Digital Oncology: Developing wearable nanofibre-based temperature sensors for early diagnosis of cancer

Breast cancer (BC) is one of the leading causes of death in women worldwide [1]. According to WHO,
it is the most commonly diagnosed cancer in the world contributing to 12.5% of the total number of
new cases (2.3 million BC cases) and about 685,000 deaths in 2020 [2]. Early detection of BC is vital to
improve the 5-year survival rate of the patient for up to 98% [3]. The existence of breast tumors can
be detected using a variety of imaging techniques such as mammography, ultrasound, and MRI.
However, these methods are impractical to be used as personal monitoring devices due to their high
cost and uncomfortable procedures for the patient. Mammography is currently the gold-standard
screening method for BC at its initial stage, however, it has a number of drawbacks [4]:
the necessity of compressing the patient's breasts
increased cancer risks due to ionizing radiation exposure
results may be less accurate for women with dense breast tissue or breast implants.
There is a correlation between breast skin temperature and cancerous breasts, and it is measurable
[5]. This has prompted the development of thermography which is now used as an additional modality
with a high potential for early BC detection. It uses an infrared camera to detect heat patterns and
blood flow in body tissues [6].
Non-invasive, radiation-free & painless.
Detects changes in breasts with dense tissue and implants.
A skilled medical professional must perform the screening in a hospital or thermography centre,
therefore even though the technology has been proven to be a possible complementary tool, it is
impractical to use as a personal healthcare device (PHD).
The goal of this research is to develop a low-cost, real-time, flexible, and breathable wearable patch
for continuous temp monitoring for early BC detection based on the theory and mechanism of
thermography. It will consist of:
A nanofiber-based wearable patch containing temp sensors.
A Bluetooth interface circuit for the patch to transmit the temp data to a mobile application.
A mobile application to display temp data from the wearable patch for an enhanced user
experience.
This device will effectively serve as a PHD that monitors breast health to:
Improve detection of fast-growing tumors between mammogram intervals and when
mammography is not indicated by screening guidelines for women under 50.
Alert the user to changes that may need further investigation.
Reduce healthcare cost burden, barriers to health services, and user anxiety.
The wearable patch should be able to identify specific features of breast heat patterns over time to
detect BC:
A. highly asymmetric temperature distributions between the left & right breasts
B. localised hot spots indicating anomalies & variations in heat patterns in the areolar and
periareolar regions.
2
Methodology
1
st Phase, Fabrication of Wearable Patch:
Fabricate the nanomesh base layer using the electrospinning tool.
Fabricate the active sensing layer.
Comparative analysis: use an existing infrared thermal imaging camera to verify the result obtained
from the newly developed patch.
2
nd Phase, Sensor Interface Circuit: use an off-the-shelf Arduino circuit and equip it with a Bluetooth
transmitter to deliver real-time temp-sensing data to cell phones for remote monitoring.
3
rd phase, Mobile Application: develop an app that is compatible with both iOS & Android to read
temp data from the patch.
Testing the Full System:
Testing of the developed patch on dead animal skin to optimize the conformability & adhesion
properties.
Design a breast phantom embedded with a heater to mimic a woman's breast & tumor
respectively and use it to test the patch in-vitro.
In-vivo test of the full system.

Impact on Health and Care
The CDT primarily addresses the most pressing needs of nations such as the UK - namely the growth of expenditure on long term health conditions. These conditions (e.g. diabetes, depression, arthritis) cost the NHS over £70Bn a year (~70% of its budget). As our populations continue to age these illnesses threaten the nation's health and its finances.

Digital technologies transforming our world - from transport to relationships, from entertainment to finance - and there is consensus that digital solutions will have a huge role to play in health and care. Through the CDT's emphasis on multidisciplinarity, teamwork, design and responsible innovation, it will produce future leaders positioned to seize that opportunity.

Impact on the Economy
The UK has Europe's 2nd largest medical technology industry and a hugely strong track record in health, technology and societal research. It is very well-placed to develop digital health and care solutions that meet the needs of society through the creation of new businesses.

Achieving economic impact is more than a matter of technology. The CDT has therefore been designed to ensure that its graduates are team players with deep understanding of health and social care systems, good design and the social context within which a new technology is introduced.

Many multinationals have been keen to engage the CDT (e.g. Microsoft, AstraZeneca, Lilly, Biogen, Arm, Huawei ) and part of the Director's role will be to position the UK as a destination for inwards investment in Digital Health. CDT partners collectively employ nearly 1,000,000 people worldwide and are easily in a position to create thousands of jobs in the UK.

The connection to CDT research will strongly benefit UK enterprises such as System C and Babylon, along with smaller companies such as Ayuda Heuristics and Evolyst.

Impact on the Public
When new technologies are proposed to collect and analyse highly personal health data, and are potentially involved in life or death decisions, it is vital that the public are given a voice. The team's experience is that listening to the public makes research better, however involving a full spectrum of the community in research also has benefits to those communities; it can be empowering, it can support the personal development of individuals within communities who may have little awareness of higher education and it can catalyse community groups to come together around key health and care issues.

Policy Makers
From the team's conversations with the senior leadership of the NHS, local leaders of health and social care transformation (see letters from NHS and Bristol City Council) and national reports, it is very apparent that digital solutions are seen as vital to the delivery of health and care. The research of the CDT can inform policy makers about the likely impact of new technology on future services.

Partner organisation Care & Repair will disseminate research findings around independent living and have a track record of translating academic research into changes in practice and policy.

Carers UK represent the role of informal carers, such as family members, in health and social care. They have a strong voice in policy development in the UK and are well-placed to disseminate the CDTs research to policy makers.

STEM Education
It has been shown that outreach for school age children around STEM topics can improve engagement in STEM topics at school. However female entry into STEM at University level remains dramatically lower than males; the reverse being true for health and life sciences. The CDT outreach leverages this fact to focus STEM outreach activities on digital health and care, which can encourage young women into computer science and impact on the next generation of women in higher education.

For academic impact see "Academic Beneficiaries" section.