The Problem

According to the World Health Organization, breast cancer is the most common cause of women’s death in both developed and developing countries, claiming the lives of 600,000 womenglobally. In Germany, breast cancer is the most common cause of death for women between 40-44 years of age. Each year, roughly 60,000 women are newly diagnosed with breast cancer, with 18,000 of these cases ultimately fatal. Early detection and treatment significantly increases the chance of survival. Yet, the standard method used - mammogram screening - is only offered to women aged from 50-69, even though around 20 percent of breast cancer is detected in women under the age of 50. In addition (and for younger women this is the only method of screening), physicians regularly examine the breast as part of a routine female check-up (usually once or twice a year). There is no standardized or evaluated method, however, for such breast examinations.

The Idea

Discovering Hands is an innovative program launched in Germany in 2006 that trains visually impaired women to detect early signs of breast cancer. After a two-year testing phase, the program is now in the process of being scaled up and expanded,both domestically and overseas. Discovering Hands is unique due to its specially designed approach,which involves educating visually impaired women in order to enhance their already superior sensory skills to more accurately identify areas of inception and detect smaller lumps. As ‘Clinical Breast Examiners’, they participate in a nine-month training program in disability centres, where they learn how to use standardized diagnostic methods for examining female breasts, as well as psychology, communications and administrative skills in medical institutions across Germany.

Clinical Breast Examiners are either directly employed by residentdoctors or hospitals, or work for different practices and/or hospitals on a freelance basis. The examination is either paid through health insurance (to date, Discovering Hands has agreements with four companies in Germany) or out of the patient’sown pocket. Beyond the health benefits involved, Discovering Hands also has a further function in influencing perceptions of disability. By using the extraordinary sensory capabilities of visually impaired women, a perceived ‘disability’ is transformed into a capability,and a new field of meaningful employment is created.

Potential Impact 

Although a peer-reviewed clinical study has not yet been completed,preliminary qualitative results show that Clinical Breast Examiners have an approximately 50 percent better rate of overall detection than doctors, and an improvement of approximately 30 percent when it comes to smaller tissue alterationsin the breast. These results have generated interest from health services throughout Europe. As of today, around 20 blind women are part of the Discovering Hands network, working in 17 gynecologist’s practices and hospitals across Germany. More than 8,000 examinations have been carried out to date. Discovering Hands plans to train approximately 40 more Clinical Breast Examiners nationally until 2017, who will have the capacity to carry out a minimum of 38,400 examinations per year. From an operational standpoint, Discovering Hands also has the potential to scale up quickly due to the self-sustaining nature of its operating model. The organization owns the patent on the specially developed braille orientation strips used by its staff, equating to a stable source of revenues able to be reinvested into the program.

Social Value

As noted, beyond the direct health benefits of improving the prevention and early treatment of a major disease through the specific work of the Clinical Breast Examiners, Discovering Hands also creates social value in two other ways. Firstly, the organization provides jobs for people with disabilities, and in the process acts as an empowering experience for members of a social group that can often be stigmatised. Moreover, the positive role they perform also works to change perceptions amongst the ‘able-bodied’.

Secondly, the very nature of the program means it is capable of capturing the public imagination, and as a result further spotlightingthe risks associated with breast cancer, and the consequent necessity of prioritizing early and rigorous prevention and detection strategies, especially amongst younger women.

www.discovering-hands.de