Simona Francese

In this room, one in eight women will develop breast cancer, and one in 43 will die.

Looks better for men, but they're not immune.

And in 2022, the deaths by breast cancer were 670,000 globally, and 11,500 in the UK.

That's 32 people every day.

And cases are predicted to rise to 70,000 by 2040, right?

But here's the good news.

The death rates are actually falling, and they've been falling remarkably, by 44 percent.

Why?

certainly because interventions and better screening and better treatments, but definitely because we can catch cancer earlier.

So let's talk about screening, right?

For breast cancer, we have the gold standard of mammography, which is followed by biopsy if the result is positive.

And we have the breast screening program that invites women every year after a certain age.

But actually, the target is 70% nationally, but the uptake can be really low in some areas of the country.

So why is that?

We really need to understand the reasons why we can't do more screening and why we can't have a better uptake.

Because I think we can.

So, NHS backlogs, obviously this has been exacerbated by COVID, let me say, also by decades of underfunding of the NHS.

We have reduced resources, so there is a disproportion between the number of screenings needed and the radiologists.

Also, the mammographic equipment isn't exactly present in every city, town, village that you will need.

So we have here an accessibility problem, which is significantly worse for underserved populations.

Let's be honest, I personally would choose my life over my modesty, but this is not exactly an exam, a test that preserves your modesty, right?

And for some populations, this is absolutely culturally unacceptable.

It is invasive.

there is a fear associated with radiation, and for many women, it's actually so painful that they refuse to go.

There was a recent survey of 2,000 women, and a standard of 21 percent said that the embarrassment of being topless and the fear of pain would actually prevent them from undertaking screening.

At least women know that it's so important to take up the screening, but this still happens.

So, but what if I told you that my team and I are on probably a game-changing test that looks exactly like a test that will bypass NHS backlogs, that doesn't need any more resources from the NHS, that actually preserves your modesty because it's completely non-invasive.

There is no radiation and pain associated with it.

And what if I told you that this comes from the world of fingerprints?

CSI and fingerprints, right?

An invisible world like that of a fingerprint.

We all know what fingerprints are for, right?

So they're used to identify a suspect by comparing the mark that they left at the crime scene with the fingerprint that has been taken upon arrest or from prior convictions, right?

So you might tell me, okay, what's got this to do with breast cancer?

So bear with me, because I need you to rethink what a fingerprint is.

So this is a close-up of a fingertip, right?

And the elevated part of the skin are the ridges, and then you see these little holes there.

Those are the sweat pores from which the sweat comes through.

And as you're sweating, as soon as you touch a surface, you transfer that sweat

onto the surface.

And now you transfer it in a rather mesmerizing way.

So it's a beautiful pattern of lines, but it is not just a pattern of lines.

It is a pattern of lines made up of molecules.

What molecules?

Whatever our body produces, metabolizes, and then eliminates through sweat.

Of course, anything that is sitting on your fingertip as you go around in your activities, touching things, right?

So that's really what a fingerprint is.

is a molecular pattern unique to an individual, a molecular pattern of lines.

And what can we do with this?

We've exploited this knowledge, and in some pioneering research, we have developed a mass spectrometry technique called MOLDI that actually measures the weight of the molecules.

And by making these measurements, we are able to know what these molecules are, who these molecules are, but we can also see them.

So if these molecules are distributed homogeneously onto the ridge pattern, by visualizing them, you can visualize a beautiful ridge pattern.

So now you get a molecular image of a fingerprint.

Or we can even resolve overlapping fingerprints because we just interrogated the software and recalled the image of distribution of molecules that are unique to each of those fingerprints.

So, for example, we can eliminate the fingerprint of the victim or we can submit to the database for identification the fingerprint of the perpetrator.

Although this technique has been used already nationally and internationally, it's been endorsed by the UOM office, that's actually not the only thing that we can do with this.

Remember, we are looking at molecules, and molecules are there for a reason.

They tell a story about you.

that tell about your lifestyle.

They might tell about the medications that you're taking.

We can even say something about your state of mind if you take drugs or abuse.

And even, what have you been doing just prior to or during committing the crime?

So now you're still asking, OK, so when are we going to get to the part of breast cancer?

OK, we're going to get there.

We were looking at personal information.

So we were looking at the possibility to, from a fingerprint, say whether that belongs to a man or to a woman.

So for this study, we asked the donors to actually swipe a fingertip.

on a surface, okay?

So this is now a smudged fingerprint.

And then we used our moldy technique with fire laser.

We get the molecules blast off and then taken up by the mass spectrometer that measures the way.

And we were looking at proteins and we discovered that the protein profiles between men and women are different enough and we can tell them apart with the 86% of accuracy, right?

And this is, folks, where serendipity manifested in all of its beauty, right?

Because my next question was, who are these proteins?

And as I was looking into this, I realized that some of these proteins actually were already reported in the scientific literature as biomarkers of breast cancer.

Let that sink in.

Fingertip smears or smudged fingerprints contain proteins that might be able to tell whether a woman is affected by breast cancer or not.

So, of course, I rushed to my team, and, you know, we have a meeting, and our jaws really dropped.

I mean, mine was still dropping from the early discovery.

And we all had the same two images together in our mind.

we had a mammogram versus a swipe of the fingertip.

And also then at that point, we thought, well, then can we further the optimization of this method?

Can we refine it to maybe produce a non-invasive screening of breast cancer?

and maybe even just as a pre-screening, so then only women that are positive to this very simple test go through mammograms.

And that is going to save a lot of emotional distress to women and to family, as well as saving the NHS a lot of resources.

So CARS organization then have actually estimated a cost of 17.5 billion pounds associated to breast cancer interventions, treatment and screening.

It's a lot.

We can reduce the distress to families, to communities, and we can also reduce this cost.

So it took me the best part of six years, because I was labeled crazy, the best part of six years to obtain £45,000.

to prove the concept.

And we did prove the concept.

So with that 45,000 pounds, I also hijacked some of the fundings that I had.

But anyway, with those 45,000 pounds, we were able to look at 15 women.

They gave us three different fingerprint smears.

We then analyzed the smears in three different locations.

So we had 135 samples to look at.

Simply, they came and did actually this three times.

One, two, three.

That's my sample.

I know it sounds crazy.

The sample preparation for us takes about a couple of hours, but the results can be obtained in minutes.

Then we trained a machine learning algorithm to recognize the protein patterns coming from women with early breast cancer

benign and metastatic, OK?

And we found out that we can tell them apart with the 97.8 percent of accuracy against the 70 to 90 percent accuracy of a mammogram.

And the results are shown in this confusion matrix.

I don't know why it's called confusion, but it's the confusion matrix.

What it tells you there is that of 135 samples, we spotted every time a woman had cancer.

So, do you think

that a test that will reduce the NHS costs, that bypasses the backlogs, that doesn't require any more resources, that is non-invasive, that is painless, radiation-free, that increases accessibility because in our vision,

We can take this test at the GP practices, even in the comfort of your own home, and then we can ship it COVID-style, as we used to do.

So it really solves the accessibility problem as well.

And in doing all this, it obviously increases compliance, and hence, it saves lives.

And do you think that something like this is not worth the investment, the dedication, the perseverance?

I think it is.

And I think that this is definitely an idea worth sharing.