From Salon: http://www.salon.com/2013/04/25/is_there_too_much_breast_cancer_awareness/
Yes, the world is a pinker place. But an author (and survivor) says we’re squandering time, money and resources
By Mary Elizabeth Williams
Thursday, Apr 25, 2013
Facing the helplessness of disease – especially a disease that has a penchant for women, for our mothers and our friends and daughters – it feels good to go on the offensive. It feels good to believe we are somehow collectively “battling” it. It feels good enough, in fact, to have turned breast cancer into a big, Pepto Bismol-colored business, and to have driven unprecedented droves of women into prophylactic mastectomies.
Yet reality is far more complicated than a jaunty ribbon on a lapel or the hopeful promise of “early detection.” And the key to unlocking the secrets of a pernicious disease will not be found in a pink bottle of nail polish — or even, very likely, in radical defensive surgery.
That point is well-illustrated in author Peggy Orenstein’s blisteringly sensible cover story for the New York Times Magazine on “Our Feel-Good War on Breast Cancer.” (It will appear in print this weekend, but is on the Times’ site now.) Orenstein knows well the nightmare of breast cancer. She was diagnosed in 1996, at age 35. A decade and a half later, she was diagnosed again. And that span of time represents a massive shift in our cultural relationship with breast cancer – and a surprising new concern: what she calls “the dangers of overtreatment.”
As Orenstein writes, a mammogram like the one that first detected her cancer does “reduce, by a small percentage, the number of women who are told they have late-stage cancer, but it is far more likely to result in overdiagnosis and unnecessary treatment, including surgery, weeks of radiation and potentially toxic drugs.” Of particular interest to Orenstein are the 60,000 new diagnoses annually – roughly a quarter of them — of ductal carcinoma in situ (DCIS). Also known as “Stage Zero,” DCIS is not cancer, just the presence of abnormal cells that could become cancer. Complicating matters is the fact that, as Orenstein notes, “There are at least four genetically distinct breast cancers,” and that “Mammograms, it turns out, are not so great at detecting the most lethal forms of disease.”
The presence of any unusual cells, of course, remains a big, scary red flag. And action has a more can-do appeal than wait-and-see. That’s likely why the same tremendous progress we’ve made in detection has led — and not necessarily helpfully — to “a 188 percent jump between 1998 and 2005 among women given new diagnoses of DCIS in one breast … who opted to have both breasts removed just in case” and a stunning 150 percent rise among women with early-stage invasive disease. There’s a whole population of women who’ve gone under the knife for something that may well never have blossomed into a life-threatening condition.
Continue reading at: http://www.salon.com/2013/04/25/is_there_too_much_breast_cancer_awareness/
