The Truth About Breast Cancer is Not Pretty and it’s not Pink

“Incidence rates of distant-stage disease have remained stable.”

- From the latest report on breast cancer from the American Cancer Society, discussing breast cancer incidence over the last several decades.

After 25 years of marking National Breast Cancer Awareness Month and promotion of mammography and early detection as the cure, the reality for 40,000 women who die from breast cancer each year remains unchanged.  Despite the increase in catching early, smaller tumors with the increased mammography, the incidence of women diagnosed with a later stage breast cancer, one that has spread beyond the breast, HAS NOT CHANGED.  Of the close to 180,000 women diagnosed each year with breast cancer, approximately 37% are diagnosed with later stage cancer every year, and still others have a breast cancer recurrence.  Why?  If mammography was going to be our cure why hasn’t breast cancer mortality declined dramatically after all these years?

The truth is that mammography and early detection are not the cures for breast cancer that everybody thought they would be, but we can’t seem to get off this train.  Pink marketing and promotion of early detection have taken on a life of their own, way out of proportion to the actual benefit.  What’s the harm?  The harm is that we’ve lost our focus for finding the real answers.  We continue to fail those 40,000 women every year.  We need less focus on “early detection” and more focus on understanding the reality of breast cancer -  how to stop the aggressive cancers that aren’t detected with mammography, how to stop breast cancer from recurring, and how to prevent it from metastasizing to other parts of the body and becoming lethal.

National Breast Cancer Awareness Month was established 25 years ago by AstraZeneca, a pharmaceutical company that has produced breast cancer drugs including Tamoxifen and Arimidex.  The goal was to promote mammography as the “most effective weapon in the fight against breast cancer.”  But back then, everybody thought breast cancers were all the same.  We now know breast cancer is not one disease, and that different breast cancers take different paths, grow at different rates, and spread differently.  Mammography is probably most helpful in finding the slowest growing and least harmful kind of breast cancer.  Many women who are diagnosed with an advanced breast cancer have “interval” cancers, or cancers that were discovered in between regular mammography screenings, or are younger women who don’t yet get regular mammograms.

If success was measured in awareness and pinkness, I’d say AstraZeneca’s campaign has far surpassed their wildest expectations.  But if we ask has mammography turned out to be the most effective weapon?  Are significantly less young women and mothers dying of breast cancer?  Then sadly the answer would be NO.

Let’s  move beyond the hype for our next National Breast Cancer Awareness Month and demand a focus on what we really need to cure this disease.