Breast Cancer in Developing CountriesWomen in developing countries lack access to safe and cost-effective breast cancer screening practices, leaving cancer frequently undetected. As a result, three times as many women in low-income, developing countries die each year due to breast cancer compared to developed countries. A team of young women from John Hopkins University is working to change this disparity and save lives through the creation of a new biopsy device.

Early Detection: A Better Chance for a Cure

Great strides have been made in the prevention and treatment of breast cancer in developed countries. More than 80 percent of women diagnosed in North America, Sweden and Japan survive. However, the situation is far different for women in the developing world. Less than 40 percent of women diagnosed in developing countries survive the disease, according to the WHO. This disparity in fatalities can be attributed to a lack of early detection. Studies in Europe and Canada found that the risk of breast cancer death decreased by more than 40 percent among women who underwent early diagnostic screening. In the U.S., data reveals the widespread use of early detection procedures and a 39 percent decrease in U.S. breast cancer fatalities after the 1990s.

Screening for Breast Cancer in Developing Countries

In 2003, the World Health Survey found that only 2.2 percent of women aged 40 to 69 years received breast cancer screening in low- to middle-income nations. More than half of women newly diagnosed with breast cancer in those nations have already progressed to stage III or IV disease. In the United States, 71.5 percent of women aged 50-74 have been screened within the past two years and over 90 percent of recently-diagnosed women have locoregional breast disease.

Why Aren’t Women Screened?

One of the main factors preventing women in low- to middle-income countries from early breast cancer detection is the high cost of screening procedures. Core needle biopsy (CNB) is a common diagnostic procedure that allows doctors to test a sample of breast tissue from the area of concern. In high-income countries, doctors use efficient and expensive disposable CNB drivers for breast biopsies. Low-income countries often cannot afford the same expense, relying instead on reusable drivers. These drivers are easily contaminated and the cleaning process is extremely time-consuming and costly, rendering breast cancer biopsies unavailable to most women in developing countries.

Ithemba: Hope for Women with Breast Cancer

A group of Johns Hopkins undergraduates won a 2019 Lemelson-MIT Student Prize for their creation of a safe, low-cost, reusable breast cancer biopsy device. After learning of the unsafe and inefficient diagnostic methods in developing countries, the team of four young women set out to create a safe and cost-effective CNB driver. Their device is named Ithemba, the Zulu word meaning “hope.” the CNB driver is centered around increasing women’s access to early breast cancer diagnosis. The device’s disposable needle contains a chamber that traps contaminants and is easily sterilized with a bleach wipe, ensuring safe reuse. Ithemba is expected to last up to 20 years before replacement is necessary.

The Johns Hopkins students have conducted over 125 stakeholder interviews. They predict that within the first five years on the market, Ithemba will impact the lives of 300,000 women in developing countries. In May of 2018, the team filed for a patent and are now searching for low-cost manufacturing methods and finalizing estimated costs.

Valerie Zawicki, one of the four undergraduates on the team, insists that the location of a woman’s home should not determine her odds of surviving cancer. The mission of Ithemba is to give all women—no matter where they live—hope with the chance to fight and survive breast cancer.

– Sarah Musick
Photo: Wikimedia