Integrated Human Practices
Inspiration
Breast cancer is the most common cancer among women. In 2020, 2.3 million women were diagnosed with
breast cancer, and 685,000 women died from this disease. Cure rates for early-stage breast cancer are
relatively high. Therefore, early screening for breast cancer is crucial to reduce morbidity and
mortality rate of patients. However, the rate of breast cancer screening in developing countries is much
lower than that in developed countries, which is mainly caused by different levels of early screening
concepts and public health awareness.
As a country with a large population, public attitudes towards breast cancer screening in China is very
representative. In early April, we collected cancer-related words through Weibo to create a
‘Cancer-related word cloud" (Figure 1). It was found that breast cancer was the most frequently searched
term and caused extensive public concern. However, most of the breast cancer-related topics were about
cancer treatment, and only few topics were about early screening for breast cancer.
Figure 1 Cancer-related word cloud
Such a situation inspired us to create a convenient and fast breast cancer screening kit, BreFast, for
potential high-risk groups, and we believe that BreFast has the potential to be included in the routine
medical checkup program in the future and contribute to the promotion of breast health in the world.
Adhering to humanistic care for breast cancer patients, scientific enthusiasm for creating a new
technology for early screening of breast cancer, and a strong desire to draw a widely public attention
to breast health, we carried out Integrated Human Practices. We engaged stakeholders through interesting
activities and in-depth communications, collected and integrated their feedback with an open mind, and
finally implemented it rigorously and effectively in all aspects of our project, achieving “close the
loop”.
Hear From the World
To ensure that our programs will benefit to the world, it is necessary to hear the voice of people from
different communities. We have interviewed citizens and medical professionals to understand the current
state of breast cancer screening, people's expectations for BreFast, and get suggestions for improving
BreFast.
Public Opinion
Street interviews were conducted to reveal the public's awareness of the early symptoms of breast cancer
and the demand for BreFast as a breast cancer screening kit. We started our interviews at South Lake
Park because it is a densely populated area with people at all ages. We randomly interviewed 50 people,
including teenagers (10-25 years old), young people (25-35 years old), middle-aged people (35-55 years
old) and elderly people (55 years old or above), with a 1:1 male to female ratio (Figure 2).
Figure 2 Age distribution of respondents
Firstly, we surveyed men and women about their awareness of early symptoms of breast cancer. To our
delight, the majority of women had fairly good knowledge about breast cancer symptoms (Figure 3), but
men were not aware of that (Figure 4), which could be due to the low incidence rate of male breast
cancer.
Figure 3 Public awareness of early symptoms of breast cancer (women)
Figure 4 Public awareness of early symptoms of breast cancer (men)
Secondly, we investigated the frequency of breast health examinations of the participants. Although most
women knew that breast cancer is a life-threating disease with a high incidence, only about 27% of women
had regular checkups for breast cancer. More importantly, 53% of women had never had a breast exam
(Figure 5). As for men, none of them had breast exam (Figure 6).
Figure 5 Breast Cancer Screening (Women)
Figure 6 Breast Cancer Screening (Men)
To summarize, people were not fully aware of the early symptoms of breast cancer, and only a few had a
breast health check, making it easy for them to miss out the golden period of cancer treatment.
Therefore, BreFast, as a breast cancer screening kit, can help more people to detect breast cancer
early.
Expert Advice
Interview with Dr. Hua Xing
We hope that BreFast can be used as a daily screening kit and also incorporated into routine medical
checkup in hospitals. It's important for a cancer screening product like this to obtain the trust and
support of clinicians.
To know the current methods of breast cancer diagnosis and the opinions of medical professionals about
BreFast, we interviewed Dr. Hua Xing, Director of Breast Surgery Department of China-Japan Union
Hospital of Jilin University (Figure 7). She said that biopsy was the gold standard for breast cancer
diagnosis. However, many people were physically and psychologically unwilling to undergo biopsy at the
initial stage of breast cancer detection, which caused the condition more serious. Therefore, there is
an urgent need for a convenient and fast detection method, and our BreFast kit fits such need well. Dr.
Xing also stated that, an early screen product that clinicians truly trust must be scientifically
designed and experimentally proved to ensure its accuracy which helped us with the design and decision
of the experiment.
Figure 7 Interview with Dr. Hua Xing
Interview with Dr. Changlong Song
After the initial design of BreFast, we sought technical advice from Dr. Changlong Song, Doctor of
Surgery, Jilin University (Figure 8). He praised us for the innovation of BreFast. At the same time, he
said that we especially needed to concentrate on two key points in our design.
- Early-stage patients usually have a very small number of cancer cells, making it difficult to
diagnose accurately.
- miRNA is usually expressed at very low levels, which is hard to detect.
He suggested that we should find a miRNA that is highly expressed in breast cancer patients to increase
its chances of being detected and reduce the possibility of false negatives. We took his suggestions,
and did a rigorous bioinformatics analysis in our subsequent lab work to find miR-21-5p that was highly
expressed in breast cancer patients as the target miRNA for BreFast detection.
Figure 8 Interview with Dr. Changlong Song
Interview with Dr. Wan Wang
How to contribute to public health effectively has always been our top priority. We have been thinking
about what our team can do for public health besides continuously optimizing BreFast in the lab. To this
end, we interviewed Dr. Wan Wang, a member of the International Medical Exchange Branch of the Chinese
Anti-Cancer Society (CACS), who is an expert in public health (Figure 9).
During the conversation with Dr. Wang, we were glad to hear that people's awareness of medical checkups
is increasing year by year, and that the percentage of early-stage breast cancer patients at China-Japan
Union Hospital of Jilin University is growing. However, she believed that awareness of medical checkups
and breast cancer screening is still not enough for the public. She thought that our team should adopt
more fun and accessible ways to promote the public awareness of breast health which inspired us
publicity campaign.
Figure 9 Interview with Dr. Wan Wang
To summarize, our interviews with medical professionals told us
that we
should continue to improve the sensitivity and accuracy of BreFast to meet the requirement of being
put into clinical use. We also need to enhance public awareness of breast health and breast cancer
screening through innovative activities.
Feedback to the World
We adhered to the people-centered principle, and after integrating people's voices into all stages of the
project, we made a great deal of effort to involve and influence stakeholders as many as possible during
the entire process of our project.
Breast Health Dance
Since square dance is one of the most popular forms of exercises in China, we collaborated with students
of preventive medicine to design a set of movements that can improve breast health. We chose the song
“Dance The Night” from movie Barbie as the background music of the dance, due to its relaxing melody and
energetic vibe.
In early July (the time right after final exams), we partnered with dance club in Jilin University to
hold public square dancing at the sports ground several times, and over one hundred students
participated
in the square dancing each time. The video below is our first exhibition. It was so simple that
participants learned how to dance easily after watching our shows once. As you can see, they all enjoyed
themselves. The participants were amazed at how innovative we were in combining square dancing with
breast health, and they were happy to be able to relax and gain breast health at the same time. We
uploaded the video to the video website Bilibili and received over 1,000 hits and countless likes. More
importantly, this public square dance ignited a wave of dance enthusiasm and enhanced the public
awareness of breast health.
Breast Cancer Awareness Board Game
We believe that Human Practices should be inclusive. In order to engage a wide range of people with
different interests, we focused on the most appealing form of activity - the game. By adding dice for
luck, playing a board game, and incorporating quizzes and information about breast health, Breast Cancer
Awareness Board Game (Figure 10) was born! Participants were divided into five groups randomly. Each
round had 4 participants who were given flag pieces. Control the Breddy (the mascot of BreFast) by dice
to advance to different positions, there will be different actions, such as knowledge quiz,
popularization of science, move forward or backward. And then, proceed to the next step until you reach
the end. We've also created game guides to help people play online as well.
Figure 10 Board Game
Figure 11 Students playing board games
The game is full of breast cancer-related knowledge. By observing participants playing the game, we found
that many participants knew little about breast health, which urged us to do more.
Breast Cancer Prevention Workshop
To reach a wide range of people with breast health knowledge, we organized a breast cancer prevention
workshop at Longquan community (Figure 12), We held a Breast Cancer Prevention Seminar in the Longquan
neighborhood, where people of all ages live. We began by introducing the prevalence of breast
cancer and the risk factors. Then, we taught the participants the public square dance for breast
health.
Figure 12 Public square dance of breast health at the workshop
In addition, we also imparted the knowledge of conducting the breast cancer self-examination by
palpation. At the end of the workshop, the participants were asked about what we had talked about breast
cancer, and we noticed that some ladies seemed to have difficulties in memorizing all the information.
They suggested us to make some leaflets about knowledge of breast cancer and breast health so that they
could read the relevant information at home.
Breast Cancer Awareness Leaflet
Thanks to the lady's suggestions, we were inspired to write and print out Breast Cancer Awareness
Leaflets (Figure 13), which were distributed to residents of the Longquan neighborhood and other
communities (Figure 14).
Figure 13 Breast cancer awareness leaflet
Figure 14 Distributing leaflets about breast cancer at South Lake Park
In conclusion, through careful preparation before each activity
and thorough evaluating feedback after each activity, the activities that we organized were interesting
and beneficial to breast health of a lot of people. In the future, we hope to organize more fascinating
events to contribute to the prevention of breast cancer.
Commercialization
We are very excited when BreFast has been successfully developed in the lab. However, this is not the end
of the story! In the future, we hope to make BreFast available to as many people as possible, and it is
our sincere hope that BreFast will be introduced to the market to enhance early screening of breast
cancer
and make a positive impact on public health. Therefore, we have made great efforts to learn how to
commercialize BreFast and make it successful in the market to benefit more people!
Consulting with Venture Capital Manager
First meeting
In most cases, innovative products cannot be commercialized without the financial support from venture
capital investment. Therefore, we interviewed Mr. Jingdong Wu (Figure 15), general manager of Academy of
Sciences Venture Capital Co., Ltd of Jilin Province, on August 6, 2023.
Figure 15 Mr. Wu's business card
As a professional investor, Mr. Wu pointed out, ‘There are several aspects to consider in attracting
investors. Where is the target population of your product coming from? If the target population comes
from more developed countries, are there similar products in the market? If the target population comes
from less developed countries, you need to focus on lowering the price of the products. In addition, if
there are no similar products in the market, our BreFast will have a good chance of being invested. So
good market research is essential. At the same time, the accuracy of the test kits should be further
improved. The higher the accuracy, the more people will be willing to buy it, and the higher the value
of the investment is."
“Low-cost, high-precision testing products have always been in demand,” he emphasizes. Seeing the great
potential of BreFast, he hopes that the product will be available at a much lower price on the market in
the future. In this way, more people will be able to have a chance to use this excellent product.
Figure 16 First interview with Mr. Wu
Second meeting
Based on Mr. Wu's suggestion, we conducted a thorough market research and improved the quality of the
product. We would like to explore more possibilities of commercialization of BreFast with Mr. Wu, and
went to his company for a second interview (Figure 16).
Mr. Wu was glad to see our detailed market research, which showed him the investment value of BreFast. He
said that our product can be combined with some existing breast cancer detection technology and added to
regular medical checkup program. He also suggested that we can try to use similar principles to develop
cancer screening kit for other types of cancer. If we can promote early screening of other type of
cancers, it will be a great contribution to the public health as well. Inspired by Mr. Wu, we felt that
perhaps we can try to establish a miRNA-based cancer screen platform，which means it can detect not only
breast cancer but also other types of cancers using miRNA as a biomarker.
Figure 17 Second interview with Mr. Wu
He suggested us to contact pharmaceutical companies regarding to massive production and cost control of
BreFast, and told us how to introduce BreFast to make it more attractive to pharmaceutical companies.
Consulting with Pharmaceutical Company
After presenting the BreFast kit and its potential business value to the experts from pharmaceutical
companies (Figure 17), the experts thought that our choice of breast cancer was an appropriate start
point, as the government of China is now promoting early screen of breast and cervical cancer. In
addition, our screening of miRNA through bioinformatics analysis was also highly appreciated. Meanwhile,
experts suggested that in the process of product transformation, we can utilize our own advantages as
students in medical school to strengthen the connection between BreFast and clinical medicine, and do
more research and planning so that BreFast can make the transition from the lab to the market smoothly.
We also consulted on how to reduce the production cost of BreFast. The experts said that cost reduction
requires a delicate arrangement of production pipeline, and they appreciated our attitude to serve
public health and were willing to try their best to work out a rational production plan for us in the
future. “Stick to it! We look forward to seeing your product”, they said.
Figure 18 Interview with experts from pharmaceutical company
In summary, in the process of trying to commercialize BreFast, we learned that we should continue to
optimize BreFast and think about how to reduce the cost to bring it to market. We hope that, one day,
people will have the opportunity to use BreFast for breast cancer screening so as to protect them from
breast cancer.
Close the loop
Our Integrated Human Practices made efforts to achieve a closed loop between design and desire. During
the design phase, we had a number of communications with diverse stakeholders and got suggestions to
help us reflect throughout our project, which affected our experimental design at each stage. In the
process of publicizing our project and carrying out interesting activities, we fully involved the public
and deeply embed the awareness of breast health and breast cancer screening in people's hearts. The
discussion on commercialization has brought the project to a wonderful full stop which also represents
“close the loop”.
