"I like it on..."

Don’t get excited.  Despite the sexual innuendo, this refers to where a woman likes to keep her purse …the floor …the couch …the kitchen counter …wherever.  This is Facebook’s attempt to create breast cancer awareness.  Also on Facebook is SC Johnson’s “Pink my Profile” app where one can tint their profile photo to show support.  Many, many groups and companies have campaigns for the annual October Breast Cancer Awareness Month.  But from all reports, while these might create some awareness, they are not creating an increase in donations for breast cancer research.

According to the National Institutes of Health, from figures compiled by the CDC and the American Cancer Society in 2006, the leading causes of death for American women are heart disease, stroke, lung cancer, COPD, and finally breast cancer, with heart disease far and away the greatest killer.  Thus said, this is not to belittle the efforts toward breast cancer awareness, but to examine the tactics of the businesses who pander to it.  For instance, Astra Zeneca, the seventh largest pharmaceutical company in the world, sponsors the National Breast Cancer Awareness Month, which began in 1985.  NBCAM is a partnership of government agencies, medical associations, and national public service organizations whose aim is to promote awareness.  Their website is impressive, but is copyrighted by the Astra Zenica Healthcare Foundation, which to my mind makes its data questionable (though not necessarily wrong), especially since they are the manufacturers of the breast cancer drugs Arimidex and Tamoxifen.

Of course, it is sadly not unusual for groups to create a lot of hoopla that in the end adds to their bank accounts.  I just wish they hadn't done it with this issue, which is near and dear to my heart.  The symbol for breast cancer awareness is a pink ribbon.  A history and explanation of the pink ribbon, "pinkwashing", and "slacktivism", along with an interesting description of medical sociologist Gayle Sulik's book Pink Ribbon Blues:  How Breast Cancer Culture Undermines Women's Health, can be seen here.  

Breast cancer has a history that is long and slow in advancement.  It is one of the oldest types of cancers written about, presumably because it is more readily observable compared to internal cancers.  The Edwin Smith papyrus, written in Egyptian hieratic script in the sixteenth century, is based on material from an ancient Egyptian text on trauma surgery.  It covers eight cases of breast tumors that were treated by cauterization.  It also stated that the disease was untreatable.

In the seventeenth century there was enough understanding about the circulatory system that doctors were able to connect breast cancer with lymph nodes.  Successful surgeries removing breast tissue, lymph nodes, and the chest muscle beneath during that century enabled the work of William Stewart Halsted, who began performing mastectomies in 1882.  The "Halsted radical mastectomy" usually involved the removal of both breasts, associated lymph nodes and chest muscle.  This form of surgery became the standard, and is still implemented today.  In the 1970s, because medicine could now recognize systemic illness due to a new understanding of metastasis, effective but less radical procedures were developed.

In the 1920s mammograms were invented, which enabled detection of a breast tumor before it had a chance to greatly develop.  With an 85% efficacy rate, it remains a very valid preventative measure.  In 1994  and 1995, the discovery was made of two genetic mutations that could cause breast cancer - BRCA1 and BRCA2.  In 2002 a third mutation was discovered - BRCA3.  These mutations explain that some families share a propensity toward breast cancer.  Someone whose mother, grandmother, aunt, or sister had or has breast cancer is advised to get a mammogram at the same age their relative was first diagnosed, or by the age of 35, whichever is sooner.

Breast cancer is not just a woman's disease.  It happens to men, too, but at a much lower rate, usually occurring between the ages of sixty and seventy.  Family history is an important indication for men to be concerned with as well.  In 2009, the third week of October was designated "Male Breast Cancer Awareness Week" by the advocacy groups Out of the Shadow of Pink, The Brandon Greening Foundation for Breast Cancer in Men, and A Man's Pink.

While I am dismayed at the way this disease has been taken advantage of by some businesses and groups  for their own interests, I have nothing but love and respect for breast cancer patients and survivors.  To the people I know and love, and to all the rest who have dealt with it or must deal with it currently, my best thoughts and wishes go out to you.  This month and every month.

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