The Pitfalls of the War on Breast Cancer [Does traditional screening more harm than good? And what does “awareness” even mean??]

Sitting alone on the exam table, in a paper gown and feeling naked in more ways than one, I stared down at the number on the card in my hand. It was for a geneticist so I could be tested for the BRCA gene, a known marker for breast cancer. “It’s time, Charlotte,” my doctor had said to me just moments earlier as she left the room. It was a scene I’ve repeated every year since, oh, hitting puberty but this time something was different. I’m still not sure what it was but instead of blowing off the doctor and dropping the number in the trash on my way out like I do every year, this time I did it. I took the test. But because it takes 6-8 weeks to get the results back, I still don’t have any answers. And I probably need them. But do I want them?

I have, as they say, a risky family history. This sterile transaction in an exam room – it was a very personal moment. But then, that’s the thing about breast cancer: you can’t talk about it without it being personal. If it isn’t you, then you have a mother, sister, friend or daughter in the crosshairs. And no one knows that better than Peggy Orenstein, the best-selling author of Cinderella Ate My Daughter, who penned the recent New York Times spread, “Our Feel-Good War on Breast Cancer.” [It’s long but it’s a must read. Seriously.]

Orenstein, as it turns out, is a breast cancer survivor herself. Twice. Yet she doesn’t like calling herself one, something she let me know mere seconds into our conversation when I interviewed her for Shape about her article. “Who am I? I know that ‘survivor’ is meant to replace ‘victim’ but that leads to the problem of making people with cancers into winners (‘survivors’) or losers (which are…‘die-ers’?). So I’ve grown uncomfortable with that term.” She paused and then added, “‘Veteran’? Maybe. I don’t know what to call myself anymore.”

The terminology isn’t the only thing making Orenstein uncomfortable these days. Her article, which reads part exposé and part personal essay, takes on the Pink Ribbon machine as we’ve all come to know it. “Every year I get this mass of mostly useless press releases [about breast cancer awareness campaigns] and it makes me angry. I can’t stand by and watch this anymore. I have literal skin in the game! This is my life!” She points out that breast cancer awareness has almost become a parody of itself with everything from t-shirts to yogurt lids to garbage cans painted in that singular shade of petal pink. It’s become cool. It’s become sexy. It’s even become the most annoying Facebook meme ever! (Post your bra color as your status! It’ll confuse all the guys! You have to do it, it’s for breast cancer awareness!!1!!) But the one thing it hasn’t become is cured.

While the technology for treating cancer is advancing – and saving lives – the technology for screening for it may be overrated. Especially when it comes to the much-touted mammograms. Orenstein writes, “If screening’s benefits have been overstated, its potential harms are little discussed. According to a survey of randomized clinical trials involving 600,000 women around the world, for every 2,000 women screened annually over 10 years, one life is prolonged but 10 healthy women are given diagnoses of breast cancer and unnecessarily treated, often with therapies that themselves have life-threatening side effects.”

But even if mammography and self-exams aren’t the panaceas we’ve been taught, so what? “If we were making progress I wouldn’t care if people were dancing topless on tables or whatever [for breast cancer], but we’re not. Not enough, anyways, and not because of those campaigns,” Orenstein says. “If ‘care’ isn’t translating into something that is effective, what’s the point? It’s not enough to care.”

Part of Orenstein’s worries stem from the fact that breast cancer treatment does not come without consequences, both physically and mentally. “Our culture of fear leads to over-treatment.” And, she explains, pushing women into treatments they may not want or even need is not only harmful but manipulative. “There are many good breast cancer advocacy groups, ones that I support, but I’m concerned that there is a part of it that is going off the rails and harming women by overselling mammography, pushing self-exams on little girls.” Referencing the younger sisters among us, she cites a recent survey of 2500 girls ages 8-18, done by breastcancer.org, that found 30% believe they might currently have breast cancer despite the fact that breast cancer at that age is extremely rare.

It’s this type of fear-based thinking that drove her to spend months researching and writing the article in spite of the personal toll it took on her. “It was very hard and emotional for me,” she explains. “But I also feel a sense of responsibility and some anxiety. A front-page spread in the New York Times is a huge platform. It can change the national conversation.” And according to Ornestein, it needs to. She recalls a conversation with Robert Aronowitz, a medical historian, who told her, “When you’ve oversold both the fear of cancer and the effectiveness of our prevention and treatment, even people harmed by the system will uphold it, saying, ‘It’s the only ritual we have, the only thing we can do to prevent ourselves from getting cancer.’ ”

So what do we do, then? My question to her was, of course, as much personal as professional. “I didn’t do testing until I knew for sure what I was going to do if it came back positive,” she told me of her own BRCA test. But hers came back negative and demonstrating again the fickle nature of screening procedures, she got breast cancer anyhow. “Look,” she said matter-of-factly, “Even if you remove your breasts, the risk is not zero. In life your risk is not zero. I’m driving over the fault line right now. And talking on my phone, by the way, which is also a risky maneuver! We need to understand reality and not react out of fear.”

But what about when reality and fear collide? She listened as I blurted out the story of my own spotted genetic history, my impulsive choice get the BRCA test done and my anxious waiting, then she answered kindly, “There is no good choice. All you can do is make the best decision you can with the information you have. And then don’t look back.”

After I finished (mentally) shrieking AHHH PEGGY ORENSTEIN CARES ABOUT MY BOOBS!!, I realized how very right she was. To test or not to test? To pancake your boobs in a mammogram machine or not to pancake? To self-examine in the physical as well as metaphorical sense? Her advice quelled the butterflies in my stomach because in the end it’s all about giving women back the control over their own health, removing the onus of guilt and fear, and giving them choices. I chose to take the test because I’m a girl who needs to know things. My sister, who shares my same genetic history, chose not to. It’s personal.

Do you do self exams? Mammograms? Would you/have you taken the BRCA test too? How crazy is it that 30% of young girls think they already have breast cancer?!

38 Comments

  1. I agree with you so hard. Awareness campaigns are important when lack of awareness is the problem you’re trying to solve. If something as cryptic as “Yellow with blue trim” or as mundane as a pink umbrella handle is enough to communicate “Hey, I haven’t forgotten that breast cancer exists!” then probably, awareness is already high enough. And if someone doesn’t get the reference then you aren’t increasing their awareness anyway.

    I’m not crazy about the breast cancer campaign for another reason too. It has a strong tendency to involve traditionally feminine things marketed in a traditionally “girly” way. That’s bothersome because it reinforces unhelpful ideas about what women like, and more bothersome because it implies that men get a free pass from breast cancer and… they don’t. It’s less common, but it happens.

    • This: ” It has a strong tendency to involve traditionally feminine things marketed in a traditionally “girly” way. That’s bothersome because it reinforces unhelpful ideas about what women like, and more bothersome because it implies that men get a free pass from breast cancer and… they don’t. ” I second everything you just said!

  2. The best material I’ve read and seen about this was Barbara Ehrenreich’s speech http://www.youtube.com/watch?v=XAGfsLUvYyI and book extract http://www.barbaraehrenreich.com/brightsidedexcerpt.htm (I’m sure you’re very aware of this, it’s just that I lack the culture background and have no idea what is self-evident and obvious in America and what is not.)
    I’m from Europe, and honestly, I swear to God, I have NEVER encountered such sickly sweet attitude towards any kind of cancer. No pink ribbons and teddies here, thank God. But the poison of positive thinking is seeping in here as well. and being a scientist myself I have to say, I get the feeling that the more ignorant and less educated a person is the more likely they are to fall for the positive thinking crap which in itself is oppressing real emotions and limiting “the human experience”. And that’s why I absolutely LOVE your blog – you are a scholar and you see and advocate the difference between proof and wishful thinking.

  3. I support breast cancer research, of course, but the pink ribbon campaign has become a parody of itself. Companies pay to use the logo and the pink stuff and it’s largely a brand now, not so much the cause anymore. And let’s not talk about the fraction of every penny that actually goes to research itself. Good grief…it’s a business now.

    I don’t get the comic. What am I missing?

  4. A couple thoughts. If I’m remembering correctly, there are two types of breast cancer, and the genetic marker only really predicts your likelihood of one. If that’s the kind that runs in your family, then the test can be useful. (The other type runs in my family, of course.) as far as the pink ribbon campaigns… Well, in the middle of the kerfluffle when Komen stopped providing mammograms through planned parenthood, it came out how much the CEO of Komen was making. That ended that campaign for me right then.
    A little off topic, but a relative of mine was diagnosed with prostate cancer awhile back. Leaving out some of the more personal details, there are basically two kinds of treatment. One has fewer lasting side effects, but if the cancer comes back down the road, you’re basically SOL. but the doctor told my relative that while cancer is a scary word and most people’s first unstinct is “get it out now!” For the VAST majority of men, she. It did come back, it was so slow growing that they frankly died of something else before they even had noticeable symptoms from it coming back, without treatment. That’s a different type than breast cancer of course, but it did make me pause, since my reaction was “get it out this minute!” I think people do live in fear of cancer, when there’s so little we can really do for the most part.

    • I believe there are 4 types of breast cancer… And yeah the gene test isn’t a guaranteed answer in any way. It’s just another piece of information. That’s a super interesting story about your relative – I’m glad they’re okay now!

  5. My father-in-law died of breast cancer. They usually don’t catch it in time in men because people think of it as a disease that only affects women. All the pink ribbons reinforce that stereotype and cost people their lives.

  6. I got into quite an argument with my (female) doctor a few years ago when I stood my ground and refused to sign up for a mammography. No breast cancer in my family, no risk factors, nothin’. But she still wanted it done because YOU NEVER KNOW, and the earlier you catch it the better.
    Still haven’t done it. Not planning to. The Pink Ribbon campaign is right up there in my mind with selling sweetened breakfast cereal to children, except the dollars are even bigger.

    • Sadly, 75% of women with breast cancer had ‘no family history’, no risk factors….The breast cancer story is so much more complicated than the reductionist view perpetuated by the medical profession and media.

      I know women with ‘good prognosis’ breast cancer who died soon and early; women with the BRCA1 mutation who are alive & well many years later. Etc…

      • I stand by my decision. Did you read the article Charlotte was talking about?

        • I read the article and I do not disagree with it.

          You are entitled to your decision not to take up mammography – my comments did not refute that.

          I merely wished to insert the less-reported fact that c. 75% women with breast cancer had no known family history, etc. I loathe the whole pink ribbon campaign, the fraud involved in raising funds for breast cancer research when only a tiny percentage ever goes to research, etc. I loathe the ‘breast cancer journey’ infantilising claptrap spouted by too many in the cancer industry. I also loathe the big pharma promotion of the well-known carcinogen Tamoxifen and that fact that a few of the major, heavily promoted adjuvant therapies do not reduce breast cancer mortality! Strange but true….

          Mammography has lots of pitfalls: it does not detect all breast cancers anyway. Invasive lobular breast cancer is especially likely to be missed and can metastasise long before it is diagnosed; Mammography is not good at detecting breast cancer in younger women (high breast density can obscure cancer); and when it is all said & done, at best, mammography is only as good as the reporting radiologist’s skills.

          My invasive breast cancer was ignored by the ‘underskilled’ radiologist and progressed…

  7. I definitely learned how hyped the pink ribbon campaign was during the koman/planned parenthood situation. It is disgusting to me how hyped it is because it does seem like while there is awareness…I’m not sure there is knowledge/action/information to go along with it. I don’t have a family history so I’m way less knowledgeable about this than you are, so I would not take the genetics test right now. I do attempt to do self exams, but I’m not regular with them like I probably should be. Something to work on I suppose.

  8. Wow, thanks for sharing this Charlotte. Super interesting. I hadn’t known any of this. But I’ve watched my mom go through tons of biopsies (all of which have thankfully been negative) for breast lumps found by mammograms. The article made me wonder if for her the mammograms were more harmful than good. I don’t know.

    What I do know is that I feel the same way as I do about campaigns to raise awareness of eating disorders. I feel like everyone knows these things exist. We don’t live under rocks. We need treatments that work and that means research. And research equals money, a lot of money. I work in HIV research and I spend hundreds of dollars a day just on basic lab supplies to keep my experiments running. And when you have to buy equipment? It’s crazy. I think awareness money would be so much better spent on research.

  9. I am 23 and not going to do any testing screening etc until I am at least 40. But my aunt (married to my dads brother, so not genetically related) has the gene. Her mom died of breast cancer. Both her sisters got it and so did she. By the time she got it she opted for a full mastectomy because so many people in her family were already dead. She made a full recovery and had been cancer free free for almost a decade. My cousin-22 now- waited 4 years to get the test done. She just had it done recently and has the gene. For now, she isn’t doing anything. With her family history she must be terrified…if the test had come back negative maybe she could worry less but now she has
    This hanging over her head with nothing she can do about it. She’s not going to get a mastectomy at age 23 withou cancer. So all she can do is sit and wait.
    I think testing for the gene is a completely different conversation than other things. Mammograms and self exams can find problems where there aren’t any. But if I wonder how the prevalence of fall-positives change for people who have the gene. Without the gene, I’m stayin far away from testing. But for my aunt, it saved her life. And for my cousin it could save her life.

  10. Having worked in a pathology research, doing grad work on breast cancer marker studies I have gotten a bit of a thick skin for this sort of thing. I am annoyed too at all the pink every year…but I still am a huge advocate for self breast exams. I haev friends who caught lumps early and are still here because of it, and I have friends who have passed on from breast cancer, because they didn’t catch it early enough and it went to their lymphatic system and metasticized.
    I get angry, but I also work to raise money and fund friends who do breast cancer research. I think if I knew of a risk of breast cancer I would do the BRCA test and use it as a guide to be more careful…the thing is you just don’t know what life will bring. My dad lost his dad and 2 brothers to prostate cancer and he and his remaining brother retired early and get regular testing and are ( 🙂 ) still healthy all these years later. He decided to not let it loom over him and live his life and I think I would take the same approach in his place if I tested positive.
    The key is to be aware of your body, treat it right and get checked when something doesn’t feel right…catching this early is the key to living past it. Until my buddies doing research and treatment find a cure it’s the best thing you can do.

  11. (I f’n hate cancer. HATE IT! I participate in the Relay For Life every year, and I really hate to see the luminaria bag section grow.)

    The pink annoys me a bit, but I think I’m more annoyed by the multitude of walks/fundraisers/etc. I mean, fundraising is awesome, but they always seem to split the donation. I kind of feel like we might do better if all of the money was pooled together to research cancer as a whole. (I do recognize that there are different things to look for. This is my completely non-scientific, English major opinion.)

    I don’t really self-test. I went to a seminar last year where the doctors who spoke talked about getting away from that and going to a more “know your body, know when something’s weird” stance…i.e. instead of doing the rigid testing, being more like “huh, I didn’t feel or see that last week”. That seemed to make more sense, especially when they were talking about lumpy or dense breast tissue.

    I think the gene testing is a good idea, but you have to be prepared to receive that information. It wouldn’t make me act preemptively, but I’d probably opt toward a double mastectomy if I ended up being diagnosed. But, my family is more geared to ovarian and lung cancers, so I signed up for the Cancer Prevention Study-3 that the American Cancer Society is running this year. My genes are probably as good as any to figure out this jerk of a disease.

  12. Charlotte – this made me think of a coworker who runs The Pink Daisy Project. http://pinkdaisyproject.com/ This organization focuses not on “raising awareness” or even on research. It is all about providing practical support for women currently undergoing personal battles with cancer. The organization provides things like groceries or diapers to young mothers and also provides a supportive community.

    I know that doesn’t really address the issues of whether so much testing is helpful or hurtful, but I thought you’d like to hear about Pink Daisy because practicality seems right up your alley.

  13. Alyssa (azusmom)

    My mother-in-law had a Brest cancer scare last week. There was a dark spot on her mammogram, so they did further tests and, thankfully, it’s a benign cyst.
    My own mother’s cancer was caught early enough, and she’s cancer-free. Because of that, and because I’m now 43,I recently had my first mammogram in 8 years. I don’t think it would have been useful to get one annually before now. Just my opinion.
    As for Komen, I get so disgusted every time I think of that situation! Not only was the CEO making ridiculous amounts of money, but millions if people were being duped into thinking they were helping cancer patients when, in fact, the bulk of the money went to overhead. And then to deny women access to what may be the ONLY health care clinic in their area because of politics is, in some cases, literally handing them a death sentence. Poor women don’t have the resources to travel to another town, county, or state to get necessary health screenings.

  14. I’m so glad I’m not the only one who gets annoyed by the pink campaign! When I grumble about it I get odd looks from some people.
    For me it’s the super hyped pink campaign the NFL has started doing for the whole month of October. I do not watch tv other than football games so maybe that’s why it’s so noticeable to me, but for the whole month the NFL enthusiastically waves the pink flag of awareness; announcers mention it more than once per game, the players’ uniforms are modified in some way so that each one is wearing pink (eg, pink gloves or pink on shoes or pink armbands etc), the officials wear something pink, the coaches on the sidelines wear a pink version of the team hat, heck even the FIELD is not exempt; the typical field layout is changed so that a huge pink ribbon is added to the field paint or somesuch.
    I love that the NFL has chosen to get involved in an awareness campaign. It annoys the ever living CRAP out of me that they chose breast cancer awareness because it smacks of gimmicky efforts to make more money by trying to bring in more female fans by seeming more female-oriented. Everytime they wave the pink flag I roll my eyes because in this day and age if I had not been very aware of the risks and issues involved with breast cancer then I have literally been living under a rock.
    If they really wanted to seem genuine in making a difference, the NFL would have taken on prostate cancer awareness, seeing as how their players and staff are all men, not to mention that their fan base is predominantly male. Unlike breast cancer, I think a lot of men still aren’t really truly knowledgeable about the disease in terms of what risks they have and the real difference screening practises can make. Having learned the iffy nature of mammogram screening a long time ago, I think the NFL telling women viewers to get tested will save a lot fewer lives in the end than being able to convince even a small % of their male viewers to start getting tested for prostate cancer.
    And creating awareness aside, if the NFL just wanted to try and make a difference, perhaps they should have taken on Heart Disease, since it kills more men and women each year than anything else, and since every other commercial during every game is for greasy, fattening foods (or for beer)…and since they are all but programming people to sit inside for hours and overeat while watching their games. It might make them seem hypocritical to some but not to me since the NFL as an organisation does not officially tell us to gorge on wings and pizza while watching the games (the advertisors do that), and it would tie in nicely with their Play 60 program, which promotes childrens’ health by encouraging them to play actively for 60 min each day…now this campaign I LOVE because it doesn’t smack of a gimmicky grab for money and it influences adults too.

  15. To say I hate cancer is an understatement; and, unfortunately, breast cancer is currently receiving all of my hate filled thoughts. Breast cancer, even when caught “early” can be caught too late – the size of a tumor really doesn’t mean a whole lot because nobody knows when or if it has moved on to hide out in yet another part of the body, doing it’s evil, waiting to attack.

    For years I have been frustrated by the fundraising efforts of Komen and their pink ribbon, knowing that they spend so much more on fundraising than they do on finding a cure or a cause. So, even though there is a war on breast cancer being fought in my own family I don’t own a single pink ribbon, instead all of my cancer donation dollars go straight to those doing the work to find a cure and a cause(I highly recommend looking at Universities research programs to find a good place to donate).

  16. My mother-in-law just started chemotherapy on Monday for breast cancer. It never would have been caught without a mammogram. Despite the tumor’s large size, neither she nor her doctor could feel it, and twice, after her initial surgery, they had to go back in because they hadn’t gotten it all. I’m really ok with mammograms and self exams, but paranoia isn’t good for anyone. My biggest problem with all the “awareness” campaigns (insert issue here) is that they don’t require action. “Hey, let’s all repost this on our Facebook page but otherwise do nothing!” And the pink ribbon? Anymore it’s just a faddish brand name.

  17. I used to work at a place that sold high end flashlights. The company that made them decided to make some that were pink and sell them under the story that they were for breast cancer awareness.
    My boss was slick and asked them if they actually donated any of the proceeds to cancer research and the rep couldn’t tell for sure if they did. My boss then read them the riot act for selling under the marketing tactic of a cancer awareness trend. She was very adamant about money needing to be spent for research because “you have to live on the moon to not know about breast cancer.”

    Since then, I’ve been very careful about anything sold under the sales pitch to “benefit cancer awareness.”

  18. No one wants to suffer themselves, or see those they love suffer. That, coupled with a growing belief that more pills/scans/treatments/intervention are better than less, has resulted in what seems like a focus on a test that is of questionable value. I was really troubled by the small % of total funds raised for breast cancer that go towards research (the majority is spent on education), given the questionable benefit of mammograms and the whole “machine” of the pink ribbon felt a little icky to me.

  19. I’m a researcher not an MD so I’m not going to write a lot here about what happens when you get a genetic diagnosis because I don’t really know exactly how beneficially some of the interventions are (though I suspect I’d want to know, personally). However, I feel strongly that if you want to do something to help with cancer research (or really any kind of disease research), write an email to your congressperson and ask them to stop cutting NIH funding for biomedical research. The VAST majority of high quality research in this country is being paid for with government dollars and no amount of pink ribbons or 5Ks are going to make up for the budget cuts that are going into effect due to sequestration. Of course, private fundraising is great too, I don’t want to discourage anyone from doing that ever, but NIH funding is absolutely crucial.

  20. This morning you stuck a nerve in me w/ the words pink ribbons,.. survivior… screening… Just two years ago this month after a colonoscopy I woke up to,” you have cancer”. The whole thing became my life…for awhile.

    At the time our local clinic was taking pictures of “survivors” in their respected color (every cancer has a color, colon cancer is blue) to hang on a hallway. Nope not gonna do that!. The whole color, survivor, awareness thing really got to me during my chemo as locally they were doing a wine-formal gala for the local cancer support group. Everyone was having a dress-up party and I was home dealing w/ chemo…great support. In a small town the world knows your business and it hurt that the party was more important than a person dealing with it right then. To get their support I had to fill out an financial application… but money isn’t the only support cancer warriors need…they need emotional/spiritual support as well.

    The Big C is out there girls, screening is important. If I hadn’t screened 2 years ago my stage 3+ colon cancer might not have been “conquered”. March is Colon Cancer Awareness month did anyone hear about it? Did any of you get a colonoscopy? Pink gets so much publicity I only wish the other screenings and cancers were talked about as well. I was over 50 and ready to be screened but my best friend buried her oldest son at age 21 of colon cancer 5 years ago. .Another friend buried her older sister at age 45 to colon cancer 7 years ago. These two were my support during my battle w/ the big C, they were both so afraid I too was going down. Not this girl, If I had not been paying attention to my body I might not have been screened. So do know thy ownself!

    Sorry to go on for so long, but a screening saved my life and it will save others, I realize insurance and cost affects many, but an ounce of prevention is less spendy than the pounds of cure. Believe me the cure is costly and emotional.

  21. I have no love for cancer. I’ve seen lovely people dwindle and die due to this disease. I also have no love for the juggernaut of pink cancer awareness. I realized it was ridiculous a couple of years ago when the grocery store I decorated cakes at decided to have “breast cancer awareness cakes” in pink. I refused to do them and nearly lost my job. The ingredient list on the icing and in the cake was atrocious. A veritable soup (cake?) of artificial ingredients, flavorings and colorings. They looked ridiculous, and tasted horrible. It was an abomination and I felt like it trivialized everything cancer and getting treated for cancer was about. I still get angry thinking about it. I believe .01% of the sale of every cake went to the Komen Foundation. On a funny side note, my male boss came up to me and asked me how the “breast awareness cakes” were coming along. I laughed out loud. Freudian slip?

  22. I pretty much gave up on Koman events when I read they had sued other organizations for using the phrase “for the cure” in regards to fundraising for breast cancer research. Sure, “Race for the Cure” is their signature event, but others were using phrases such as “Crawl for the Cure” and “Walk for the Cure.” The Koman organization had a fit and spent over $1million in court. Personally, I’d rather see them embrace other organizations fighting for the same cause and give that money to cancer RESEARCH.

    As for breast cancer screenings, I’m torn. Part of me thinks I should do the mammograms and such because it’s just what you’re supposed to do. But, in my family, the cancer has all been colon cancer up to this point. I’ll be starting my colonoscopys very early for prevention.

  23. I have been aware of the pre-screening debate lately– it’s a big issue. It seems like the current research says it’s not needed for most low-risk women.

  24. Cancer is a monster any way you look at it, and yes I think it’s been marketed to death, but I also believe that reminding people of it’s presence is critically important. Getting yourself checked is an important decision to make, not just for you, but also for the loved ones around you. We can all hope that one day a cure will be found, but until then we must stay vigilant against it and do what we can to educate ourselves and others about it.

  25. After having breast cancer twice (at 28 and 40 – both successfully treated) I decided to have the BRCA test – my mum had breast cancer (in her early 40s – she’s now 70) so I was pretty sure I was carrying the gene. The results showed that I did so I decided to have a double-mastectomy and reconstruction at age 43. That was two years ago and I have had no regrets. My mother got BRAC tested – she is not a carrier, so my father was tested – he’s the carrier.

    From my experience anything that stops women from putting their heads in the sand is a good thing. The right information is key and enables us to make the best decisions for ourselves. If coloured ribbons and charity events result in raising awareness and this leads to action (self examination is a good start!) then that’s great. And the more we talk to one-another the better. Realistically, we don’t take cancer seriously enough until someone we love (or we ourselves) are diagnosed – and I’m happy, healthy, living proof that early detection and preventative action saves lives.

  26. That was great!

    In a former life I spent some time working with a breast surgeon before making the switch to radiology. My aunt died when she was in her early 40s from breast cancer. Having watched all the debate etc over the past few years, my own personal choice will be not to have screening until at least 50 and, considering it was just one relative, not to have any genetic testing. Just too many variables for me otherwise. False negatives in the young breast, call-backs that turn out to be nothing, biopsies. And, a biggie, lack of true understanding of the natural history of DCIS (the early form often found by screening).