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  • Writer's pictureBen Freeberg

Oncology Ventures Thesis: Early Detection for Breast Cancer

The state of breast cancer early-detection today

One out of every eight women we know will be diagnosed with invasive breast cancer in their lifetime.

If we catch breast cancer early (Stage 0, 1), the survival rate is 99%. If caught late, the survival rate is 31%.

Due to 1) inadequate breast cancer risk assessment tools, 2) inefficient breast cancer screening methods, and a 3) complicated healthcare system that makes it difficult for patients to follow through on best next steps, we fail to diagnose breast cancer early one-third of the time - resulting in 42,000 unnecessary deaths each year.

  1. Current state of breast cancer risk assessment

    1. Traditional, “best-practice”, risk assessment relies on having a primary care provider (“PCP”)

      1. Yet, only 5% of PCPs and OB/GYNs appropriately assess breast cancer risk in female patients

      2. And, 50%+ of women under 30 years old don’t have a PC

    2. Current guidelines for risk assessment are built on antiquated, homogenous datasets for women over 40 years old

      1. Existing risk models for women under 35 years old and women of color are only 53% accurate

  2. Current state of breast cancer screening

    1. Today, screening guidelines provide one-size-fits-all “solutions”

      1. The National Comprehensive Cancer Network recommends “women with average risk” of breast cancer get a mammogram every year starting at the age of 40

      2. But, mammograms are ineffective for the ~50% of women who have dense breasts

    2. Genetic testing provides false sense of security

      1. As genetic testing only uncovers the highest possible risk for the 1.6% of women who actually have a genetic mutation. Just because you are negative for a genetic mutation does not mean you are not at risk

  3. Complicated, inefficient and complex healthcare system that is difficult and expensive to navigate

    1. It takes the average woman 38 weeks to get a diagnosis after finding a lump in their breast

      1. It could take 6 weeks to get a clinical breast exam and another 6-12 weeks to get a diagnostic mammogram as a next step

      2. As we now know, mammograms could be inconclusive, so you then have to add in 3-4 weeks for a biopsy and another 3-4 weeks for a breast ultrasound

When you combine all of the above, you can easily see how one-third of women end up getting diagnosed with late-stage breast cancer, bringing their chance for survival down from 99% to 31%.

Treating late-stage breast cancer costs more than 2x what it costs to treat early-stage breast cancer, providing an $8.5B savings opportunity.

With the right screening and curated action plan, the number of late-stage breast cancer diagnoses for the 197M women over 21 years old in the U.S. could be 0.

Why is breast cancer early detection prime for disruption?

  • Early detection of cancer in the U.S. is projected to lead to $26B in annual savings (17% of overall cancer spend)

    • It is proven that it’s 50-90% cheaper to treat cancer in Stages I and II than to treat cancer in Stages III and IV

  • Breast cancer presents the largest opportunity by cancer type, as it represents a third of newly diagnosed cancer among American women and has the highest cost, at $30B (14% of all cancer spend)

    • Note that while rare, ~3k men per year will also get diagnosed with breast cancer

  • Of the total $26B savings opportunity for early detection in cancer care, $8.5B is impactable through breast cancer if we can ensure that the 33% of women who are getting diagnosed with late stage breast cancer find and treat their cancer earlier

  • Data-driven, personalized screening is important, as $4B of the total $15B spent on screening is attributed to inappropriate screenings and improper care

How is Gabbi changing the way we approach early detection for breast cancer?

  • Gabbi provides women with the opportunity to understand their risk of developing breast cancer and enables them to take proactive action for their next steps of care

  • Gabbi’s data-driven, clinical platform called the Gabbi Risk Assessment Model (GRAM) aims to eradicate late-stage breast cancer through:

    • A best-in-class breast cancer risk assessment tool for patients with 4x more predictive value and 54% higher sensitivity than current industry standard

    • And a curated action plan to help with the inevitable swirl in the system patients experience during their peri-diagnosis period (period before treatment is initiated) of care, with the guidance of Gabbi Care Coordinators

  • The comprehensive, end-to-end nature of their offering is key to Gabbi’s success. Gabbi achieves localized care at scale as they curate and guide users on best next steps according to an individual’s personalized risk

    • For example, in most cases, a 25-year-old woman with dense breast tissue and a high-risk profile should not get a mammogram, yet that is the current standard of care

    • Gabbi will order that user a breast MRI, skipping ineffective screening

    • This can reduce treatment cost by 49% and shorten her time to diagnosis from 38 weeks to 6 days

Oncology Ventures is thrilled to partner with Kaitlin Christine and the Gabbi team as they seek to eradicate late-stage breast cancer.

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