Breast cancer’s history is rife with empowered patients willing to fight for the cause. How can breast imagers continue that effort?
Breast cancer awareness is everywhere. Once October hits, the varied pinks of breast cancer awareness ribbons and products are just as common as the red and oranges of falling leaves. It’s hard to believe that decades ago even mentioning breast cancer was frowned upon.
In 1913, the year the American Cancer Society was founded, any type of cancer was considered an unspeakable death sentence, appropriate to discuss only in hushed tones and medical circles.1 And no cancer was more taboo than breast cancer. So how did the disease go from “the unspoken affliction” to one of the most well-known public health causes in America?
The answer lies in its proponents. “Breast cancer awareness is so pervasive because women came together around it,” says Allyson N. Parnes, MD, breast imager at Women’s Breast Center of Stamford Hospital in Stamford, Conn., and breast cancer advocate and survivor. “Patients and their friends and families have rallied behind women fighting breast cancer, making them feel like heroes. Their advocacy efforts have had a major influence on Congress and big business, increasing funding for awareness efforts, access to care, and research.”
Despite the success of the breast cancer awareness movement, one of the keys to fighting the disease is again under attack. With the USPSTF recommending mammography for most women starting at age 50, empowered patients and physicians must again take up the mantle and fight for their care. And it’s up to breast imagers to help make that happen — by using some of the same tools that brought breast cancer to the forefront of the public’s mind in the first place.
The history of breast cancer features a host of women who battled the disease and fought to ensure better care for those who came after them. One of the earliest proponents for better breast health was Terese Lasser, whose breast cancer was treated with a radical mastectomy. Frustrated by a host of unanswered questions about post-cancer care, Lasser founded the Reach to Recovery program in 1954. Reach to Recovery still provides women with social support and encourages them to participate in their own health care today.
The movement also gained important and powerful advocates: In the early 1970s, First Lady Betty Ford revealed her breast cancer diagnosis and subsequent mastectomy, as did former child star and diplomat Shirley Temple Black. Women began writing publically about their experiences with breast cancer. “A lot of women realized that this disease was not uncommon. They thought, ‘If the wife of the president, someone who has the greatest access to health care, can develop breast cancer, then so can I.’ And the result was that they began demanding better care and education for women,” says Parnes.
Just as empowered women who felt strongly about the breast cancer movement were key to its success, engaging patients today is imperative, notes Parnes. You can begin by educating your patients and helping them understand why mammography is so vital, says Debra L. Monticciolo, MD, FACR, chair of the ACR Commission on Breast Imaging.
“It’s hard because the lay media is more interested in controversy — medicine is boring to them when it saves lives like it’s supposed to,” says Monticciolo. “It’s up to us as radiologists to lead the way, look at the data, and explain it in a cogent way. We need to explain to patients the inaccuracies they’ve been reading about and how the facts presented in the lay media are not necessarily based on credible science.”
One way to do that is to make use of the information on the ACR Breast Imaging Resource page for the Society of Breast Imaging. Advocacy sites such as mammographysaveslives.org and RadiologyInfo.org contain patient-friendly information, talking points, and brochures that can help explain why mammography is vital for women over 40.
You can continue to empower patients by educating your colleagues as well. “Their help is invaluable in encouraging patients to get screened. Most patients trust their doctors more than they trust the lay press,” says Monticciolo. Talk to your referring physicians about mammography and explain why the USPSTF ruling may be incorrect, she says. Monticciolo plans on speaking to the OB/GYN department in her hospital, going through the data piece by piece to demonstrate that mammography does in fact save lives.
Another way to help educate and empower your peers is to put a face on the breast cancer movement. “A huge part of breast cancer’s success is that women were able to share their stories and the public could empathize with their struggles,” says Parnes. She notes that it’s important to share personal stories and accounts with your patients and those you’re educating. “When I meet with patients, especially those who are long overdue for their annual exam, I tell them that finding this disease early can make it a whole different ballgame. I tell some patients that I know this because mammography saved my life. It becomes a little more motivating than ‘See you next year.’”
This openness around breast cancer explains in part why interest in mammography grew after women like Betty Ford spoke up. “I’m sure it became more real to some women. And it became permissible to have a dialogue about it,” adds Parnes.
You can also do a lot of good by putting a face on the physicians behind the movement, says Monticciolo. Visit health care fairs and patient groups to explain the logic and science behind mammography screening, she says. Parnes’ hospital creates a huge breast imaging event each year, complete with a fashion show, golf tournament, lunch-and-learn events, and more. She says, “Women enjoy the fashion, but also want to learn the latest recommendations from the medical community. We also talk to the media and are able to reach even more women with their coverage.”
The Search for Funding
Breast cancer awareness also owes its success to its long partnership with advocates on Capitol Hill. During the 1980s, breast cancer advocates noted the success of HIV/AIDS patients who were advocating for increased research funding. With this example in place, several breast advocacy groups joined together in the early 1990s to create a petition aimed at convincing Congress to fund breast cancer research. After gathering over 2.6 million signatures, they were successful — President Clinton signed the National Action Plan on Breast Cancer into law, which brought policymakers, scientists, providers, and patients together to search for a cure for breast cancer.
Today, with mammography under attack, advocacy from patients and physicians is still imperative. “More than 50 percent of Congress is new since 2010, and only 7 percent of the current members have a health care background.
So radiologists have a lot of educating to do on important issues like mammography. And congressmen and women are more than willing to learn, especially about mammography. It’s seen as a patient-oriented issue, and often it’s a personal issue to these members,” says Ted Burnes, director of RADPAC and political education at the College.
Getting involved in advocacy can mean any number of things. You can support RADPAC, host a member of Congress for a facility visit (read about one member’s experience at bit.ly/PracticeVisit), or participate in the College’s Capitol Hill Day, adds Burnes.
Breast cancer’s success in drawing the public eye cannot be disputed, largely in part because of the actions of patients and physicians who were willing to share their stories and empower others to fight for the cause. By continuing their efforts and empowering allies, radiologists may be able to make history repeat itself.
Breast Cancer Timeline
The history of breast cancer and its advocacy movement is full of landmark events that have helped shapred breast cancer as we know it today. Check out some of the key moments in this timeline by clicking the image below.
By Meghan Edwards, copywriter for the ACR Bulletin