Breast Density

Carly OsmanThat's perfect. So this is a topic that I think all women need to one, be aware of and to understand about themselves. And it's something that I didn't know until probably three weeks ago was an actual thing. And knowledge is power. And once we understand, we can advocate for ourselves. So Adrian, before we dive in today, I'd love to firstly ask you, who are you and what do you do?

Adrian (Micrima)It's a very good question. Yeah. so So my name's Adrian. So I'm chief exec of Microma. So I actually started off life as an aerospace engineer. So kind of fixing planes. And then at some point in my 20s, kind of discovered I was also quite good at fixing business problems and problems with teams and things like that. and i can done And then I kind of moved into med tech. And I kind of been in and around med tech for the past 20, 25 years. Breast cancer specifically for probably orlimy over 10 years now. And yeah, I got approached six or so years ago about coming to join Micromer to trying to get there their product and their technology kind of over the line and and and commercialized and available for use. And yeah, I kind of saw that as a great opportunity to, you know, make a difference for my career, make a difference for my girls, make a difference for yeah all the important ladies in my in my life and in everybody else's life. same so yeah, so that's where am. where i am

Carly OsmanSo firstly, what is breast density?

Adrian (Micrima)So So breast density effectively is the kind of makeup of the tissue in your breast. So every woman has a kind of mix of fat and fibroglandular tissue or kind of, you know, depending on what you read, it might be described as milk ducts, you know, kind of all of those kind of glandular things kind of mixed up with fat in your breast. So each woman has a different kind of mix up of those different tissues. It's impossible to kind of tell from look or feel or size or you know anything anything like that. Unfortunately, dense fat can feel very similar to kind of dense glandular tissue if you're trying to feel around to see what's going on. Yeah, and essentially, clinicians kind of grade your density into different kind of categories. But really, that density is all talking about the amount of kind of glandular tissue that you have within your breast.

Carly OsmanThat was gonna be my next question. I can't feel it because I've got very heavy breasts. That wouldn't tell me anything.

Adrian (Micrima)Nope. So, I mean, that could just be that you've got a lot of fat in them. It could be you've got a lot of glandular tissue. So, you know, I think, yeah. So, you know, from everything that I've kind of, all the papers that I've read from all of the conferences that I've been to, and I've been to a lot of them. I think that, you know, the general consensus is, you know, you can't tell by look or by feel because something that might feel like glandular tissue to you could actually be something and completely different. And unfortunately, until you've had an image of kind of, you know, the inside of your breasts and and that has to be an appropriate imaging technique to be able to see the right tissues within your breast, then, you know, unfortunately, you can't you can't tell by look or by feel.

Carly OsmanI know I have desperate and dense, I can't say this word today. I know I have dense breasts.

Adrian (Micrima)Even thinking about it too much.

Carly OsmanBut I know I have, oh my gosh, I know I have dense breasts because of a passing comment that I got given when I had a mammogram after an ultrasound just to check out on something. I didn't think anything of it. Why is it important that we know and we understand our breast density makeup? why Why do we need to know what's bits the glandular tissue versus the fatty elements? what why is that important?

Adrian (Micrima)So two reasons, really. So the first one is, you know, when it comes to your actual risk of getting breast cancer. So unfortunately, most breast cancers, again, i should, you know, I need to be completely open here. I am an engineer and, you know, and a change agent and a manager. I'm not a clinician. But again, from everything that I've read and everything I've seen, you know most cancers, especially the aggressive ones, kind of form within that glandular tissue in your breast. So the more of it you have within your breast, you know the the higher the chance, the higher the risk of getting breast cancer. So breast density or that amount of glandular tissue in your breast is considered to be a major risk factor in in getting breast cancer. So up to four or six times risk, depending on the amount of glandular tissue that you have in your breast. So, you know, the the the denser your breasts, the higher your risk. And well, I guess I should kind of add on to that, that You know, I said earlier on it's pretty much impossible to tell, you know, how what ratio of fat to fibroglandular tissue you have in your breast. I think the only thing that is known is that the amount of glandular tissue in your breast does change as you go through various hormonal stages. So when you first go through puberty, when you have your first period, when you have children, if you then go on to breastfeed, for instance, All of these things obviously change the amount of glandular tissue and milk duct and activity, all of that kind of thing that you have going on in your breast. So typically what's known is that younger women typically have denser breasts, well although for a reason that I'll come on to in a minute, there's never really ever been a study of women under 40 and their breast density, but it's generally considered that you know younger women have denser breasts. And that's because as you kind of go through menopause, That amount of dense tissue does start to break down. So so women typically have that kind of perimenopausal menopausal postmenopausal age will have a lower breast density. So, I mean, this kind of leads on to the second issue with breast density or the other reason why breast density is important. And one of the reasons why mammography is only really done in in older women. And that's because x-rays are very good. So x-rays, which are used in mammography in a mammogram, it's the type of energy that's used in order to produce the image. They're very good at penetrating soft tissue, but they're not great at penetrating through dense tissue.

Carly OsmanThank

Adrian (Micrima)So if you think about an X-ray of an arm, for instance, so the X-rays go through the soft tissue really easily through to the X-ray detector on the other side of your arm. And they get blocked by your bone and they'll creep through a crack or any kind of anything else. And you get this nice contrasty image that a radiologist who's a doctor that reviews the images is able to look at and quite easily see from the contrast in the image what's going on. So when you have a mammogram, the system squeezes your breast as flat as it can in order to help the x-rays get through the breast. But ultimately, those x-rays suffer the same problem. So they will go they'll go through fat really nicely. But if you've got lots of overlapping layers of glandular tissue, those x-rays get absorbed by that glandular tissue. And if you've got lots of it, they may not even make it through the breast at all. so So what you end up with is is it becoming very difficult to detect cancer in that glandular tissue. So when when a A breast radiologist, so again a doctor who's reviewing these images to try and find cancer, reviews an image of a woman with dense breasts. Cancer also produces very kind of dense areas of tissue, lots of high blood flow in the breast. So when you're looking at a mammogram that appears white in the same way as the glandular tissue does. So it makes it really difficult for a radiologist or even an AI algorithm to be able to detect cancer in really dense breasts.

Carly OsmanSo this is why, oh sorry to interrupt you.

Adrian (Micrima)And it no no it's just going And it reduces detection rates to less than one in two for, you know, for women with really dense breast tissues.

Carly OsmanSo is this why then, because after I heard you speak and then i went into a wormhole and I read lots of different stories and there were lots of people talking about how they'd actually had mammograms And they were told they were given the all clear, but then two months later, three months later, they were told they had stage, some of them even stage four breast cancer.

Adrian (Micrima)Yeah. yeah

Carly OsmanIs that why it's not picking up because they're not the technology at the moment isn't actually able to detect it.

Adrian (Micrima)Yeah, 100%. I mean, there can obviously be all sorts of different reasons, but typically, you know, the majority of missed breast cancers are typically because mammography isn't great at detecting cancer in dense tissues. It's also better at detecting some cancers than others, but, you know, that's a whole whole different rabbit hole. but But yes, you know, it comes down to the issue of breast density. So, i mean, we've got a story of somebody on our website that we've used as kind of a patient advocate for a long time. you know She did just that. She went for a normal screening mammograms. No cancer was detected. She then felt a lump. She was really kind of unhappy. She booked herself a private ultrasound on Harley Street, went and had her ultrasound done. They found a pretty significant cancer. in her breast, one that they actually think was probably there for anywhere between six and eight years that had been, you know, that had not been, and she was in the high risk, should say she was in the high risk breast cancer pathway. She had family history.

Carly OsmanWow.

Adrian (Micrima)So she was having annual mammograms. So she'd had annual mammograms for some seven or eight years that hadn't detected her cancer. And this is, you know, purely again, just down to the fact that the radiologist couldn't see it within her image.

Carly OsmanSo what is the solution? do we... how do we get, how do we bring this to the surface? What, is there any thing that's being done at the moment?

Adrian (Micrima)So I think historically, radiologists kind of, all but they've yeah when they go through training, they're kind of you know taught not to talk to women about their breast density because the image the issue historically has always been that the really the only gold standard way of imaging women with all different breast types is MRI. mr MRI is very expensive. It's, you know, it's limited in terms of the number that we have. An MRI imaging technique takes you know half an hour. You know, it's quite long. And there's just no way that, you know, any health system could really deploy MR, you know cost effectively for for all women. So historically, you know, everyone's kind of steered away from this discussion because the only thing you can really do realistically for women who've got dense breasts is after they've had that mammogram to identify that they've got dense breasts is to move on to an ultrasound to maybe look at an area of concern in their breast and see if you can see anything. But I think that's, you know, that has definitely changed. So in particular, with the introduction of the use of a cop what's called a contrast agent with mammography. So there's some 10 years worth of trial data now, including most recently, I think I sent you a, you know, a link to the BRAID study. which is a big 20,000 participant study in the UK looking at different imaging techniques that can be used for women with with dense breasts to increase their the detection rate. And essentially, you can do what is a very similar, certainly for the lady imaging technique in a mammography room. But if you If you inject a lady with an injection of iodine a couple of minutes before she has a mammogram done, so iodine is pretty safe. There is a very small risk risk of anaphylaxis. It's less than a risk of from antibiotics. And from all of the studies I've seen published, there hasn't been a significant reaction. There's been some mild reactions. But essentially, that but iodine injection gets attracted to high areas of blood flow. And as I said earlier on, you know, when cancer starts to form, it starts to suck in lots of blood to help it to grow.

Carly OsmanThank

Adrian (Micrima)So you end up with these collections of iodine in those high areas of blood flow in the breast. So the mammography machine for this technique does something slightly different. So it does its kind of normal image technique, but then it will do a very high energy technique. exposure almost instantaneously afterwards. So the time is pretty much the same. And as I said, the patient doesn't really experience anything extra. You don't have and have to have extra breast compressions, for instance. But that high energy x-ray dose basically goes straight through the breast, all of the soft tissue. I don't know if you you remember the old camera days. So if you let too much light in, you'd end up with this massively overexposed photograph that's all white.

Carly OsmanThank you.

Adrian (Micrima)So normally, you know, this is what you would get. So you can't use high energy normally because it will just go all go straight through and you you don't see anything. The great thing about iodine is iodine blocks x-rays. So you get this high energy goes through, it gets blocked by that area of concentrated iodine within the breast. And you basically end up with two images, one which is kind of functional image of the breast, where it it shows where the blood flow is, and then your normal image And then lots of clever software kind of combines those two images together and you get what's called an enhanced mammogram image, which all of those studies to date have all shown that you get significantly uplifted levels of of what they call specificity and sensitivity. So basically significantly higher detection rates in particular for women with dense breast tissue. And in fact, very close to MRI. The BRAID study showed that a particular MRI technique that they're trying to deploy, which shortens the time, is called an abbreviated MRI. A contrast mammogram is actually you know pretty much as good at detecting cancer as an abbreviated MRI.

Carly OsmanIs this the basis of the technology that you're bringing to market?

Adrian (Micrima)So I think, so originally we were all based on, so I mean, we've been around 20 years. We span out of Bristol University in 2005, believe it or not. yeah And the whole focus of us was developing a new type of energy, a new technology that was as good in dense tissues as it was in fatty tissues. So we specifically focus on something called RF. So this is radio waves that are in a specific frequency range. So it's actually very similar to your mobile phone or your Wi-Fi router. So 5G is 5 gigahertz, 6G, 6 gigahertz, 4G. And we we operate on a 3 to 8 gigahertz range. so So our technology, essentially, we do these broad spectrum of different frequency transmissions through the breast tissue. And we get different responses from different tissue types at different frequencies, kind of depending on what they are. But the the the whole reason for the development is... It's not impacted by density. In fact, RF travels slightly better through dense tissue than it does non-dense, but you know it's kind of negligible really. So our technology is really the only technology other than MR that gets whole breast coverage and is good in all different tissue types.

Carly OsmanThank

Adrian (Micrima)So originally we were focused on producing images like lots of you know other systems out there. When I joined about five years ago, you know we kind of looked at the performance of that and kind of you know where our technology best fitted. And actually, we kind of looked at these problems that were ongoing. So at this point, those contrast studies had already been going on for five to six years. And I saw a kind of problem coming at some point in the future. And this was the issue around, well, yes, you can use contrast for women with dense breasts, but you only know that she's got dense breasts after she's had her initial mammogram.

Carly OsmanThank

Adrian (Micrima)So this is the problem today is capacity. So there's an ever increasing shortfall of breast radiologists. So young doctors aren't taking up the profession because they see all of the ingress of AI in radiology, looking at pattern recognition, you know something AI is very good at. So they're not you you're not getting the same number of young doctors choosing to be in radiology. Then you have the shortfall. So then all of the more experienced and that they're the key opinion leader radiologists are all looking at AI more in order to fill in the shortfall. So the issue here is is capacity. So we've got a certain number of radiologists. We've got a certain number of mammography machines. So let's say, you know, all women in existing screening systems have a mammogram. And then 50% of them, because it's 50% of women who have a mammogram who have a dense breast, you know it's not a small proportion of women. This is 50% of women who have a mammogram are going to have detection impacted. That 50% would need a second imaging technique. so So we originally developed the device to very quickly measure breast density upfront.

Carly OsmanThank

Adrian (Micrima)So the first algorithm we focused on looks at that ratio of fat to fibroglandular tissue. And this was really to enable radiology to move to the first imaging technique first time. So that, you know, you knew a woman had dense breasts. So rather than giving her a mammogram and then a contrast mammogram or an MR or an ultrasound or whatever it is that you wanted to do, you could go straight to the most appropriate imaging technique for her breast type. So that was the original kind of concept. And I think, you know, we've kind of moved on from that a little bit. So I then started to find out about a lot of work that's going on by a particular clinician in Manchester who's looking at breast cancer risk in younger women. And I started to understand about this kind of risk factor with breast with breast density. And there are existing breast cancer risk models that are out there. Two of them are used by the and NHS and NICE approved for predicting a woman's likelihood of getting breast cancer. And in Manchester, they were looking at looking at this for for younger women and for kind of kind of underserved communities and trying to understand because breast cat you screening only happens in the UK post 50. It's the biggest single killer of women in the UK over 35.

Carly OsmanYeah yeah

Adrian (Micrima)So, you know, it's not you one in seven women are going to get breast cancer. So it's not an old woman's disease. You know, you can get breast cancer from puberty. You know, as soon as you start forming that tissue in your breast, you're at risk. Obviously, risk and increases as you get older, but it's that single biggest killer over 35. So how do we understand what we can do with younger women, especially when we know yeah the imaging technique that we can deploy most widespread, know, a most widespread basis, mammography isn't very good at detecting cancer in younger women who have dense breasts. So they were doing this big study using these breast cancer risk models to look at breast cancer risk. So Because density is such a major factor, they needed to to understand these women's breast densities. But the only way they could do that was by giving them a mammogram. And legally, ethically in the UK, you can't give a woman under 40 a mammogram unless you believe there's a significant risk that she's got cancer or she's had cancer before. So they got special ethical approval to give a lo what they called a low dose non-diagnostic mammogram to younger women purely to understand their breast density. So when I found out about this, I thought, oh great, because you can use our device. So our device is small and portable, can be used anywhere. And essentially, yeah, we we went down this route of of risk profiling. So I'm waffling on a little bit, which I have a bit of a tendency to do. Luckily, you can edit. But you know essentially we're now at this point where we can combine the density output from our device with these breast cancer risk models, where we send out an email link to the patient or the lady who'd like to buy a breast cancer risk profile. You fill out all of your family history, your hormonal life changes, other factors like, you know do you smoke? How much alcohol do you drink? All of the things that contribute to your breast cancer risk. You then have a very quick one minute scan on our device to measure your breast density, which feeds that in. And we can also add in kind of genetic factors from a saliva genetic test that you can take at home. And this basically builds, a very accurate breast cancer. It's kind of statistical, but, you know, what is your statistical risk of of breast cancer? And studies have shown that that can catch, you know, 40, 50 percent of breast cancers in women of all ages. So the short answer to your original question is, you know, you what our device enables is accurate breast cancer risk profiling of women of all ages and something that can be done in any setting. So, you know, you could have this done in your GP. You know, the study in Manchester is doing it in churches, in mosques, taking it out to women who don't normally like to come into those kind of settings. And combining it with all of your kind of patient of your risk factors to understand your risk. And what this enables us to do is to look at more stratified risk profiling techniques. And this is absolutely what the NHS 10 year plan is about. you know Community diagnostic centres. These are all about detecting more risk. disease a kind of earlier stage in the community, and then ensuring that the very limited diagnostic capacity that we have you know isn't just limited to those who are statistically higher risk because you're over 50 and you're better for having a mammogram because you're over 50 in postmenopause or perimenopause, but we're actually targeting those women who are at the highest risk. And because we know your density at that point, you can also be referred and have the most appropriate imaging technique for your breast tissue type first time.

Carly OsmanAnd this is what I think is so important. So I mentioned when we first met that four dear friends of mine were diagnosed with breast cancer. All of them were under 40 and one of them was diagnosed quite late and it's now been classified as incurable. And it just makes me so angry that these women should were just dismissed and pushed away. Oh, you're too young. Don't, don't worry about it. Come back. And they had to really fight and advocate for themselves. And I love the fact that what you're, you're developing and what you're bringing will change that for them. And it will. And you said shared a really kind of shocking fact when we last spoke, which was one in seven women will develop breast cancer. And it was something like 50 million after of women living will actually die because they got diagnosed too late. And this is set about to change that.

Adrian (Micrima)Yeah. Yeah. So, I mean, what's what's not to be passionate about passion? idea I mean, the the maths is pretty easy. So, you know, you're absolutely right. yeah one in around Between one in seven, one in eight women will get breast cancer at their lifetime. So there's 3.6 billion women on the planet, I believe, you know, if you stick it in chat GPT. So, you know, that's 500 million women alive today that are going to get breast cancer at some point in their life. So I think the really shocking thing here is that breast cancer, you know, with modern medicine has a near 100% survival rate. If you find it whilst it's still localized in the breast, as soon as it spreads outside of the breast and starts metastasizing, makes it to the lymph nodes, moves to other parts of the body, you know, you can, you can be looking at one in three women, you know, not making it beyond five years, you know, and that's a shocking statistic. So you Ultimately, 10% women who get breast cancer go on to die from the disease, and that is purely because of late detection. And I think historically, you know, that has absolutely been because of limitations with diagnostic technologies. You know, we don't produce images, you know, we're not going to fix that problem. You know, contrast enhanced mammography, in my view, in my, you know, 10 plus years of experience of going and listening to key opinion leaders from around the world, you know, leading doctors talking about the problem. You know, I think the ability to have a dense, non-dense pathway with contrast or non-contrast mammography is the long-term solution. It's the same staff, it's the same equipment, you're just deploying it in a different way. you know What we're really trying to do is to make sure that you know you can make sure it's the right women who are having those tests. So you know not just statistically women over 50, but those women you know who have a breast cancer risk score of over 20%. you know Today, there are high-risk pathways for younger women, but you've got to be over 40% risk. You know, so you've got to have such a strong family history that, you know, nobody can ignore it.

Carly OsmanYeah.

Adrian (Micrima)So, you know, we're about enabling that. And then, you know, making sure that when you go and you have imaging done, we're not race wasting resources by giving you tests that aren't appropriate for your imaging type, but making sure that, you know, a radiologist or a you radiology department is able to give you the most appropriate imaging technique for your for your breast type first time. And I think, I think, I mean, this may be a question you're going to come on to in a minute. And if you are, you know, tell me and we can obviously come back and and and you can ask the question. But, you know, I think the the the biggest thing we need to do now is to raise awareness. So I think, you know, is that something you do? you Do you want to come on to that?

Carly OsmanThat is exactly where I'm going next.

Adrian (Micrima)OK, so I'll let you ask the question and then and then we can go through that.

Carly OsmanSo the US and the UK are very different. So at the moment, no one really in the UK understand what breast density is, but US it's a very different field. Women know what type of breast density they have. What needs to change here in order to have that broader level of awareness that's been happening in the US?

Adrian (Micrima)Yeah. So I think you spoke earlier on about, you know, women, you know, that you've read about or even, you know, personal examples that you know of, of women who've been for mammograms, basically got an all clear letter from their screening system and then, you know, find a lump two or three months later, go and have a, you know, have some follow on imaging, probably an ultrasound, maybe a contrast mammogram or an mri and find out that actually they have got breast cancer and they may have had breast cancer for years. And it's just gone undetected because, you it's not that it wasn't there. It's just that the radiologist couldn't see it within their mammographic image. So I think, you know, what's happened in the US in particular is, you know, women finding out about this. I think litigation in the US has you know had a big factor. You know, it's it's been become big news in the US. And I think what we've seen in the US is formation of at least a couple of really big patient advocacy groups. Yeah. you know specifically focused around breast density and changing the pathways to make sure one that women know that an all clear letter isn't just doesn't mean all clear what an all clear letter means is that the radiologist can't see something in your breast doesn't mean it's not there And to make sure that women are informed of their density. So, you know, if you've got dense breasts, it's, you know, that is your body. You know, in my view, that is your information. And that shouldn't be held back from you because today, you know, I can't give you an alternate technique. You know, you need to know. that yes, I can't see something in your breast, but you've got a lot of glandular tissue in your breast. So it could be, you know, one, you're high risk, you know, two, it could be that, you know because of this masking effect, we just can't see it. So, you know, you need to know that you need to keep checking your breasts probably more regularly, you know, than you did before. And, you know, if you can't get something from the NHS, at least you you know you can go to a private provider, you know, pay, you yeah I think it's £150, something like that, to have an ultrasound you know done, for instance, or if you can afford it, have an MRI done. But you know at the very least, you need to know And I think, you know, this is the this is the biggest challenge that I see, you know, outside of outside of everything that we're trying to do to enable different pathways and to be able to enable health systems to be able to do things differently. You know, and I should say, you know, kind of alongside all of that, you know, we are commercially making our services available. So that you know whilst we're fighting this 5, 10, 15 year battle to change health system pathways, you know we can make this available to women, you know albeit you know privately. That women need to know. And it's women knowing about this issue, knowing about the issues of breast density, knowing that there are alternative imaging solutions available now that can be effectively deployed. So I know i know from some you know kind of publicly available statistics or or statistics that available to suppliers of the UK that around 90 to 95% of mammography machines that are being sold into the and NHS at the moment are contrast enabled. So these could all do a dense and non-dense technique. Majority of them aren't. you know They're just being bought because everybody knows at some point this is going to come. It needs to come now. you know that The braid study should have been you know the final...

Adrian (Micrima)Final changing factor. And, you know, and I know this to get this to change, it has to become a political hot potato. And the only way we'll see that is by women finding out, you know, as many women, you know, this is amazing what you're doing, you know, and I, you know, and I am, massively grateful for, you know, you listening to a talk that you happen to hear me do, you know, finding out about it and, you know, and being so passionate and empowered about it, to you know, to to want to spread the word. You know, the more of this we can do, the more we can make women aware, you know, the more women start standing up for this and not accepting the fact that the biggest killer of women, just because, you know, the excuse is we've got a screening system.

Carly OsmanYeah. Yeah.

Adrian (Micrima)You know, you'd have seen in the news, you know, prostate cancer is the biggest killer of men.

Carly OsmanYeah.

Adrian (Micrima)There isn't a screening solution. You know, so the political answer is, well, we've got a screening solution for breast cancer, but it's not good enough. And we don't have to spend significantly more money to save a significant number of lives. Fifty million women alive today will die purely because of late detection. And it's completely avoidable. A hundred percent avoidable. So and you, any woman who's listening to this, you know, go off, research, find out about it.

Carly OsmanOkay.

Adrian (Micrima)Ask what your breast density is when you have a mammogram. you know if they say we're not going to tell you or we can't tell you you know don't don't stand for that request you know you can request your data you can request your images you can request your density reports if you can't get somebody to look at your images when you get them from your hospital or from the screening system to tell you if you've got dense breasts or not you know email me and i will find you somebody who will that women women need to know and we can't allow this kind of

Carly OsmanYeah.

Adrian (Micrima)Continued what I see as overly academic approach to deployment of change when the evidence is just absolutely in our face now.

Carly OsmanYeah. Well, thank you for everything you're doing and I'll put all the links to, in the show notes below. So if anyone wants to get a private test with you and any offices, any buildings, if anyone owns any businesses, I know that you're doing this in a corporate level too. So every woman let's get our breasts checked and understand. Yeah. I'll make up.

Adrian (Micrima)Yeah. And again, you know, we're, we're as much about informing women as we are about selling. Cause I think, you know, ultimately it's change, you know, which is going to, which is going to met you make our company survive ultimately. So, you know, we have all sorts of links to women's stories about breast density and about breast cancer to independent data sources, you know, links to those on the website. So, you know, yeah. So www. microma. com and, you know, everything that you you know links to everything that you should need to help inform yourself will be there.

Carly OsmanAmazing. Thank you, Adrian.

Adrian (Micrima)Thank you.