The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century AmericaIn this riveting narrative, Barron H. Lerner offers a superb medical and cultural history of our century-long battle with breast cancer. Revisiting the past, Lerner argues, can illuminate and clarify the dilemmas confronted by women with--and at risk for--the disease. Writing with insight and compassion, Lerner tells a compelling story of influential surgeons, anxious patients and committed activists. There are colorful portraits of the leading figures, ranging from the acerbic Dr. William Halsted, who pioneered the disfiguring radical mastectomy at the turn of the century to George Crile, Jr., the Cleveland surgeon who shocked the medical establishment by "going public" with his doubts about mastectomy, to Rose Kushner, a brash journalist who relentlessly educated American women about breast cancer. Lerner offers a fascinating account of the breast cancer wars: the insistent efforts of physicians to vanquish the "enemy"; the fights waged by feminists and maverick doctors to combat a paternalistic legacy that discouraged decision-making by patients; and the struggles of statisticians and researchers to generate definitive data in the face of the great risks and uncertainties raised by the disease. As easy as it is to demonize male physicians, the persistence of the radical mastectomy and other invasive treatments has had as much to do with the complicated scientific understandings of breast cancer as with sexism. In Lerner's hands, the fight against breast cancer opens a window on American medical practice over the last century: the pursuit of dramatic cures with sophisticated technologies, the emergence of patients' rights, the ethical and legal challenges raised by informed consent, and the limited ability of scientific knowledge to provide quick solutions for serious illnesses. A searching and profound work on an emotionally charged issue, The Breast Cancer Wars tells a story that remains of vital importance to modern breast cancer patients, their families and the clinicians who strive to treat and prevent this dreaded disease. |
Contents
2 | |
3 | |
2 Establishing a Tradition | 15 |
3 Inventing a Curable Disease | 41 |
4 The Scalpel Triumphant | 69 |
5 A Heretical Interlude | 92 |
6 Reality Check | 115 |
7 I Alone Am in Charge of My Body | 141 |
10 The World Has Passed Us By | 223 |
11 The Past as Prologue | 241 |
12 Risky Business | 276 |
13 Epilogue | 291 |
14 Postscript | 297 |
Glossary of Breast Cancer Operations | 303 |
Sources | 305 |
Notes | 309 |
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Common terms and phrases
aggressive American Cancer Society Archives argued Babette Rosmond Bailar Barney Crile Bayh BCDDP believed Bernard Fisher Betty Ford Betty Rollin biological biopsy BRCA1 BRCA2 breast cancer breast cancer patients breast cancer treatment cancer surgery carcinoma carcinoma in situ chemotherapy controversy Cope Correspondence folder courtesy Crile Papers critics curable cure Cushman diagnosis disease doctors early detection England Journal feminist geons George Crile Haagensen Halsted radical mastectomy Halsted's Health Holleb Hospital Ibid January Johns Hopkins Journal of Medicine Kushner Papers LCIS lesions lumpectomy lymph nodes mammogram mammography modified radical mastectomy mutation October operation Pack pathologist percent performed Philip Strax physicians procedure prophylactic radiation radical surgery radiotherapy randomized trials RCTs removal reported risk Rollin Papers Rose Kushner scientific Shimkin simple mastectomy superradical surgeons surgical survival tamoxifen therapy tion tomy treated Treatment of Breast tumor Univ Urban woman women with breast wrote York