Engineering students at the University of Connecticut testing out their breast cancer screening tool in the lab. Photo / Chris LaRosa, UConn Photo
Twenty years ago, Leslie Holton was a graduate student studying virtual reality in medicine when her mother died of metastatic breast cancer.
“My [mother] and grandmother both died of breast cancer,” said Holton, who was 26 at the time.
Losing them made her want to find a way for other women to detect breast cancer before it was too late.
She had an idea: “I wondered, could we create a simulator that could help women learn how to do a self-breast exam, and help them understand what they’re looking for?”
Holton tried to push forward with the project, but the timing wasn’t right.
“The technology wasn’t there, the interfaces weren’t there,” she said. Plus, “it was really expensive to do, and I couldn’t get funding for it”.
Nearly two decades later, Holton - an innovation director at Medtronic, a healthcare technology company - led a group of engineering seniors at the University of Connecticut, as they brought her initial vision to life.
They created a tool for women that simulates the feeling of finding a breast tumour during a self-examination.
“For me, this was a total full-circle moment,” Holton said.
The opportunity came about during an academic-industry collaboration meeting about a year and a half ago.
Holton outlined her long-dormant idea of creating a virtual reality simulator to teach women how to detect abnormalities in their breast tissue, and one UConn professor expressed interest.
With breast cancer rates rising among young women, Holton said, executing the project felt more pressing than ever.
Many women find self-breast examinations challenging, either because they’re not sure what to feel for, or because their breast tissue makes it difficult to detect changes, particularly if they have fibrocystic breasts which causes the tissue to feel lumpy.
A recent study found that most women lack clarity on what a self-breast examination entails, and another study found that the two main barriers preventing women from conducting regular checks is that they forget, or they don’t know how to do it.
Some experts have stopped recommending self-checks specifically, and instead say people should focus on breast self-awareness by paying attention to what feels normal for them and noticing small changes.
Using simulation techniques can help women understand exactly what to feel for and familiarise themselves with what’s normal and what’s not.
Five students signed up to partake in the capstone project, which kicked off last August and culminated at the end of the school year in May.
Among them were Grace Bonacci and Carrie Nguyen, both of whom are now fulltime Medtronic employees. The project was part of UConn’s year-long senior design programme, which pairs students with real-world industry sponsors.
From the get-go, Holton gave her students creative freedom.
“She came to us with a vision for her project, but she gave us total freedom for how we wanted to do that,” Nguyen said.
With guidance from Holton and senior Medtronic engineer Emily Jacobs, the team of students designed a virtual reality training tool that uses a mechanical glove to simulate the feeling of both healthy and tumorous tissue.
“We used MRI scans that we found in online databases, and we did some image processing on those to create the model within the virtual reality simulation,” Nguyen explained.
To use the tool, a person wears a virtual reality headset, as well as one mechanical glove.
“You would see a breast model, and as you move your hand in real life, there is hand detection software so you would be able to see your hand moving within the virtual reality environment,” Nguyen said.
“As you are hovering over the breast model, the mechanical glove has balloons which inflate and exert pressure on your finger, depending on where you’re palpating on the breast model.”
Although it is not a diagnostic tool, it is intended to help users gain confidence and familiarity with what to look and feel for during a self-examination and identify potentially tumorous versus healthy breast tissue.
“I wanted it to be fun and gamey and approachable so people would not feel concerned about playing with it,” Holton said. “They really did a fantastic job of taking that vision and demonstrating it in reality.”
The project required months of troubleshooting and trial and error, and both Bonacci and Nguyen said they developed skills they will take with them in their future careers. The project, they said, has also deepened their interest in women’s health.
“This project has made me even more passionate about it, and even more aware,” Bonacci said.
Nguyen agreed, adding: “There is so much more to be done”.
The students got the first-place prize at UConn’s Senior Design Demonstration Day, outperforming about 20 other projects.
When Holton became an engineer, she recalls being one of few women in the industry.
“When I came into the industry 20 years ago, there were not a lot of people like me,” she said. “The other piece of this that really makes me smile is knowing we have new, diverse, really, really smart talent that are females.”
Holton said the tool is a first-step simulation, and she hopes it will be refined further by future senior students and one day be rolled out at clinics and hospitals.
“My ultimate dream would be to have a non-profit pick this up and make it widely available,” Holton said.
Until then, she said, she feels proud of the project - and she knows her mother and grandmother would be, too.
“This idea that I had 20 years ago is now a thing,” she said. “It’s amazing; it really is.”