TAILIEUCHUNG - DO NOT DELAY: BREAST CANCER AND TIME, 1900-1970

Scientists do not know exactly what causes most adrenal cortical tumors. Over the past few years, they have made great progress in understanding how certain changes in a person's DNA can cause cells in the adrenal gland to become cancerous. DNA is the molecule that carries the instructions for nearly everything our cells do. We usually look like our parents because they are the source of our DNA. However, DNA affects more than the way we look. It also determines our risk for developing certain diseases, including some types of cancer. Some genes (parts of our DNA) contain instructions. | Do Not Delay Breast Cancer and Time 1900-1970 ROBERT A. ARONOWITZ University of Pennsylvania Beware the beginnings for an after treatment comes often too late. Thomas Aquinas American women understand and experience the potential dangers posed by breast cancer in very dif ferent ways at the beginning of the 21st century than women did at the beginning of the 20th century. Contemporary educational campaigns emphasize that a woman s lifetime odds of developing breast cancer is a frighteningly high one in eight. These greatly increased odds mean that most women today have close friends or relations who have been diagnosed with breast cancer. Screening mammography tests for breast cancer genes breast cancer preventive medications and media attention to the breast cancer dangers associated with dif ferent lifestyles environments and medications have also insinuated breast cancer into the routines choices and concerns of many women today. Researchers policymakers clinicians advocacy groups and laypeople have struggled to make personal and policy sense of this increased prominence incidence and risk. The considerable powers of evidence-based medicine have been brought to bear on controversies such as the proper age to begin screening mammography the dangers posed by hormone replacement therapy and oral contraceptives the use of tamoxifen to The Milbank Quarterly Vol. 79 No. 3 2001 2001 Milbank Memorial Fund. Published by Blackwell Publishers 350 Main Street Malden MA 02148 USA and 108 Cowley Road Oxford OX4 1JF UK. 355 356 Robert A. Aronowitz prevent cancer and whether and when to test women for putative breast cancer genes. Despite and in some cases as a consequence of this research controversies continue. Missing in these public and scientific controversies is anything more than a superficial awareness of the historical continuities that have shaped the nature and magnitude of breast cancer risk and our response to that risk. Yet in so many ways our individual and .

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