The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America

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Oxford University Press, May 31, 2001 - Medical - 400 pages
In 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

Abbreviations
2
1 Introduction
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

8 No Shrinking Violet
170
9 Seek and Ye Shall Find
196

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About the author (2001)

Barron H. Lerner, M.D. is Angelica Berrie Gold Foundation Associate Professor of Medicine and Public Health at the Columbia University College of Physicians & Surgeons, where he teaches internal medicine, medical history, and bioethics. He is the author of Contagion and Confinement: Controlling Tuberculosis Along the Skid Road as well as articles in professional journals and publications such as The Washington Post. He lives with his wife and two children in Westchester County, New York.

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