Nobody Likes a Mammogram

Breast cancer is not just an issue for women on a global scale; however, one man is working to help lower breast cancer mortality rates. His solution: the iBreastExam.

The Economic Times

Women are affected by breast cancer each year, both in and outside of the United States.

Amazon

This was true for a poet that was diagnosed with breast cancer, Audre Lorde. As she described her experience in her book The Cancer Journals she battled breast cancer and a mastectomy. Throughout the book, she talks about just her personal experience with cancer, however, in the beginning of the book, she discusses how many different women go through the challenges of breast cancer. Lorde states, “Breast cancer and mastectomy are not unique experiences, but ones shared by thousands of american women” (Lorde, 8).

However, it is not just women who are diagnosed that are affected, but it is also their friends and families that are dealing with this tough time as well.

Mihir Shah, a computer engineer also had his own experience with breast cancer that lead to something greater. Shah was getting married right after his mother-in-law was diagnosed with breast cancer. After this experience with breast cancer, Shah realized how lucky he was that the women in his life, both in the United States and India were fortunate to have the accessibility to receive proper breast cancer screenings.

According to an article that was published by “The Lancet”, the five year United States survival rate for breast cancer is significantly different than a lot income country. For example, the five year survival rate for breast cancer in the United States is 90.2 percent and the five year survival rate for breast cancer in India is 66.1 percent. There are many reasons for this, such as lack of access to adequate healthcare, healthcare is unaffordable, or lack of testing resources.

CPN Public Information

But why is women’s health not a priority and why are there no options for alternative types of testing?

This is exactly what Shah was thinking when he tried to develop a way to bring cancer testing to low income countries, like India. This lead Shah to help develop a new type of breast cancer testing that was pain free, quick, and easy to learn. This is when the iBreastExam was developed. This device can offer women a quick and affordable test to see if they may have breast cancer or not.

This new device is made out of ceramic and puts off no radiation to the woman’s (or man’s) body. This new technology is easy to use, a quick assessment, and is not invasive. This device completely changes the the way that cancer screening is conducted.

According to a New York Times article, the same one where Shah was introduce, explained how the device itself works. The article states that the device, which is small and portable, connects to a smartphone. The trained professional then goes over four quadrants of the patient’s breast, which will either appear green on the screen, meaning the area is clear, or red, where the area is questionable and the patient is going to have to a nearby hospital to talk with a doctor about the possible cancerous area. This type of screening takes only 10 minutes and the person that is conducting the screening can be trained in just 8 hours. The results of the test automatically save to the smartphone and the patient gets the results right away.

Another major added benefit to this type of screening is that there is no radiation being given to the patient. This is one of the main concerns with mammograms, is that women are concerned about the radiation that is being exposed. Also, mammograms just flat out hurt, causing women to steer clear of them.

So, with the technology such as the iBreastExam, does this change women’s health?

Dallas Post Tribune

I would say that it most definitely has changed women’s health and cancer awareness for the better. This is especially true in low income countries where there is a lot of less advocacy or education provided for breast cancer. With the device such as the iBreastExam, which has been implemented in twelve countries and 200 plus locations worldwide, more and more women are getting testing and treated for breast cancer. The iBreastExam also gets more and more women in the clinics to receive education surrounding breast cancer, such as signs and symptoms of breast cancer and how to conduct at home breast exams.

However, the only issue with the iBreastExam being widespread around the world is the different cultural practices within each country.

In the New York Times article, the author discusses how officials were worried about the iBreastExam being a device that uses ultrasound. The developers of the device had to show that there was no ultrasound technology within the device. This worry from the officials is because the ultrasound technology can determine the sex of a fetus. However, the ultrasound technology is now banned from India due to the fact that mothers were terminating the pregnancy due to the sex of the fetus, causing a very skewed population. So, different approaches and methods of convincing that the device is safe and effective in each country may be difficult but it is ultimately necessary.

Overall, the iBreastExam is a major step in the right direction in terms of advocacy for turning around the statistics of breast cancer cases around the world. Although it may not the absolute best type of cancer detection, it is better than nothing, which is what women had before.

Regardless of the device, women around the world need to know about the cancers that can take over their body. Cost and location of these services should not impact the chances of these women potentially saving their own lives.

Related Course Reading: Lorde, Audre. "The Cancer Journals: Special edition." San Francisco: Aunt Lute (1997).

The Dying Need for an IUD

With the increasing rise of death related to childbirth, women in the United States need effective forms of birth control now more than ever.

Source: Case Western Reserve

According to an article written by USA Today, the maternal death rates have more than doubled in the United States over the past 25 years. In 2014, the United States had the highest maternal mortality rate of 18 deaths per 100,000 live births. Not only is this statistic alarming, but it also makes me wonder how many of these births were planned for and how many of these women could possibly have reduced their chance at death with proper access and knowledge about birth control.

There are many issues within our healthcare system regarding the topic of birth control such as: improper education surrounding the use of birth control, the lack of knowledge of the options that are out there for birth control, or lack of access these women have to birth control. As these are all major issues, I think one of the simple issues that could help reduce the overall risk of maternal mortality is increasing the knowledge of the different forms of birth control, especially long term, reversible, birth control.

On the right is the IUD on the left is the arm implant
Source: babygizmo.com

In a piece written by Governing, Mark Funkhouser, the former mayor of Kansas City, MO talks about long-acting reversible contraceptives (LARC) such as intrauterine devices (IUDs) or the arm implant. He states some of the statistics of the amount of women in the United States that use these contraceptives compared to those statistics around the world. According to the census in 2012, only 5.3 percent of women who use contraceptives use LARCs compared to the 23.3 percent of women who use them in Norway. I do not think that women in the United States have proper knowledge about LARCs. Compared to the United States, Norway has a much lower maternal mortality rate of 2.2 deaths per 1,000 births. With these statistics alone, I think that there is a major correlation in LARCs and maternal mortality rate. We should be acting more like Norway and take the incentive to try and lower our maternal mortality rates.

Source: Case Western Reserve 

Whether this be the older population of women hearing horror stories from the early stages of the IUD or younger girls hearing different stories about how their friends’ experience has been with an IUD, women are scared of the IUD. When thinking about the early stages of the IUD, Chikako Takeshita does a great job describing what happened in the early stages of development in her book The Global Biopolitics of the IUD. When discussing the early stages of the IUD in the United States, she describes the horrible stories of one of the first IUDs, the Dalkon Shield. The Dalkon shield caused horrible infections, miscarriages, sterilizations, and even death. The connotation of the IUD has not changed much today with the young women in the United States, they hear how horrible the implantation process is, how it is possible to cramp out the IUD, and how it can get lost inside of the body. As these are all risks, you do not hear many positive remarks made towards the IUD.

The story surrounding the IUD needs to change, as it could possibly save a woman’s life.

Women should be talking to their healthcare professionals about what the best option for them is. An article posted by CNN does a great job laying out both the positives and the negatives of the IUD. Articles such as these are so important for women to see how great of an impact they can have, so they can start to see the positive impacts of the IUD. In this article, the author discusses how the IUD is very low maintenance, so basically the woman does not have to think about her birth control at all. The article also discusses how the device can help reduce menstrual pain and heavy flows and how the device is 99% effective for protecting against pregnancy.This brings up another issue of how a lot of women do not have access to healthcare or cannot afford a specialist, such as a gynecologist.

This is where my struggle with IUDs comes in. With the United States maternal mortality rate being so high, it is especially high within African American women at 40 deaths per 100,000 live births, as stated by the same Governing article. It is no secret that the African American community within the United States is lower to middle class families. So, when these women get pregnant, I would have to imagine that it may not be planned, or if it was, they may not be getting the best prenatal care or birthing care within hospital systems. However, if the answer to the lower mortality rates could be LARCs or more specifically the IUD, how do you expect these women to pay for it? The CNN article regarding the IUD states that an IUD can cost up to $1,300. If this woman is even a part of a middle class family, they cannot pay that much money for contraception. So then these families are going to test their luck with different forms of birth control such as condoms, withdrawal, or possibly the pill, which all take serious discipline to administer correctly. This then leads to unwanted pregnancy and comes full circle with the high risk of maternal mortality.

The IUD and other long-acting reversible contraceptives are a great idea on a way to start lowering the maternal mortality in the United States. However, I think there needs to be lots of change before the IUD can become a majority of contraceptive use in the United States. To make this happen, the conversation needs to include informed consent in a way that benefits women. Takeshita mentions, “The feminists’ aim to enable women to make informed decisions about birth control…” (Takeshita, 97).  Making these informed decisions about what type of birth control would be the best for the woman’s body and the most manageable for her lifestyle is so important in helping reduce accidental pregnancy which then lowers maternal mortality. As Takeshita believes, the original intent of informed consent is to allow women the full knowledge they need to make proper decision for their own personal healthcare (Takeshita, 97). Overall, we need more knowledge and positive information going to the women who do not yet have a family or cannot afford the best healthcare. These women are the ones at risk for a tricky pregnancy and therefore a tricky birth. We need to change the way that we view contraceptives, especially LARCs, and the way we promote the products. We need to find a way to fund the IUD to get it to the women who need it the most.

Relevant Course Readings:

Takeshita, Chikako. The Global Biopolitics of the IUD: How Science Constructs Contraceptive Users and Women's Bodies. The MIT Press, 2012.