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.

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Comments

  • marie  On October 2, 2009 at 11:57 am

    I wonder where your statistics come from, I’m not questioning them at all, just would like to cite a source before passing this on.
    I’m a stage iv patient… bracing myself for the onslaught of pink this month.

    • breastcanceradvocate  On October 2, 2009 at 12:57 pm

      I’m sorry I did not put a link to the statistics. I got the information from the American Cancer Society’s Report “Breast Cancer Facts & Figures 2009-2010.” You can download the report at http://www.cancer.org/docroot/stt/stt_0.asp. They use data from the National Cancer Institute’s Surveillance, Epidemiology & End Results (SEER) program. Page 7 of the ACS report shows the striking graph – flat lines showing incidence of large tumors and later stages over time. No changes over all these decades.

  • kittykitty7555  On October 21, 2009 at 8:05 pm

    You are right and the American Cancer Society is close to admitting it! Maybe you saw this in the New York Times:

    http://www.nytimes.com/2009/10/21/health/21cancer.html?scp=2&sq=gina%20kolata&st=cse

    You have done a wonderful public service by educating people about this issue when the powers that be were giving people advice that could subject them to unnecessary cancer treatment. And what could be worse than that? It must be horrific even if you need it.

    At any rate, many thanks for an intelligent alternative point of view.

  • breastcanceradvocate  On October 21, 2009 at 9:19 pm

    I did see the NYTimes article – it’s causing quite a stir! Here is an article and video from ABC News on the controversy.

    http://abcnews.go.com/WN/CancerPreventionAndTreatment/breast-prostate-cancer-screening-criticism-stirs-debate/Story?id=8881664&page=1

  • Tami Boehmer  On November 23, 2009 at 3:43 pm

    Amen to that. We need to find out why the disease spreads and find a cure. I was first diagnosed with Stage II, no lymph node involvement and a slow-growing cancer. My prognosis was excellent. Now I’m looking at Stage IV cancer. Early is better than later, but it still can happen. So enough patting themselves on the back and put money into finding a cure.

    BTW: I still think women should do self breast exams and mammography. It’s all we have for now.

  • Ryan  On April 8, 2010 at 8:30 pm

    AWESOME post; this stuff is in the news all over the place in the news now, here’s one from February this year

    http://doctorcrafts.blogspot.com/2010/02/httpwww.html

    Me talking about this science news article http://www.sciencenews.org/view/generic/id/55755/title/Making_informed__decisions_about_mammograms

    Women need to be clear about their chance of developing breast cancer, how much mammography reduces that chance and what are its associated harms. Imagine 10,000 women age 40. Over the next 10 years, without mammogram screening, about 35 will die of breast cancer. With screening, 30 will die — five fewer. But of 10,000 getting screened, 600 to 2,000 will have at least one false positive leading to a biopsy, and 10 to 50 will be overdiagnosed. They will be told they have cancer, and they will undergo surgery, chemotherapy or radiation, which can only hurt them since their cancer was never destined to cause symptoms or death.

    Overdiagnosis is the most important harm of screening. People sometimes find it hard to believe that overdiagnosis is possible. These cancers look the same under the microscope but don’t behave like cancer. Because we can’t tell which cancers constitute an overdiagnosis, everybody who has cancer is treated.

  • Elayne  On August 5, 2010 at 1:51 pm

    Does anyone have any idea on how many of the Breast Cancer patients worked in the medical field?

  • Vicky  On February 17, 2011 at 5:47 pm

    Thank you so much for telling the real truth about breast cancer – we have a false sense of hope, since we see so much fundraising, etc. I have read just about every book on breast cancer (since I was diagnosed 2 years ago), and a light bulb went off for me – we don’t know anymore about breast cancer than we did 30 years ago. We don’t have the tools to diagnosis it – just found out I have extremely dense breast, and they continue to perform mammograms on the remaining breast, even though we know for a fact that mammogram may not pick up cancers on dense breasts (I have one left, since they took my other one, even though no cancer cells were found in the biopsied breast after the removal! – oh yes, I was told it “isn’t a perfect science” after my breast was removed-I had never been so angry, but realize now, that statement was the most honest statement I got from the medical professionals. Of course, too bad it was after they removed my breast for no reason. One thing I discovered, is that DCIS is NOT defined as cancer; however, they are removing breasts for DCIS diagnosis. Of course, women agree to it, since the think it is full blown cancer, and FEAR is a powerful too!

  • vicky clancy  On March 25, 2011 at 10:53 am

    50% 0f woman with early stage breast cancer will eventually die regardless of treatment.The 5 year cure is not true as it can come back at any time. the predicated suvival rates at 20 years is 62% but they are not all cured but are included in the figures. also younger woman are more at risk for recurrence because the longer you live the chances of it coming back are higher. older woman doe of bc too but are more likely to die of heart disease.

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