Feasibility and outcomes of using a novel artificial intelligence enhanced breast thermography technique, Thermalytix, in screening for breast abnormalities at primary health centres at the community level in South India

Authors

  • Geetha Manjunath Niramai Health Analytix, Data Science, Bangalore, Karnataka, India
  • Himanshu Madhu Niramai Health Analytix, Data Science, Bangalore, Karnataka, India
  • Nirmala Buggi Bruhat Bengaluru Mahanagara Palike Hospital, Bangalore, Karnataka, India
  • Anasuya Suggaiah Bruhat Bengaluru Mahanagara Palike Hospital, Bangalore, Karnataka, India
  • Revathi Muthanna Niramai Health Analytix, Data Science, Bangalore, Karnataka, India
  • Charitha Gangadharan Niramai Health Analytix, Data Science, Bangalore, Karnataka, India
  • Jilsy M. Joy Niramai Health Analytix, Data Science, Bangalore, Karnataka, India
  • Sathiakar Collison Niramai Health Analytix, Data Science, Bangalore, Karnataka, India
  • Lakshmi Krishnan Niramai Health Analytix, Data Science, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20223225

Keywords:

Artificial intelligence, Breast neoplasms, Mammography, Early detection of cancer, Thermography

Abstract

Background: Women from low-income families have poorer health-seeking behavior, particularly when it comes to cancer screening. A community health initiative was launched by Niramai in collaboration with city officials in Bangalore as a pilot to increase awareness and make breast health screening available to all. This study describes a community-level breast screening for underprivileged women in south India adopting Thermalytix, a thermography-based artificial intelligence device.

Methods: This observational study was conducted at 25 municipal primary health centers where women over 18 years of age were enrolled. The project started on 14 November 2017 and is ongoing. Procedures include a brief meeting on camp procedures, identification of eligible candidates, health education, and Thermalytix testing.

Results: A total of 6935 women underwent artificial intelligence (AI)-powered Thermalytix screening in 25 Bruhat Bengaluru Mahanagara Palike (BBMP) hospitals. The median age was 42 (range 18-86) of the 5248 women enrolled as per inclusion. Among the 5248 women recruited, 62 (1.18%) women were detected with some abnormalities in Thermalytix. Out of the women who underwent follow-up investigations (11/62), eight were positive on radiological evaluation, further histopathological evaluation confirmed one ductal carcinoma in situ.

Conclusions: Community participation with the engagement of the local government health officials enabled us to develop screening strategies for underprivileged women. Thermalytix could be a potential screening tool in resource-constrained settings and the portable equipment enabled easy movement across different primary health centers (PHCs). Since it is a privacy-aware test, there was less refusal to participate in the test.

References

Malvia S, Bagadi SA, Dubey US, Saxena S. Epidemiology of breast cancer in Indian women. Asia Pac J Clin Oncol. 2017;13(4):289-95.

Jacques F, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. “Latest world cancer statistics – GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012–IARC.” Available at: https://www.iarc. who.int/news-events/latest-world-cancer-statistics-globocan-2012-estimated-cancer-incidence-mortality-and-prevalence-worldwide-in-2012/. Accessed on 08 September 08 2022.

Dhillon PK, Mathur P, Nandakumar. India State-Level Disease Burden Initiative Cancer Collaborators. The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990-2016. Lancet Oncol 2018;19:1289-306.

Duffy SW, Tabár L, Yen AM, Dean PB, Smith RA, Jonsson H, et al. Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women. Cancer. 2020;126(13):2971-9.

Singh S, Shrivastava JP, Dwivedi A. Breast cancer screening existence in India: A nonexisting reality. Indian J Med Paediatr Oncol. 2015;36(4):207-9.

Negi J, Nambiar D. Intersectional social-economic inequalities in breast cancer screening in India: analysis of the National Family Health Survey. BMC Womens Health. 2021;21(1):324.

Mishra GA, Pimple SA, Mittra I, Badwe RA. Screening for breast cancer: Cost-effective solutions for low- & middle-income countries. Indian J Med Res. 2021;154(2):229-36.

Li J, Shao Z. Mammography screening in less developed countries. Springerplus. 2015;4:615.

Hackshaw AK, Paul EA. Breast self-examination and death from breast cancer: a meta-analysis. Br J Cancer. 2003;88(7):1047-53.

Albert US, Schulz KD. Clinical breast examination: what can be recommended for its use to detect breast cancer in countries with limited resources? Breast J. 2003;9(2):S90-3.

Mittra I, Mishra GA, Dikshit RP. Effect of screening by clinical breast examination on breast cancer incidence and mortality after 20 years: prospective, cluster randomised controlled trial in Mumbai. BMJ. 2021;372:n256.

Ngan TT, Nguyen NTQ, Van Minh H, Donnelly M, O'Neill C. Effectiveness of clinical breast examination as a 'stand-alone' screening modality: an overview of systematic reviews. BMC Cancer. 2020;20(1):1070.

Kiely BE, Goodwin A. Is it time to abandon clinical breast examination? Med J Aust. 2021;215(10):458-9.

Mani S. Guidelines for ultrasound owners and owners of clinics, diagnostic centres, nursing homes and hospitals. Indian J Radiol Imaging. 2012;22(2):125-8.

Khan AA, Arora AS. Thermography as an Economical Alternative Modality to Mammography for Early Detection of Breast Cancer. J Healthc Eng. 2021;5543101.

Krishna S, George B. An affordable solution for the recognition of abnormality in breast thermogram. Multimed Tools Appl. 2021;80:28303-28.

Singh D, Singh AK, Tiwari S. Early Thermographic Screening of Breast Abnormality in Women with Dense Breast by Thermal, Fractal, and Statistical analysis. Research Square. 2022.

Omranipour R, Kazemian A, Alipour S, Najafi M, Alidoosti M, Navid M, et al. Comparison of the Accuracy of Thermography and Mammography in the Detection of Breast Cancer. Breast Care (Basel). 2016;11(4):260-4.

Kakileti ST, Manjunath G, Ramprakash HV. Advances in Breast Thermography. In (Ed.), New Perspectives in Breast Imaging. IntechOpen. 2017.

Kakileti ST, Madhu HJ, Krishnan L, Manjunath G, Sampangi S, Ramprakash HV. Observational Study to Evaluate the Clinical Efficacy of Thermalytix for Detecting Breast Cancer in Symptomatic and Asymptomatic Women. JCO Glob Oncol. 2020;6:1472-80.

Schwartz RG, Brioschi M, Pittman J, Rind B. Guidelines for Breast Thermography. Pan Am J Med Thermol. 2021;2(1):26-34.

Anderson BO, Cazap E, El Saghir NS, Yip CH, Khaled HM, Otero IV, et al. Optimisation of breast cancer management in low-resource and middle-resource countries: executive summary of the Breast Health Global Initiative consensus, 2010. Lancet Oncol. 2011;12:387-98.

Anderson BO, Shyyan R, Eniu A, Smith RA, Yip CH, Bese NS, et al. Breast cancer in limited-resource countries: an overview of the Breast Health Global Initiative 2005 guidelines. Breast J. 2006;12(1):S3-15.

Vang S, Margolies LR, Jandorf L. Mobile Mammography Participation Among Medically Underserved Women: A Systematic Review. Prev Chronic Dis. 2018;15:E140.

Sankaranarayanan R, Ramadas K, Thara S, Muwonge R, Prabhakar J, Augustine P, et al. Clinical breast examination: preliminary results from a cluster randomized controlled trial in India. J Natl Cancer Inst. 2011;103(19):1476-80.

Scheel JR, Lee JM, Sprague BL, Lee CI, Lehman CD. Screening ultrasound as an adjunct to mammography in women with mammographically dense breasts. Am J Obstet Gynecol. 2015;212(1):9-17.

Rebolj M, Assi V, Brentnall A, Parmar D, Duffy SW. Addition of ultrasound to mammography in the case of dense breast tissue: systematic review and meta-analysis. Br J Cancer. 2018;118(12):1559-70.

Brem RF, Tabár L, Duffy SW, Inciardi MF, Guingrich JA, Hashimoto BE, et al. Assessing improvement in detection of breast cancer with three-dimensional automated breast US in women with dense breast tissue: the SomoInsight Study. Radiology. 2015;274(3):663-73.

Mango VL, Olasehinde O, Omisore AD, Wuraola FO, Famurewa FC, et al. The iBreastExam versus clinical breast examination for breast evaluation in high risk and symptomatic Nigerian women: a prospective study. Lancet Glob Health. 2022;10(4):e555-63.

Singh D, Singh AK. Role of image thermography in early breast cancer detection- Past, present and future. Comput Methods Programs Biomed. 2020;183:105074.

Downloads

Published

2022-11-28

How to Cite

Manjunath, G., Madhu, H., Buggi, N., Suggaiah, A., Muthanna, R., Gangadharan, C., Joy, J. M., Collison, S., & Krishnan, L. (2022). Feasibility and outcomes of using a novel artificial intelligence enhanced breast thermography technique, Thermalytix, in screening for breast abnormalities at primary health centres at the community level in South India. International Journal Of Community Medicine And Public Health, 9(12), 4634–4640. https://doi.org/10.18203/2394-6040.ijcmph20223225

Issue

Section

Original Research Articles