EARLY DETECTION
Blind women detect breast cancer significantly earlier than doctors
More and more studies are showing that visually impaired people can sense even the smallest changes in tissue during tactile examinations. What this could mean for cancer screening
June 2, 2023, 06:00In 2007, gynecologist Frank Hoffmann had an idea that would change cancer screening: With their highly developed sense of touch, trained blind or visually impaired women might be able to detect a change in breast tissue particularly early, possibly even earlier than doctors. A disability could thus become a talent. Cancer screening would be revolutionized and, at the same time, a career opportunity would be created for blind and visually impaired women, according to the idea.
Since then, Hoffmann's project, called "Discovering Hands," has often been challenged. Today, more and more studies are proving him right on the point that palpation by people with visual impairments can significantly improve breast cancer screening. When a gynecologist palpates a lump, it is often already one to two centimeters in size. Trained palpators could detect changes as small as six millimeters. A study from India with more than 1,000 participating women showed that medical tactile examiners, or MTUs for short, were unable to palpate only one percent of malignant tissue changes in the breast. This is a particularly good predictive value, the authors of the study write. And this predictive value is crucial. Because if breast cancer is detected early, the chances of cure are 80 percent. In Austria, around 5,600 women are diagnosed with breast cancer every year, and around 1,600 die as a result of the disease. Breast cancer is thus the most frequently diagnosed cancer in women.
Complementary measure
Similar data has already been collected in Austria. MTUs detect twice as many changes in tissue as sighted physicians, shows a study conducted as part of Discovering Hands Austria. These results were presented to the Ministry of Health at the end of 2021 - and they were convincing. For one and a half years, it has now been possible to perform these palpation examinations as a voluntary supplementary measure for early breast cancer detection.
So far, there are three MTUs in Austria, with another three women in training until the summer. They are active at six locations (five gynecological practices and one radiology center) in Vienna, and in the future they would like to expand the offer to other provinces, says Stefanie Bramböck, managing director of Discovering Hands Austria, to the STANDARD.
Improving existing examinations
The fact that the examination takes place directly in medical practices is essential, explains Bramböck. This is because, despite convincing study data, the tactile examination is not classified as an independent medical screening examination, but rather as a supplement for gynecologists to improve their examinations. The responsibility for further action - be it referral or diagnosis - always lies with the physician.
The tactile examination takes 45 minutes; physicians would often have considerably less time in practice. The patient is palpated both lying down and sitting up. Orientation strips are applied to the breast beforehand so that the MTU can tell the doctor exactly where she felt something. Using ultrasound or mammography, doctors can then determine whether breast cancer is present.
"This palpation examination cannot replace a mammogram, but it is an important additional measure," says Bramböck. She therefore sees the potential of this type of examination above all for young women who do not yet fall into the early detection program: "Until now, they have hardly been able to do anything in terms of breast cancer screening; the tactile examination of our MTUs changes that." But even for older women, he says, the barrier to going for a tactile exam is lower than going for a mammogram. Bramböck hopes that the service will also help those women who have not taken advantage of preventive examinations in the past. (poem, 6/2/2023)
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