He invented a tool to make mammograms less painful: ‘You can’t go for a screening that you hate’

A mammogram is a potentially lifesaving screening tool that can help with the early detection and timely treatment of breast cancer. Unfortunately, many women also rate it as one of the most unpleasant and uncomfortable health screenings.
During a mammogram, which takes an X-ray of the breast, the woman stands in front of a machine and the breast is placed on a flat plate. Another plate presses down from above to flatten the breast to get a clear image. This is repeated on the other breast.
Up to 46 per cent of women in Europe and the United States chose not to go for subsequent mammogram screening after experiencing the pain of breast compression, according to one study in Elsevier, which publishes peer-reviewed scientific literature.
However, “most of the pain from breast compression is actually avoidable by applying the right amount of force,” said Luke Goh, a 26-year-old industrial design graduate from the National University of Singapore (NUS).
The young inventor explained that it is hard for radiographers to accurately estimate the compression force required for each individual to get a clear reading, so they usually end up over-compressing the breast.
To reduce unnecessary discomfort, Goh designed Mammosense, a tool placed at the mammagraphy unit that analyses each breast during a mammogram, to determine the optimal compression force required for that individual.
Initial trials have shown that the tool reduces the compression force applied to the breast by 34 per cent, and dials down the pain by 25 per cent.
Breasts are compressed during a mammogram to spread out the breast tissue and reduce the thickness of the breast. This enables radiographers to use less radiation to effectively penetrate the tissue and detect abnormalities such as tumours.
In general, larger breasts usually require more compression force to spread out the breast tissue, and vice versa for smaller breasts, explained Goh. However, other factors, such as breast density, can influence the amount of compression forced needed.
Radiographers rely on their experience to estimate the force required for each patient. Many healthcare institutes also have minimum compression guidelines and, in such cases, patients with smaller breasts may suffer unnecessary discomfort, Goh added.
Tapping into LiDAR (Light Detection and Ranging), Goh’s invention maps the size (cross-section area) of the breasts to calculate the appropriate force required to get a clear imaging while minimising discomfort as much as possible.
The invention made Goh the national winner of the annual James Dyson Award, which comes with a S$8,400 grant to further develop his project.
The James Dyson Award is an international design innovation competition open to current and recent university students in engineering, product design and industrial design. Designers have to create products with simple engineering principles, that have technical and commercial viability.
Goh will progress to compete on the international stage, where winners will be announced in November.
Mammograms would probably never cross the minds of most young men. Goh was no different.
It was a chance conversation with Dr Serene Goh, an associate consultant at NUH and a friend of Goh’s design mentor in mid-2023 that made Goh aware of the problem.
“She mentioned that the breast screening rate in Singapore is very low. One of the things she wanted to do was to improve screening rates,” he said.
“I thought, if we can make [the mammogram experience] a lot better, it is going to benefit a lot of people. But I thought that I was not the right person to do it, because I’m a guy – this is a very female procedure,” he added.
Goh went home and spoke with his 55-year-old mother about it. She told him she had only gone for one mammogram in her forties and shared her experience with him.
“She told me that it was very painful, very horrible, and that she has never been to another one since – she wouldn’t want to do it again,” he said.
That was what got the ball rolling for Goh.
“As I dug deeper and talked to more people, I realised that this is a very pressing problem, but no one’s talking about it,” he said. “The [radiographers and patients] I spoke to are like, oh yeah, this is the way things are.”
Hence, a few months after his conversation with Dr Goh, in around September or October, Goh decided to try cracking the problem as his final-year project at NUS.
Goh’s first order of business: Go for a mammogram to experience it for himself.
Just before his screening, he went to two health screening roadshows to speak to other women about their experience.
“I said, ‘I am going for a mammogram tomorrow. Can you tell me more about what I can expect?’ Everyone that I spoke to was like, ‘Oh, you’re going to regret it. Get ready for some tears,’” he said.
“It didn’t look that bad to me. But after I tried it, I saw where they were coming from.”
“When the radiographer pulled my breast into the machine and compressed it, I could feel the tension increasing and that was uncomfortable – it’s like a dull, sore sensation,” he said.
“I know some people feel it a lot harder. I have heard that some women cry during the procedure and ask [the radiographer] to stop.”
Noting that most of the major upgrades in the mammogram machine have been results-driven, and relate to imaging and accuracy, Goh felt that much more could be done about patient comfort.
So he began to look at ergonomic ways to make mammograms more comfortable, including the use of air cushioning, or incorporating warming therapies before compression. But he quickly realised that these would compromise the standard of imaging.
“I knew I needed to find something invisible to X-ray. But every material is visible – except light,” he said.
That was his eureka moment.
Recalling how LiDAR sensors are used in self-driving cars to map the environment, he thought about using the same technology to map the breast and determine its cross-section area and the corresponding optimal force of compression for each patient.
Goh adapted the LiDAR sensors for breast imaging and developed a software to process the data in real time – an algorithm calculates the force required for the optimal compression.
Mammosense is patented in Singapore, in partnership with NUS and the National University Hospital. Goh is currently enhancing the hardware and software for even more accurate mammogram force recommendations for each patient, including factoring breast density when calculating optimal compression force, to further reduce discomfort.
The young inventor hopes to commercialise Mammosense and is currently in talks with an industry partner. He is also looking to collaborate with hospitals in Singapore to perform larger pilot tests with patients to evaluate Mammosense’s effectiveness in enhancing the screening experience.
Goh hopes his invention will encourage more women to go for screenings.
“If you screen regularly, you can catch the cancer before it becomes anything serious. Rate of survival drops as the cancer progresses,” he pointed out.
This is why it is important to make mammograms less painful, Goh said. “You can’t go for screening that you hate”. And screenings should be made as comfortable as possible.
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