New technology can bring breast cancer screening into the
20 February 2012
Breast cancer has made regular news headlines over the past
year, from the annual breast cancer awareness month, to the PIP breast
implant scandal. Arguably the most significant breast cancer news in the
UK broke in October 2011, with the announcement by national cancer
director, Sir Mike Richards, of the first independent investigation of
the UK’s breast cancer screening programme since the mammogram system
was first implemented by Margaret Thatcher’s government in 1988. Jack
Kaye, CEO of Westhouse Medical Services, provides insight into the
situation, and analyses the options available for the progression of
The medical profession relies on the continued advancement of
technology not only to enable the identification and treatment of an
increasing number of conditions but to keep improving the quality of
healthcare delivered. Breast cancer care is no different. Our
current mammogram screening system undoubtedly saves lives, proved
by a decrease of 6,000 deaths per year from breast cancer since the
launch of the UK Breast Screening Programme in 1988. However, the
mammogram-based system is now outdated, hugely expensive at a time
of financial pressure and struggling to cope with an aging
population. Can new technology improve the situation?
The Government’s decision to review the screening programme comes
at a time when a number of issues relating to accuracy, cost and the
real benefits have come to light. The mammogram’s ability to detect
small tumours, and even smaller collections of cancer cells, has
been queried. Of the tumours ‘detected’ 10% are false alarms,
according to researchers at Southampton University.
Breast screening should be deliberately non-specific — aiming to
indicate a wide range of pathologies, which mammograms unfortunately
do not. This way, should a pathology be identified, it can be
investigated with more specific diagnostic tests.
Moreover, many believe the invasive, physical nature of mammogram
screening may actually do more harm than good. Mammogram researcher
Peter Gøtzsche, director of the independent Nordic Cochrane
Collaboration, recently claimed the procedure harms ten out of every
2,000 women scanned.
As there is no precursor to the mammogram, Gøtzsche argues, women
who do not have the disease are subjected to a treatment that may
damage the breast and increase chances of breast cancer development
later in life — ultimately costing the National Health Service (NHS)
more through further treatment.
Cost has become an increasing issue due to the current economic
climate, as well as changing population demographics in the UK.
Government cuts in healthcare expenditure are forcing the NHS to
reform financially. Each mammogram costs an average of £53.63 in the
UK. There are 2.3 million mammogram scans performed a year at
present, giving a total bill of over £120 million.
Due to the UK’s aging population, and a widening footprint of
women being tested at a younger age, the total number of tests
conducted is rising rapidly. It is predicted that three million
scans will be performed by 2013/14 as the scan footprint widens by
35%. If alternative breast screening methods are not adopted,
mammograms will cost the NHS £160 million a year by 2014.
The research by Gøtzsche affirms the reality that breast cancer
screening needs revolutionising. However, Gøtzsche recommends that
‘women do nothing apart from attend a doctor if they notice anything
themselves'. This conclusion ignores the fact mammograms have
resulted in the UK breast cancer death rate dropping from 18,500 a
year to 12,500 over the last 25 years. Consequently I believe the
removal of the mammogram per se is unjustified; however, it is
essential alternative screening methods precede it.
Alternative to mammogram
New technological advances will provide some alternatives in the
screening dilemma. Westhouse Medical is currently developing a
breast scanning device that can act as an effective, low-cost
precursor to mammogram screening. The new scanner responds to a
large variety of pathologies of the breast because it works on
temperature differentials; many pathologies (including tumours)
cause higher skin temperatures in the region near them due to a
build up of blood capillaries.
Currently women have no easy, regular access to breast scanning
until they pass fifty. The new device can be used at home, or at the
GP’s surgery, potentially by women of all ages, allowing women to
opt for a mammogram should the pre-scan indicate any anomalies in
Consequently only those in actual need of further screening will
undergo the mammogram procedure — creating a broader more efficient
multi-layered system, capable of increasing early detection rates
and reducing mortality. Furthermore, Westhouse Medical’s breast
scanner will cost a quarter the price of a mammogram, giving it the
potential to save the NHS close to £100 million.
It is now nearly 33 years since the Thatcher administration came
to power, so Sir Mike Richard’s independent investigation of the UK
breast cancer screening programme is both timely and very welcome.
It is the case, though, that in in the intervening years both the
demands on the NHS and the potential for new technological
approaches to increase the quality of care patients receive have
It is essential that a thorough examination of the potential of
new technology to increase both the efficiency and effectiveness of
breast cancer screening is carried out. Innovative medical devices
have the capability to alleviate pressure on the NHS and provide the
UK with a successful, effective and cost-efficient breast screening
system suitable for the twenty-first century.
1. James Raftery, Possible net harms of breast cancer: updated
modelling of the Forrest Report. BMJ.com. 8 December 2011.