Helen Frazer is changing the future of breast cancer screening (using AI)

by The M-POWERed Collective
Tuesday 30 May 2023

“I was always interested in science, but it was probably an accident that set up my interest in human biology and x-rays,” recalls St Vincent’s BreastScreen Clinical Director and Adjunct Associate Professor Dr. Helen Frazer, when asked about when her fascination with science and medicine was first sparked. “As a young child, I was mischievously playing on a staircase at a shopping centre and decided to slide down the banister. Needless to say, I fell off and landed on a concrete floor. I subsequently had head and limb x-rays and remember the awe I felt being able to look inside my body by holding the x-rays up to the light. I really do think that set a pathway for my interest in medicine and radiology.”

That interest grew into a flourishing career which spans over two decades, as a radiologist, a breast cancer screening clinician, an AI researcher, an epidemiologist, and, last year, cumulated in Helen being awarded the ANZ Women in AI Innovator of the Year. “Winning such an award was quite a surprise and a delight. I really felt it was a recognition of the great team and partners that have worked with me over the last three years,” she says. Dr. Frazer is a true innovator, and one who gets up every day and works tirelessly to change the world. “On being innovative, my reflection is that there are opportunities everywhere to advance the human condition and improve global health and care. Often the new innovative solutions lie at the intersection of disciplines, requiring bringing people together from different disciplines to orient towards a shared mission. I am a pragmatic tech optimist motivated to find solutions through innovation for the most pressing clinical problems.”

Knowing that breast cancer is the most common cancer affecting Australian women, Helen identified a clinical challenge for women. Mammographic screening reduces the risk of dying from breast cancer, however, interpretation of mammographic images is challenging, and subject to human variability. Despite independent double reading of all mammograms by radiologists (and a third arbitration read if there is disagreement), approximately 33,000 Australian women are recalled annually for assessment and later determined not to have breast cancer (false positive), whilst approximately 1,000 women subsequently discover they have breast cancer after receiving an “all clear” result and before their next mammogram in 2 years’ time (false negative). The cost of the public breast screening program, at over $270m annually, is also rising with Australia’s ageing population.

This clinical challenge inspired the creation of the “Transforming Breast Cancer Screening with AI” (BRAIx) project, which aims to transform breast cancer screening using artificial intelligence (AI). MECCA M-POWER has provided a generous gift to support Helen’s world-first research using artificial intelligence (AI) technologies to improve the accuracy of breast cancer screening.

By choosing to support this ground-breaking project, MECCA M-POWER is fast tracking the development of a technology that will provide generations of women with access to more accurate and personalised breast screening. “I am deeply honoured to receive this generous support from MECCA M-POWER. I am inspired by their passion and belief in the work we’re doing that could potentially save the lives of thousands of women. This support also acknowledges the incredible team and partners involved in this project. Together, we are on a mission to transform breast cancer screening with AI,” said Helen. “We know that screening saves lives but we can do it better. What’s most exciting is that it can change the way we screen women. The transforming breast cancer screening with artificial intelligence program (BRAIx) uses cutting-edge artificial intelligence technology to improve cancer detection, service delivery times and program efficiencies. Essentially, by combining human and artificial intelligence we can make an enormous difference to how we provide breast screening to women.”

Sue Parkes, CEO St Vincent’s Foundation Victoria, said she is delighted to work with donors whose vision aligns with work that has the potential to have such a significant impact on women’s health. “I am grateful to MECCA M-Power. They have shown visionary support by identifying an area of great need where they could make a significant impact. We celebrate the MECCA M-Power team for taking the initiative to instigate such important change for generations of women to come.

Successful implementation will improve breast cancer detection, lower harms, reduce costs and cause less stress for women. It will enable the breast cancer screening model to transform to a personalised approach based on a woman’s risk of developing breast cancer. More broadly, it will improve the AI capabilities of the interdisciplinary teams that support BreastScreen throughout Australia and increase understanding and support of AI from consumers and clinicians. We aspire to establish an exemplar for broad AI deployment in healthcare and the prospect of a global software service creating value from the 30-year public investment in population health and screening data.

“It is a pivotal time for Australia in terms of both the next wave of technology developments with AI as well as for the evolution of the healthcare system which is under significant strain. I see us developing the sovereign capabilities to deploy and manage evidence-based AI solutions that are safe and fair for all. The potential for technology to transition screening to a personalised program that can save more lives and enhance the woman’s experience is exciting and very real,” she says.

Having worked in breast cancer screening for over 20 years, Helen has experienced many challenges, three of which come to mind. “Firstly, lifting participation rates has been a constant challenge. Currently around 50% of women in the target age group (50-74 years) participate. Increasing participation would save more lives. Secondly the transition to digital mammograms and workflows some ten years ago was a significant transformation that has set up the datasets and opportunities that are now available to us with AI. Finally, the recent Covid pandemic was a challenge for screening and the health system. And it is now vitally important for anyone who delayed their screening to make an appointment,” she says.

We know that screening saves lives. “Breast cancer is a major public health challenge,” says Helen. “The good news is early detection significantly improves the chances of survival. A review of the Australian screening program demonstrated that women attending the national screening program have a 41-52% reduction in death from breast cancer.” Currently screening for most women is recommended every two years between the ages of 50-74 years, and women from age 40 are also eligible to attend. “The most common symptom of breast cancer is a breast lump,” says Helen. “Other changes can include nipple discharge, nipple crusting/redness, nipple inversion, changes to the skin such as puckering or dimpling, a change in size or shape and a pain or redness that does not go away.”

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