By Harold Selden
One might never think that Cisco would be involved with wearable tech, never mind breast cancer – but a movie?
Yes, Cisco underwrote a movie: Detected. It is a documentary about an iTBra (#iTBra) and a vision of using Big Data and wearable technology to drastically improve – for less money as well – a method to detect breast cancer early. Before we get to the "why Cisco" part, let’s discuss the technology behind this ground-breaking bra. A trailer for the movie can be found here.
Rob Royea, the CEO and Chairman of Cyrcadia Health, his wife, and the film’s director were the stars of the discussion following Detected’s west coast premier earlier this year at Laemmle’s Ahrya in Beverly Hills.
The film tells the story of a startup that seeks to bring a medical product to market. Rob finally gets a working prototype, and has his wife wear the bra, then upload the data for analysis. In between the nerve-wracking wait for results, along with the inevitable startup travails, the film interleaves stories of breast cancer survivors and, stories of uncomfortable breast screenings.
The bra itself is based on older research that showed a difference in dynamic circadian temperature between normal breast tissue and tissue with even small tumors, when sampled at many points. However, that research was impractical to implement: it used custom lab grade thermo probes, and individual analysis of each pattern. Here, the Cyrcadia team went to Israel for a custom design using advanced manufacturing techniques to make custom prototypes with embedded probes throughout the bra. Another group based in Singapore directed creation of custom algorithms that could analyze the collected data in the cloud, and apply machine learning to interpret the data sets.
The traditional screening technique for breast cancer – X-ray imaging – is uncomfortable, is not ever close to 100% detection, and does not work well on women with dense breast tissue. X-ray imaging is unavailable to more than 50% of the world’s women, and is extraordinarily uncomfortable. The film showed some women complaining about squished breasts. For those unfamiliar with the procedure, the technique seeks to flatten the breasts in what can only be described as a pancake. Other cancer screening modalities, such as MRI, are even more expensive and limited by availability, or do not have a high detection rate (ultrasound). These techniques are based on the differential reflection of density changes within breast tissue to pinpoint abnormal changes; the iTBra is based on detecting metabolic changes.
For the iTBra, the time period necessary to collect valid results was initially 48 hours; that has now been reduced to 12 hours. The Cyrcadia team hopes to get that time down to close to two hours at about the time the first commercial product is ready for full scale testing. The first roll-out will be in Asia, because of several factors: less entrenched traditional screening, lack of general availability of breast cancer screening, and lack of suitable screening: in the Asian population, 80% have dense breast tissue, compared to 40% of Americans. Traditional screening techniques are only 48% accurate with dense tissue. The iTBra has an 82% accuracy (against biopsy results, not other screening techniques), comparable to traditional techniques, but also presents results this accurate for dense tissue. Since this result was achieved with a small population, continued refinement of algorithm coupled with additional AI/machine learning and larger sample size should increase the accuracy.
Another reason for using the cloud as a repository: the intellectual property is not available to the referring physician. Only the results are sent to the physician, and the patient is able to upload the data to the cloud from home. This also keeps the physician in the loop. The data is appropriately anonymized and encrypted so only the physician knows the results, and only Cyrcadia knows how it was analyzed, but not the patient’s PII. This bodes well from a privacy perspective – leaving the patient to manage their own personal health data.
Why Cisco was a question directed to the Cisco VP at the screening. His answer was that Cisco seeks to be involved in cutting edge IoT, security, and cloud computing, especially machine learning and AI. Through in wearable devices, saving lives, and Cisco was on board. Though it was unknown at the project’s start if clinical success would be achieved, it appears the gamble has paid off for Cisco and Rob Royea.