A decision by the nation’s leading breast cancer advocacy group, Susan G. Komen for the Cure, to largely cut off financing for breast cancer screenings at Planned Parenthood set off howls of outrage last week. Once again, it seemed, political gamesmanship was jeopardizing women’s health.
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Cancer Group Backs Down on Cutting Off Planned Parenthood (February 4, 2012)
Outcry Is Fierce to Cut in Funds by Cancer Group (February 3, 2012)
Uproar as Breast Cancer Group Ends Partnership With Planned Parenthood (February 2, 2012)
Health Guide: Breast Cancer
The widespread anger forced Komen to reverse its decision, and it has certainly reinvigorated the women’s health movement. But the furor misses an important fact: Women have been led to believe that screening is the best prevention.
In reality, we still do not know what causes breast cancer, which means we really do not know how to prevent it, either. That has pushed us to focus on looking for cancers that are already there, a practice long based on the assumption that all cancers were the same, grew at a similar rate and were visible in the breast for a period of time before spreading. It made sense: If you could find cancers earlier, you could save lives.
Indeed, the original screening study done in the 1950s on postmenopausal women in New York demonstrated a 30-percent decrease in deaths from breast cancer. It also led to the conjecture that if we just carried out more screening at a younger age, and more often, we could improve these statistics and “win the war” on breast cancer.
But decades later, the success rate of screening remains nearly the same, even with much better imaging: routine mammography screening results in a 15- to 20-percent decrease in mortality in women over age 50.
Why hasn’t the situation improved? It turns out that there are at least five, and probably more, different types of breast tumors,...