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==Overview== | ==Overview== | ||
==Historical Perspective== | ==Historical Perspective== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Jack Khouri, Mirdula Sharma, MBBS [2]
Overview
Historical Perspective
Discovery
- The oldest evidence of breast cancer was discovered in Egypt and dates back to approximately 1600 BC.[1]
- The Edwin Smith Papyrus describes 8 cases of tumors or ulcers of the breast that were treated by cauterization. The writing says about the disease, "There is no treatment."[2]
- The ancient medicine, from the times of the Greeks through the 17th century, was based on humoralism, and thus believed that breast cancer was generally caused by imbalances in the fundamental fluids that controlled the body, especially an excess of black bile.[3] Alternatively, patients often saw it as divine punishment.[4]
- In the 18th century, a wide variety of medical explanations were proposed, including a lack of sexual activity, too much sexual activity, physical injuries to the breast, curdled breast milk, and various forms of lymphatic blockages, either internal or due to restrictive clothing.[3][5]
- In the 19th century, the Scottish surgeon John Rodman said that fear of cancer caused cancer, and that this anxiety, learned by example from the mother, accounted for breast cancer's tendency to run in families.[5]
- Although breast cancer was known in ancient times, it was uncommon until the 19th century, when improvements in sanitation and control of deadly infectious diseases resulted in dramatic increases in lifespan. Previously, most women had died too young to have developed breast cancer.[5]
Landmark Events in the Development of Treatment Strategies
- Mastectomy for breast cancer was performed at least as early as AD 548, when it was proposed by the court physician Aetios of Amida to Theodora.[3]
- It was not until doctors achieved greater understanding of the circulatory system in the 17th century that they could link breast cancer's spread to the lymph nodes in the armpit.
- The French surgeon Jean Louis Petit (1674–1750) and later the Scottish surgeon Benjamin Bell (1749–1806) were the first to remove the lymph nodes, breast tissue, and underlying chest muscle.[6]
- Their successful work was carried on by William Stewart Halsted who started performing radical mastectomies in 1882. William Stewart Halsted was helped greatly by advances in general surgical technology, such as aseptic technique and anesthesia. The Halsted radical mastectomy often involved removing both breasts, associated lymph nodes, and the underlying chest muscles. This often led to long-term pain and disability, but was seen as necessary in order to prevent the cancer from recurring.[7] Before the advent of the Halsted radical mastectomy, 20-year survival rates were only 10%; Halsted's surgery raised that rate to 50%.[8] Extending Halsted's work, Jerome Urban promoted superradical mastectomies, taking even more tissue, until 1963, when the ten-year survival rates proved equal to the less-damaging radical mastectomy.[7]
- Breast cancer staging systems were developed in the 1920s and 1930s.[7]
- The first case-controlled study on breast cancer epidemiology was done by Janet Lane-Claypon, who published a comparative study in 1926 of 500 breast cancer cases and 500 control patients of the same background and lifestyle for the British Ministry of Health.[9]
- Radical mastectomies remained the standard of care in America until the 1970s, but in Europe, however, breast-sparing procedures, often following radiation therapy, were generally adopted in the 1950s.[7]
- Radical mastectomies remained the standard of care in America until the 1970s.
- During the 1970s, a new understanding of metastasis led many to perceive cancer as a systemic illness, as well as a localized one; more sparing procedures were developed that proved equally effective. Modern chemotherapy developed after World War II.[10]
- In the 1980s and 1990s, thousands of women who had successfully completed standard treatment demanded and received high-dose bone marrow transplants, thinking this would lead to better long-term survival. However, it proved completely ineffective; 15–20% of women died because of the brutal treatment.[11]
- The 1995 reports from the Nurses' Health Study and the 2002 conclusions of the Women's Health Initiative trial conclusively proved that hormone replacement therapy significantly increased the incidence of breast cancer.[11]
Cultural References
Before the 20th century, breast cancer was feared and discussed in hushed tones, as if it were shameful. As little could be safely done with primitive surgical techniques, women tended to suffer silently rather than seeking care. When surgery advanced, and long-term survival rates improved, women began raising awareness of the disease and the possibility of successful treatment. The "Women's Field Army", run by the American Society for the Control of Cancer (later the American Cancer Society) during the 1930s and 1940s was one of the first organized campaigns. In 1952, the first peer-to-peer support group, called "Reach to Recovery", began providing post-mastectomy, in-hospital visits from women who had survived breast cancer.[12]
The breast cancer movement of the 1980s and 1990s developed out of the larger feminist movements and women's health movement of the 20th century.[13] This series of political and educational campaigns, partly inspired by the politically and socially effective AIDS awareness campaigns, resulted in the widespread acceptance of second opinions before surgery, less invasive surgical procedures, support groups, and other advances in patient care.[14]
Pink ribbon
A pink ribbon is the most prominent symbol of breast cancer awareness. Pink ribbons, which can be made inexpensively, are sometimes sold as fundraisers, much like poppies on Remembrance Day. They may be worn to honor those who have been diagnosed with breast cancer, or to identify products that the manufacturer would like to sell to consumers that are interested in breast cancer—usually white, middle-aged, middle-class and upper-class, educated women.[15]
The pink ribbon is associated with individual generosity, faith in scientific progress, and a "can-do" attitude. It encourages consumers to focus on the emotionally appealing ultimate vision of a cure for breast cancer, rather than on the fraught path between current knowledge and any future cures.[16]
Wearing or displaying a pink ribbon has been criticized by the opponents of this practice as a kind of slacktivism, because it has no practical positive effect. It has also been criticized as hypocrisy, because some people wear the pink ribbon to show good will towards women with breast cancer, but then oppose these women's practical goals, like patient rights and anti-pollution legislation.[17][18] Critics say that the feel-good nature of pink ribbons and pink consumption distracts society from the lack of progress on preventing and curing breast cancer.[19] It is also criticized for reinforcing gender stereotypes and objectifying women and their breasts.[20] Breast Cancer Action launched the "Think Before You Pink" campaign, and said that businesses have co-opted the pink campaign to promote products that cause breast cancer, such as alcoholic beverages.[21]
Breast cancer culture
Breast cancer culture, or pink ribbon culture, is the set of activities, attitudes, and values that surround and shape breast cancer in public. The dominant values are selflessness, cheerfulness, unity, and optimism. Appearing to have suffered bravely is the passport into the culture.
The woman with breast cancer is given a cultural template that constrains her emotional and social responses into a socially acceptable discourse: She is to use the emotional trauma of being diagnosed with breast cancer and the suffering of extended treatment to transform herself into a stronger, happier and more sensitive person who is grateful for the opportunity to become a better person. Breast cancer therapy becomes a rite of passage rather than a disease.[22] To fit into this mold, the woman with breast cancer needs to normalize and feminize her appearance, and minimize the disruption that her health issues cause anyone else. Anger, sadness and negativity must be silenced.[22]
As with most cultural models, people who conform to the model are given social status, in this case as cancer survivors. Women who reject the model are shunned, punished and shamed.[22]
The culture is criticized for treating adult women like little girls, as evidenced by "baby" toys such as pink teddy bears given to adult women.[22]
The primary purposes or goals of breast cancer culture are to maintain breast cancer's dominance as the preëminent women's health issue, to promote the appearance that society is "doing something" effective about breast cancer, and to sustain and expand the social, political, and financial power of breast cancer activists.[23]
Emphasis
Compared to other diseases or other cancers, breast cancer receives a proportionately greater share of resources and attention. In 2001 MP Ian Gibson, chairman of the House of Commons of the United Kingdom all party group on cancer stated "The treatment has been skewed by the lobbying, there is no doubt about that. Breast cancer sufferers get better treatment in terms of bed spaces, facilities and doctors and nurses."[24] Breast cancer also receives significantly more media coverage than other, equally prevalent cancers, with a study by Prostate Coalition showing 2.6 breast cancer stories for each one covering cancer of the prostate.[25] Ultimately there is a concern that favouring sufferers of breast cancer with disproportionate funding and research on their behalf may well be costing lives elsewhere.[24] Partly because of its relatively high prevalence and long-term survival rates, research is biased towards breast cancer. Some subjects, such as cancer-related fatigue, have been studied little except in women with breast cancer.
One result of breast cancer's high visibility is that statistical results can sometimes be misinterpreted, such as the claim that one in eight women will be diagnosed with breast cancer during their lives—a claim that depends on the unrealistic assumption that no woman will die of any other disease before the age of 95.[26] This obscures the reality, which is that about ten times as many women will die from heart disease or stroke than from breast cancer.[27]
The emphasis on breast cancer screening may be harming women by subjecting them to unnecessary radiation, biopsies, and surgery. One-third of diagnosed breast cancers might recede on their own.[28] Screening mammography efficiently finds non-life-threatening, asymptomatic breast cancers and pre-cancers, even while overlooking serious cancers. According to H. Gilbert Welch of the Dartmouth Institute for Health Policy and Clinical Practice, research on screening mammography has taken the "brain-dead approach that says the best test is the one that finds the most cancers" rather than the one that finds dangerous cancers.[28]
References
- ↑ "Oldest evidence of breast cancer found in Egyptian skeleton". Reuters. 24 March 2015. Retrieved 25 March 2015.
- ↑ "The History of Cancer". American Cancer Society. 2002-03-25. Retrieved 2006-10-09.
- ↑ 3.0 3.1 3.2 Olson 2002, pp. 32–33
- ↑ Yalom, Marilyn (1997). A history of the breast. New York: Alfred A. Knopf. p. 234. ISBN 0-679-43459-3.
- ↑ 5.0 5.1 5.2 Aronowitz, Robert A. (2007). Unnatural history: breast cancer and American society. Cambridge, UK: Cambridge University Press. pp. 22–24. ISBN 0-521-82249-1.
- ↑ "History of Breast Cancer". Random History. 27 February 2008. Retrieved 8 May 2010.
- ↑ 7.0 7.1 7.2 7.3 Olson 2002, pp. 102–6
- ↑ Olson 2002, p. 1
- ↑ Alfredo Morabia (2004). A History of Epidemiologic Methods and Concepts. Boston: Birkhauser. pp. 301–302. ISBN 3-7643-6818-7. Retrieved 2007-12-31.
- ↑ Marc Lacroix (2011). A Concise History of Breast Cancer. USA: Nova Science Publishers. pp. 59–68. ISBN 978-1-61122-305-7.
- ↑ 11.0 11.1 Sulik, Gayle A. (2010). Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health. USA: Oxford University Press. pp. 200–3. ISBN 0-19-974045-3. OCLC 535493589.
- ↑ Sulik 2010, pp. 37–38
- ↑ Sulik 2010, p. 4
- ↑ Bob Riter. "History of Breast Cancer Advocacy". Cancer Resource Center of the Finger Lakes. Retrieved 29 June 2013.
- ↑ Sulik 2010, pp. 27–72
- ↑ Sulik 2010, pp. 359–361
- ↑ Sulik 2010, pp. 366–8
- ↑ Landeman, Anne (11 June 2008). "Pinkwashing: Can Shopping Cure Breast Cancer?". Center for Media and Democracy.
- ↑ Sulik 2010, pp. 365–6
- ↑ Sulik 2010, pp. 372–4
- ↑ Breast cancer month overshadowed by 'pinkwashing' 9 October 2010, Angela Mulholland, CTV.ca News
- ↑ 22.0 22.1 22.2 22.3 Ehrenreich, Barbara (November 2001). "Welcome to Cancerland". Harper's Magazine.[dead link]
- ↑ Sulik 2010, p. 57
- ↑ 24.0 24.1 Browne, Anthony (7 October 2001). "Cancer bias puts breasts first". The Guardian. London.
- ↑ Arnst, Catherine (13 June 2007). "A Gender Gap in Cancer". Bloomberg Businessweek. ISSN 0007-7135.
- ↑ Olson 2002, pp. 199–200
- ↑ Ave, Melanie (10 October 2006). "Tampabay: All May Not Be in the Pink". St. Petersburg Times.
- ↑ 28.0 28.1 Aschwanden, Christie (17 August 2009). "The Trouble with Mammograms". The Los Angeles Times.