For many of us, COVID, and the periods of quarantine required with it, have meant that we have allowed certain things to lapse. Regular trips to the hair salon, the manicurist, or the esthetician have all but disappeared from the calendar. But while grey roots and dangling cuticles may be bothersome, they certainly aren’t life-threatening. On the other hand, according to the American Society of Clinical Oncology, this year has also resulted in a significant uptick in skipped cancer screenings—in April they were down by a staggering 89%—which is, says Rachel Freedman, MD, MPH, a senior clinician in medical oncology at Boston’s esteemed Dana-Farber Cancer Institute, a real cause for concern. “It’s one thing to delay one’s screening tests for a few months which often has little downside in healthy individuals, but it’s another thing to delay screening for a prolonged period or to delay evaluation of symptoms because of fear of going to hospitals and clinics,” says Freedman. “As the pandemic wears on we will be seeing more patients with locally advanced cancers—meaning larger tumors and node-involved tumors—if women don’t get the health care they need.” Freedman points out that most medical communities have taken all the necessary precautions to safeguard anyone coming in for appointments and encourages patients to engage in their care because, particularly with breast cancer, early detection is key. Regular screening mammograms help find cancers early, “often before they are even felt,” says Freedman. And when cancer can be detected earlier, surgeries can often be smaller and treatments sometimes more limited—and the smaller a cancer is, the less likely it is to recur over time, she explains.
So, increasing access to cancer screening has serious life-saving potential. When 23-year-old inventor Judit Giró Benet discovered how often screenings are skipped (even pre-COVID, and especially, according to the American Cancer Society, among the uninsured—their latest figures show only 30% of uninsured women were up to date with breast cancer screening in 2018, compared to 64% of insured women), she began thinking about how to address the issue. Three years of research resulted in her invention of The Blue Box, which just earned the Spanish biomedical engineer the prestigious James Dyson Award, a design prize presented annually to someone whose creation innovates to solve some of the world’s largest problems.
The Blue Box—which is, quite literally, a small blue box—is a biomedical device that takes a non-irradiating, non-invasive approach to breast cancer detection. To use it, a urine sample is simply slid into a drawer of the device, then The Blue Box’s chemical sensors scan it for targeted biomarkers and the information is sent via an app to be processed. “The Blue Box sends the info to the phone and then to the cloud and then our server uses an artificial intelligence algorithm [to assess the results],” Benet, who graduated from UC Irvine this summer with a Master’s in Embedded Cyber-physical Systems, explains. “So even though what you see is the box, the key value is the software behind it.” Once a diagnosis is reached, results are sent back to your phone.
Benet doesn’t see her invention as a replacement for the traditional mammogram, but rather a device that will support it and, more importantly, help look at breast cancer screening from a new perspective. “The Blue Box is about disrupting the way we think about screening and encouraging women to take a more active role,” Benet adds. She was motivated in part by an awareness of the innate gender bias in cancer research: “Women are two to three times more likely to have adverse symptoms to cancer drugs because research is typically done on the male population and is also being carried out by men,” she says.
While the device is still in the early stages of development—they are in the process of patenting the technology, undertaking further testing on even more cancer patients at a hospital in Spain, and applying for FDA approval, which will hopefully come in about two years—Benet envisions it one day becoming just another part of women’s health and wellness routines. “I want it to become something so typical that everyone can have The Blue Box in their home and families can screen regularly as part of their breast cancer prevention,” she says. And while Benet’s initial impetus with The Blue Box was intellectual, it would become personal as well. “In the middle of this Blue Box adventure my mom actually got diagnosed with breast cancer,” she shares. “She was lucky and she’s now perfectly healthy, but her diagnosis made me realize how much this disease really touches every family.”
Benet’s invention is an extremely promising development in the world of breast cancer screening and joins a wave of new devices. While Freedman finds these new technologies exciting, she emphasizes the need for further study of their potential. “I encourage these technological advances to pursue the right type of clinical trials to make sure the benefits of a test—improved cancer detection, improved survival—outweigh any harms—such as false positives, anxiety, additional testing for benign findings, finding cancers that would never harm a patient,” she says. “I really look forward to seeing how these advances can be integrated into care over time.” Benet’s hope for the future, once she does get FDA approval, is that her invention might one day be used to detect other cancers as well. “That’s the fun part about artificial intelligence, you get to discover what an algorithm is capable of,” she adds. For the future of breast cancer screenings, it’s a marriage of artificial and human intelligence that may hold the most promise.