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In 1971 U.S. President Richard M. Nixon declared a war on cancer and poured more than $100 million into cancer research due to public outcry against the disease. Cancer kills more than half a million Americans each year (American Cancer Society [ACS] 2006, p. 4). One of the most common types of the disease was also one of the first identified in humans, breast cancer. Physicians have recognized it for thousands of years. However years of research and hundreds of millions of dollars have not resulted in an exact cause or cure. Breast cancer is still a major health problem in the early-twenty-first century and one out of eight American women was diagnosed with the disease in 2005 (ACS 2006, p. 14; Olson 2002; Surveillance, Epidemiology, and End Results Program [SEER] 2002, p. 1). The history of breast cancer is filled with controversy because of the highly gendered nature of the disease and the status of the female breast as a cultural symbol of sexuality.

Breast cancer diagnosis and its related treatment inflict physical as well as psychosocial discomfort on patients. Some discomforts such as fatigue and hair loss are transitory, but others such as weight gain, premature menopause, and the loss of a breast linger on. Research focuses most of its attention on the effect of breast surgery on women's sexuality and body image. The mystique of a woman's breast in popular culture has deeply affected how women and men view themselves and their partners. Popular media reinforces these images by linking a woman's beauty to a slim, fit body with large breasts (Altman 1996, Dinnerstein and Weitz 1998, Olson 2002). Even the ACS held breast cancer survivors to these standards of beauty. During the 1980s, Darlene Betteley, a volunteer for the Reach to Recovery Program, was required to wear a prosthesis for hospital visits because the ACS did not want women who just had a mastectomy to be reminded of how the surgery changed a woman's exterior. According to the ACS, a woman without a breast is not a normal woman and volunteers were expected to look normal during hospital visits (Batt 1998).

Contrary to popular belief, a majority of women who had mastectomies did not undergo breast reconstruction, even when the procedure would be covered by medical insurance. Empirical studies on the impact of breast surgery on the quality of life among survivors revealed mixed findings. Some reported that women who had lumpectomies were more satisfied with their body image and marital relationships than women who had mastectomies, but others reported no significant differences between the two groups in terms of psychological well-being and marital relationships (Altman 1996; Fung, Lau, Fielding, Or, and Yip 2000). Another effect of breast cancer treatment on a woman's body is weight gain. Studies confirmed that weight gain and obesity are common in women diagnosed with breast cancer. Weight gain was also related to higher rates of breast cancer recurrence and mortality, in particular in women who had never smoked (Irwin, McTiernan, Baumgartner, et al 2006; Kroenke, Chen, Rosner, Holmes 2005).

The post-World War II generation of women transformed societal reactions toward breast cancer because of their own breast cancer experiences. These courageous women challenged cultural norms about women's breasts and empowered patients' rights in breast cancer treatment. Today breast cancer research and survivors receive unprecedented support from governments and communities. Early-twenty-first-century studies also confirmed that the quality of post-treatment life was better for women who were actively involved in the treatment planning (Hack, Degner, Watson, and Sinha 2006). New patient advocacy organizations targeting specific groups such as Sisters Network Inc and Young Survival coalition were established in the late-1990s. Despite this progress, the incidence of breast cancer remains higher than it was in the mid-1970s and cancer-related disparities remain among population subgroups. Future study should focus on how certain cultural practices or beliefs affect breast cancer diagnosis and treatment decisions. Finally women who are uninsured or underinsured are less likely to receive the same quality of treatment as their peers, which may contribute to these disparities.

References:

Altman, Roberta. 1996. Waking Up, Fighting Back: The Politics of Breast Cancer. Boston: Little, Brown.

American Cancer Society. 2006. Breast Cancer Facts and Figures 2006. Atlanta: American Cancer Society, Inc.

Batt, Sharon. 1998. '''Perfect People': Cancer Charities.'' In The Politics of Women's Bodies, ed. Rose Weitz. New York: Oxford University Press.

Dinnerstein, Myra, and Rose Weitz. 1998. ''Jane Fonda, Barbara Bush, and Other Aging Bodies: Femininity and the Limits of Resistance.'' In the Politics of Women's Bodies, ed. Rose Weitz. New York: Oxford University Press.

Fung, Kin Wah; Yvonne Lau; Richard Fielding; et al. 2000. ''The Impact of Mastectomy, Breast-Conserving Treatment and Immediate Breast Reconstruction on the Quality of Life of Chinese Women.'' ANZ Journal of Surgery 71(4): 202-206.

Hack, Thomas F.; Lesley F. Degner; Peter Watson; and Luella Sinha. 2006. ''Do Patients Benefit from Participating in Medical Decision Making? Longitudinal Follow-Up of Women with Breast Cancer.'' Psycho-Oncology 15(1): 9-19.

Irwin, Melinda L.; Anne McTiernan; Richard N. Baumgartner; et al. 2006. ''Changes in Body Fat and Weight after a Breast Cancer Diagnosis: Influence of Demographic, Prognostic, and Lifestyle Factors.'' Journal of Clinical Oncology 23(4): 774-782.

Kroenke, Candyce H; Wendy Y. Chen; Bernard Rosner; and Michelle D. Holmes. 2005. ''Weight, Weight Gain, and Survival After Breast Cancer Diagnosis.'' Journal of Clinical Oncology 23(7): 1370-1378.

Olson, James S. 2002. Bathsheba's Breast: Women, Cancer & History. Baltimore, MD: The Johns Hopkins University Press.

Surveillance, Epidemiology, and End Results Program. 2002. ''Cancer Facts & the War on Cancer.'' www.cancer.gov

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