She has worked on the project for nearly six years and is excited with the results. She wasn’t always interested in issues of women’s health; electrocardiography was her area of research.
“I wouldn’t even go for a mammogram until my physician pushed me to it,” she says, “Even when my cancer was first detected, I thought they were worrying about absolutely nothing. I was relatively young and was convinced that it was benign.”
She knew little about breast cancer when she started but remembered a paper from a symposium that had mentioned methods other than mammography for breast exams. That piqued her interest.
Finding the resources at the Texas Advanced Computing Center (TACC) was fortunate because she is at the stage where “serious computational work” is necessary.
“My school is a small one with no large central computational facilities,” she says. “TACC members were very supportive. I received computational help as well as consulting time. Without TACC, I couldn’t have done this work.”
A lot more work remains, most important of which is developing the hardware for the actual robotic device. Extensive testing on tissue phantoms (essentially tissues made of gelatin where tissue stiffness can be controlled) will then help refine the device.
And the best advantage if her research succeeds?
“The risk-free aspect of it,” says Olson. “There is no radiation involved. People can have it done every year and at any age, even when they have their first annual exams.”