In 2020, 2.3 million women were diagnosed with breast cancer, making it the world’s most prevalent cancer, according to the WHO. For women today, breast cancer is a very real and salient health concern. What’s more, diagnoses are increasingly located in the developing world, where treatment can be more difficult to access, and among younger women, with one-third of new breast cancer cases occurring in women under 40.
The good news is that if it is identified early, breast cancer can be treated very effectively, with patients having a more than 90% chance of survival. But barriers to breast cancer screening continue to prevent patients from getting the treatment they need early enough. This issue is especially significant in developing countries such as Jordan, where the five-year survival rate for breast cancer is around 43%, compared to 85% in the US. Where current screening methods are falling short, lives are being lost.
The mammogram is the current gold standard for screening for breast cancer, but it has serious drawbacks which are impairing its usefulness for certain populations. With more effective screening having the power to save huge numbers of lives, a new method is called for.
The challenge for researchers is to find a screening method to rival the mammogram: one which is simple, accessible and effective.
Imagine if the air we breathe out could tell us what we need to know about our health. Breath analysis research is making enormous strides in oncology, with the potential to identify not only breath cancer but cervical cancer, stomach cancer and others. Numerous studies indicate that breath analysis has a high degree of effectiveness, along with all the advantages of a simple, non-invasive point-of-care test.
This is an area of huge promise, with the potential to transform cancer outcomes for some of the most at-risk populations.
The need for a new method
The process of getting a mammogram can be uncomfortable and intrusive. Not only that, but it also exposes patients to ionising radiation, which is itself a risk factor for cancer.
Cultural barriers also mean that mammograms are inaccessible for certain populations, and low screening rates in many developing countries may be due to a lack of resources. Mammography equipment is expensive, and scarce resources may be focused elsewhere, such as on illnesses like HIV and malaria. Where mammogram machines are available, they may still be inaccessible for populations in more rural or remote areas.
Alternative methods for identifying breast cancer include DNA sequencing and MRIs, which, while highly effective, are even more costly. And other methods like serum markers and biopsies are more invasive, requiring blood draws.
It’s clear that there is room for improvement when it comes to screening methods for breast cancer. “We perform around 37 million screening mammograms per year in the US and identify about 250,000 new cases of breast cancer,” Bill Wittmeyer, CEO of vapour analysis pioneer Electronic Sensor Technology (EST), emphasises. “That makes the incidence of breast cancer less than one in 100. That means a lot of women are being exposed to a lot of unnecessary radiation and discomfort.”
The goal is to develop a non-invasive, cheap, accessible method to rule in or out the presence of breast cancer. If this can be done at the point of care, more women can be screened, from more populations, increasing the chance of early detection. Resources can then be used much more effectively to diagnose and treat the one in 100 patients who receive a positive result.
The potential of breath analysis
Breath testing has been shown to have significant potential for oncology applications. Cancerous cells appear to produce biomarkers and volatile organic compounds (VOCs) that can be detected in alveolar air. The patterns of these compounds can be analysed to identify the presence of breast cancer.
Compared to other screening methods, a breath test is cheap, fast and simple. The patient simply provides a non-invasive breath sample, meaning that no radiation or skilled specialist is required. It is also mobile and can be done at the point of care. This type of screening promises to be far more accessible, especially for women living in developing countries or previously excluded communities.
Over the last 25 years, multiple peer-reviewed studies have demonstrated the effectiveness of breath analysis as a screening method. For example, in 2020, Phillips et al studied 593 patients and identified significant biomarkers in alveolar breath which could identify breast cancer with 83% accuracy and 82% sensitivity.
Research is ongoing. In collaboration with medical institutions and cancer research institutes EST is planning a breast cancer screening clinical trial in Mexico, where there is a potential market of an estimated 23 million women. Similar studies are planned for the Palestinian territories and Jordan, bringing this trailblazing innovation to where it is needed most.
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