A helping hand – a tale of robots, AI and accessible breast screening for all

Although it is possible to perform mammography in some wheelchair users, for others it is a significant challenge or impossible. Over the years several requests for alternative screening methods from people with severe disabilities, who were unable to be screened with mammography, have sadly been met with apologies from clinical staff – there is just no suitable alternative screening test available.

However, the urgency for changes to be made came into sharp focus for me when I received a letter from a woman called Jane in 2020. An accident had left her paralysed, and she was a permanent wheelchair user, consequently she had been unable to have mammograms performed despite the best efforts of both her and the radiographers. Six months later she was diagnosed with breast cancer. It highlighted that the status quo was simply not good enough.

This was a clear clinical issue in need of a solution – but I didn’t know what that was or where to start.

A collaborative way forward…

In March 2023, in collaboration with the University of York, I organised a research meeting at York Medical Society bringing together clinicians from the hospital and researchers from the university presenting cutting-edge new technologies. It was here I heard Dr Jihong Zhu, a robotics expert, present his work on robotic dressing assistance.

It was a fascinating talk on the use of robots to help humans with daily living activities. I had never seen robots used in this way and I approached Dr Zhu to see if he thought he might be able to help me with my clinical problem. Thankfully, he enthusiastically agreed to accept the challenge.

After several visits to the hospital for Jihong to see what was involved in taking a mammogram and myself visiting his lab at the University to see the robot in action, it seemed that finally there might be something we could do to help improve access to breast screening for disabled clients.

We decided it was important to get patient feedback early on and so approached Jane – the catalyst for all this – to see how acceptable she thought it would be and ask her to be a part of the project. Jane was only too delighted to help.

Of course, we then needed to find funding to turn this idea into a reality and the CRUK Early Detection & Diagnosis Primer Award seemed a good starting point. A collaborative approach with the help and expertise of colleagues meant we were successful in our bid, and the project has now launched. Without the opportunities created by this crucial funding from cancer research UK we wouldn’t have been able to get started.

As is often the case, while the problem seemed like a simple one on the surface to solve, it became clear the reality is much more complicated and truly does require a multidisciplinary approach to make things work.

The mammographers at the Magnolia centre, York hospital alongside Jane have been amazing in supporting the project and giving invaluable feedback as to the usability of the prototypes so far. I am massively appreciative of the vision and positivity of Jihong and his team at the University in driving this project and we look forward to succeeding in this initial step closer to being able to provide a more equal access to breast screening.