As National Breast Cancer Awareness Month draws near, you can feel the soft rumble of approaching awareness efforts, now unavoidably clothed in pink. For the past several years, the voices of those who question these efforts have become nearly as loud as those who support it. The rising din can make it a real challenge for consumers to know what to believe. It’s vitally important that all of us putting out messages about breast cancer be truthful about what we know, and just as important, what we do not.
One of the most visible debates not only in October but in breast cancer science is whether mammography’s potential to save lives has been exaggerated in an attempt to encourage women to get screened. One thing supporters and critics have to agree on is that the public should be told the truth not only about mammography’s potential, but also its limitations. By the same token, we must be honest about other potential risk factors for the disease.
So what to make of a blog post from Breast Cancer Action, a group focusing on environmental risks that is perhaps the most prominent critic of breast cancer awareness efforts? The post questions Susan G. Komen For the Cure’s focus on mammography.
At Breast Cancer Action, we bring a markedly different understanding of what action we all need to take—for ourselves, each other, our mothers, daughters, and granddaughters—to truly end the breast cancer epidemic. Komen’s faith in mammograms to bring the “end to breast cancer” is misplaced.
And later adds….
More women getting more mammograms is not going to end the breast cancer epidemic.
I think it is quite reasonable to question the heavy focus by groups like Komen, and by extension our own organization, on mammography. They are correct to point out that getting a mammogram cannot prevent a woman from getting breast cancer (not that anyone claimed it could) and that many women die from breast cancer even if it is diagnosed early. But then BCA does something that should give pause to those with a bit of knowledge about breast cancer risk.
Neither, of course, are healthy diets and good exercise regimes.
One of the ugly truths of breast cancer is that more than half of all breast cancers have no known cause and scientific evidence suggests that many cases are linked to exposure to environmental toxins.
While it is true that most cases of breast cancer have no known cause, the implication that exposure to environmental toxins is more important than diet and exercise would be –at the very least–an exaggeration. It minimizes the strong role diet and exercise play, and sends the message that environmental toxins are a proven risk. By doing that, BCA has taken part in the same practice they so vocally call out in other groups: using strong language to overstate the evidence to suit their own agenda.
By the same token, we should question the use of the term “breast cancer epidemic.” An epidemic is described as an unexpected rise in the number of events in a certain population. There is no breast cancer epidemic. The fact is, after increasing for more than two decades, female breast cancer incidence rates decreased by about 2% per year from 1998 to 2007, likely due at least in part to a decrease in the use of hormone therapy after the results of the Women’s Health Initiative were published in 2002.
Groups like Breast Cancer Action play a vital role in keeping all of us focused in our efforts in breast cancer. They keep us honest, ask challenging questions, and force all of us to look closely at what we say and what we do. But all too often, journalists and the public –often the same folks who question groups like Komen and the American Cancer Society– give activists a pass when they make questionable claims to pursue their own agenda.
It’s time to stop the hype, and give women information and advice we can all agree can lower their risk of breast cancer. That means paying attention to those risk factors most likely to get results; getting exercise, staying at a healthy weight, and eating a healthy diet. It also means getting answers to other potential environmental risks, like the thousands of chemicals we’re exposed to at home and at work. And finally, it means encouraging the appropriate use of screening tests that can detect cancer when it’s most treatable. Let’s agree that mammography has played a role in recent and gratifying drops in breast cancer deaths. The best estimates are it’s responsible for about a third of the drop in mortality. And while mammography is not the magic bullet that will end breast cancer forever, it’s an important part of the progress that’s been made. Mammography is a good test. We need a great test.