1664746956 Artificial intelligence to detect breast cancer in the poorest women

Artificial intelligence to detect breast cancer in the poorest women

Artificial intelligence to detect breast cancer in the poorest women

“What all women need to understand is that the arrival of breast cancer is not a warning… It doesn’t hurt, often you can’t even feel it; That’s why it’s so dangerous,” says Argentinian Silvia Verón, 45, as she reenacts the entire process she faced when the results of her first mammogram in 2020 announced nodules in her right breast and microcalcifications in her left. “The results came to me in the middle of the pandemic, with no job and no social security… And here the public hospitals are doing shifts for a year or even longer, so I’ve decided to let it go while I most urgently need to pay off debts,” admits he.

For Verón, the priorities were clear: supporting her children and managing the weight of the pandemic. A few months passed before she received a call from her GP, who informed her that she would have free access to the surgeries to remove the benign masses from both of her breasts. Then his life took a turn: “I saw myself with women who had occasional chemotherapy, no hair, no breasts … And that’s the least of it. I even lost one of my friends to this disease.” According to the World Health Organization (WHO), there were 2.2 million cases of breast cancer and 684,996 deaths from the disease worldwide in 2020 alone. which has made it the most diagnosed malignant tumor on the planet and the leading cause of death in women. Although comprehensive treatment for this disease is available in less than 15% of low-income countries, coverage in high-income countries is 90%, according to the Pan American Health Organization (PAHO).

An idea and a lot to do

As early as 2020, Argentina was the fifth country in Latin America with the highest rates of cancer patients, with numbers bordering on 130,878 new cases across both genders. Of these data, 73% correspond to breast cancer. Guillermo Pepe is CEO and founder of Mamotest, a platform for diagnosing and monitoring patients. Through coordinated work with local governments and social welfare foundations, it has been possible to subsidize the costs of mammograms, breast ultrasounds and even treatments for more than 600,000 women of the highest risk age, aged 40 and over. Since 2021, when it made the leap to Mexico, it has supported 18,000 new patients.

Pepe says that in 2013, when the initiative was launched, the biggest challenge was talking about telemedicine. In a country that lacked connectivity and efficient medical systems in the areas furthest from the capital, the work had to start from scratch. “Even today, people believe that teleradiography makes telephone calls,” he admits while explaining how this large network works. “The patient comes in person to the nearest radiology center, these X-rays are sent to our specialists via the Internet and the results are available in two days, along with a new doctor’s appointment to analyze her health condition.”

In 2020, there were 2.2 million cases of breast cancer and 684,996 deaths from the disease worldwide

But the telematics of this system is not only the use of the Internet to send the X-rays, but also what Pepe calls “the missing link”. “We mix teleradiography with artificial intelligence, which allows us to examine criteria such as socioeconomic status, medical history and genetics of the patients,” he says. This information has become a point of interest for local governments and healthcare companies to determine cancer prevention needs and possible solutions. In turn, the same organizations that are interested in this data are the ones who have to subsidize the care, diagnosis and treatment of patients.

But ignorance, rejection and above all poverty made the difference between surviving cancer and not.

Not only the disease kills: lack of resources, poverty and inequality

“Many women in a situation of poverty delay their check-ups because they can’t pay, most don’t have social security and private clinics charge you an arm and a leg; some are housewives or prefer not to miss a day’s work to do their annual check-ups,” laments Agustín Fernández, Mamotest’s medical director, after finishing a lecture on breast cancer prevention at a school in the province of Corrientes. “We started with my school San Nicolás and now we have already trained 15 other centers in Buenos Aires and Corrientes on how to perform breast self-examination, risk factors and prevention methods. You saw that it’s the guys that create debates at home because you already have them, now they know too,” he says in a relaxed tone.

In areas far from big cities, the medical team is analogous, lacking specialists and laws that require education and prevention campaigns and payment options.

For Fernández, prevention means a difference in the quality of life of a patient in the early stages of cancer, but he makes it clear that this is not so easy to achieve. “In areas far from the big cities, the medical team is analogous, there is a lack of specialists, and there are laws that require awareness and prevention campaigns and payment options,” he says. “When you live with just enough, you have a hard time deciding whether to spend 100 or 150 euros for a mammogram. This is also a question of poverty,” he says. The WHO, in its latest report on the impact of this disease, announced that the survival rate of breast cancer five years after diagnosis in high-income countries exceeds 90%, while it is 66% in India and 40% in South Africa.

Fernández says it’s not just about holding patients accountable for their self-care, but that the medical system needs to provide regular monitoring of treatments as well as emotional support. “We have cases of women refusing mammography for fear of death, and what they should know is that with early detection and full and ongoing treatment, time and quality of life can be guaranteed.”

From the age of 30, women should have follow-up ultrasounds, while from the age of 40, hormonal changes require more detailed examinations such as a mammogram, as recommended by international health organizations. Now, prevention is one thing and another when the disease is caught at an advanced stage. Fernández claims that the key to ensuring longer lives for patients living in hard-to-reach areas is to adapt radiation-oncology solutions to the local situation, supported by adequate safety infrastructure.

From the age of 30 women should have a follow-up ultrasound, from the age of 40 hormonal changes require more detailed examinations such as a mammography

Pepe and Fernández agree that provinces like Jujuy, Chaco, Buenos Aires, Corrientes and Santa Fe in Argentina and now cities like Monterrey, Veracruz, Guadalajara, Pachuca and Metepec in Mexico have already lowered the standard age for mammography screening from 55 to 43 Years ago, cancer is still the leading cause of death among women. “The problem is that this disease is still diagnosed late. There is still a lot to be done,” says Pepe, who was recognized in 2021 by the United Nations, the World Economic Forum and the Zayeb Sustainability Award for his work on democratizing health services. “The idea is to keep building a highway where there is no road yet,” concludes Pepe, who is already preparing for the new Breast Cancer Prevention Month campaign.

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