Words from Women on the Global Stage, Part 3: Shiho Azuma, CEO of Lily MedTech

October 2, 2023

This time, we interviewed Shiho Azuma, the CEO of Lily MedTech, which has developed an ultrasonic diagnostic breast imaging system, called “COCOLY,” that makes breast cancer screening more comfortable both physically and psychologically in the hope of encouraging more women to get tested. We spoke with Shiho about her experiences as a female executive, and asked her to give us a message for young women in Japan.

CEO Shiho Azuma (left) and CTO Takashi Azuma (right) of Lily MedTech Inc., at the University of Tokyo’s Entrepreneur Lab

Can you tell us about the advantages of COCOLY and how the market has responded?

COCOLY was developed in response to societal concerns such as the low percentage of women who get screened for breast cancer and the low rate of cancer detection when using mammography. Breast tissue includes fatty tissue and glandular tissue, and in x-rays, like those obtained by a mammogram, tumors and glandular tissue both appear white, making it difficult to detect tumors hidden within glandular tissue in women under 65, who tend to have more glandular tissue. COCOLY takes advantage of the fact that in an ultrasound, glandular tissue appears white while tumors appear black, allowing for a high degree of accuracy regardless of the amount of glandular tissue. Another advantage is how easy the imaging process is: the patient lies face down on a table and places one breast at a time into an opening. Unlike radiography, ultrasound does not carry health risks, and COCOLY allows imaging to be performed with the breast hanging freely, with no compression, eliminating both the pain that can accompany a mammogram and the risks of radiation exposure.

In 2021, we went through the medical device approval process and a one-year trial sales period, and at present, we’re working on developing AI-based diagnostic imaging using COCOLY. A key part of that process is the linking of diagnoses to image data collected in clinical trials.

Was there anything that you tried to keep in mind, or found difficult, when building relationships with investors as a startup?

Raising capital was challenging, and still is. Since it costs a lot of money to develop a medical device, and there aren’t very many female entrepreneurs in the manufacturing industry, even globally speaking, raising capital was especially challenging at the beginning. Because the majority of investors are men, who don’t have first-hand familiarity with women’s medical issues, I made sure to start my pitch by helping investors relate to the issues surrounding breast cancer.

The biggest reason that we were able to raise the capital we needed, I think, is that with the Japanese government working to support workplace gender equality, the climate in financial circles was one of helping nurture female entrepreneurs. Another big reason is that right as we were getting off the ground, the problem of mammography’s low accuracy at detecting breast cancer in dense breasts (which contain a higher proportion of glandular tissue) had just come to light, making the public more aware of issues related to breast cancer. On top of that, we worked to gradually increase our media exposure by pursuing a variety of awards. Finally, I think we were aided, in terms of gaining investors’ trust, by the fact that thanks to the high proportion of Lily MedTech employees with previous experience at companies making medical devices, we’ve been able to work closely with medical practitioners during both the startup phase and product R&D.

Any tips for succeeding with a startup company?

Although I suspect that people often tend to have a glamorous image of startups, I don’t think the business process involved is any different from at other companies, especially smaller companies. I feel that it’s critical to use a logical, data-based approach to draw up a business plan, and to proceed in a rational fashion. I also work to ensure the integrity of collected data by building good relationships with external partners, and I’d say that judging which aspects of the business process to rely on external partners for is an important element of building a working business.

What would you say are your strengths that have helped you to be able to run a business?

Whether in business or not, I feel that making decisions without understanding things necessarily leads to failure, so I make sure not to do things that I don’t myself understand. On the other hand, once the challenges of the startup period have been overcome, I do try my hand at plenty of things that I’m not sure about. I make an effort to adjust which types of risks I take to fit the situation, and when it comes to decisions about what kinds of risks to take, I trust myself.

Right now there are just two of us at Lily MedTech, but at one point we had around 50 employees. When managing employees, I avoid micromanaging, strive for an open and tolerant atmosphere, share the company’s basic strategy and mission with them, and make sure to double-check only the key elements of their results. It’s important to create an environment in which everyone’s strengths are valued—sometimes there are things that men take for granted but that I as a woman don’t. I also tried to create an environment in which horizontal communication between departments could lead to spontaneous synergies. The useful opinions that come out when everyone is allowed to put their individual strengths to good use can foster good ideas, wouldn’t you say?

CTO Takashi Azuma (left) and CEO Shiho Azuma (middle) of Lily MedTech Inc., and Tomoki Sawai (right), Director of WIPO’s Japan Office, in front of the University of Tokyo’s Entrepreneur Lab

Can you leave us with some words for young women in Japan? Also, what would you say are some strengths of women in Asia?

With support of workplace gender equality gaining momentum in Japan, I think that understanding your strengths and weaknesses, finding value that is unique to you, making sure not to lose sight of whatever that is, and not giving up before it’s shown that you can add value to the world helps further true gender equality and leads to a better life. One of the strengths of Japanese women, I would say, is that it isn’t yet set in stone what we’re supposed to be capable of. That is, since the number of women in management positions is still low in Japan, especially relative to other developed nations, going forwards, there are no limits on the ways in which the potential of Japanese women, who have not previously been in the forefront, can be demonstrated. As for Asian women in general, I think that one of our strengths is that we tend to be good at managing social distance. I also feel that the less-forceful approaches that women often use, and our compassion, make it easier to obtain the support of those around us.