The people of Thermaiscan: Dr. Axel Gräwingholt

Thermaiscan is a HealthTech business. But it is the people behind the tech that has brought us to where we are.

Follow along while we introduce our dedicated team with a joint mission to build a healthier world.

Kicking off this series is our recently onboarded colleague & Medical Advisor – Dr. Axel Gräwingholt, a radiologist specialized in breast cancer detection.

Clinical co-chair of the guidelines development group of the European Commission Initiative on Breast Cancer, ECIBC, and now  – of course – a valuable team member of Thermaiscan.

How come you started working within medicine, and specifically oncology?

– I wanted to become a medical doctor already at the age of 5. So – all my life. It just fascinated me.

Axel talks about the time he spent in the United States during high school, and that he lived with a family with a medical doctor. 

– He took me to the laboratory as often as I wanted, it was fascinating, Axel reminisce.

When Axel started medical school, he chose radiology as his specialization.

– It’s visual and has a lot of patient contact. Perfect, since I love to meet people and I am very visually oriented. Patient work always comes first, he says.

During Axels first years of residency, he worked at a large community hospital. They did all sorts of examinations: MRI, CT, x-ray and mammography.

He continues: It was here I discovered my interest in breast cancer care and mammography. It was a lot of patient contact and follow-ups. I could see the patient progress and closely follow how the treatment was working.

After the residency, Axel went to a private institute and continued his journey as a breast cancer specialist. And when the German national screening program started, Axel was not late to apply for a job at one of the screening units. He continues:

– In 2006 we started a close collaboration with the local breast center. It was at this time I started to help implement the cantonal screening program in St. Gall in Switzerland. In 2015, the European Union made a call for experts. They needed a new version of the European guidelines on Breast cancer screening. I was chosen as an expert for radiology. The group elected me as their clinical co-chair in 2017.

Many countries lack specialized breast radiologists. This is why Axel – parallel to his clinical practice and his work with the European Commission – started educating peers in breast imaging, in 2014. 

– I went to Armenia and held courses on mammography. I have been doing it ever since. To exchange knowledge is a fascinating experience. And I love to meet colleagues eager to learn.

Through the years, Axel have been teaching in several countries. Switzerland, Greece and China.

– This is very important to me, because it opens completely new horizons and helps to understand different strategies and approaches to detect breast cancer as early as possible. A few years ago I became interested in AI – as a detection tool in breast imaging and – this is fairly new: in risk prediction. 

Axel shares that he is currently working on the use of AI in breast imaging, mainly detection algorithms and risk algorithms:

– We are running a European validation study on a risk model based on mammographic features, together with Karolinska Institutet in Stockholm.

How come you are working with Thermaiscan?

– By chance! I held a lecture on how breast cancer screening might develop in the future, during a health care conference in Armenia in 2021. And I mentioned thermal imaging. Afterwards, an Armenian breast surgeon came up to me. He told me that Thermaiscan is developing thermal imaging and having good results. I wanted to know more, Axel says.

The surgeon was Dr. Nerses Berberyan, a team member of Thermaiscan. Not long after – Axel was on board the team.

What do you do here at Thermaiscan?

– I aim to improve things for the patients. With about 30 years of experience, I have seen a lot of things happen. For the good and for the bad. And the patient will always be my focus, Axel states.

Besides knowledge about breast cancer in general and methods of screening, Axel helps with ideas on how to improve the standard strategies used for screening nowadays. 

What is the future of breast cancer screening?

– Personalized screenings. Current guideline recommendations are already heading in that direction, Axel says. He goes on to describe an example: The conditional recommendation to use tomosynthesis in women with dense breasts. Risk prediction, especially based on imaging and AI-evaluations, is also gaining more traction. Axel continues:

– One day, we might be able to enhance how we identify women in need of more frequent screenings or different supplemental methods. Thermal imaging can help with that.

On the other hand, there are many low- and middle income countries where mammography screening is just not affordable for everybody. A screening can cost as much as a month’s worth of pay.

Axel adds:

– But thermal imaging is much less expensive, and can be done by local health centers after an introduction.

Our hope is to identify women who definitely must get a mammography to detect cancer. 

What is commonly misunderstood about breast cancer and screenings?

– People often think that going to screening will prevent the disease. They do not realize that even in the interval between two screenings, cancer can develop, Axel says.

To shorten the interval, more mammography screenings might not be the best option, due to the radiation. He proceeds:

– If we can introduce less harmful examinations like thermal imaging, in the interval, it could help to detect these cancers early. Interval screenings could be performed at the house doctor or at the gynecologist. 

What is the largest obstacle according to you, regarding introducing more preventative health?

– Money and human resources. And the lack of radiologists. This is very evident in the European Union.

What is something you wish for?

– I would really like to have a solution for the time in between screenings, to be able to find cancers effective and with lower effort. It pains me not to be able to find cancers earlier. 

Cancer is just sometimes not detected by mammography. And after two years, it might have grown to a large size, with all the complications, such as metastasis. I want to change this, Axel finishes.