Harriet S.MeyerMD, Contributing EditorJonathan D.EldredgeMLS, PhD, Journal Review EditorRobertHoganMD, adviser for new media
by Karen Stabiner, 518 pp, $25.95, ISBN 0-385-31284-9, New York, NY Delacorte Press, 1997.
As the title suggests, this book is not an objective discourse on a pathophysiologic process. Ms Stabiner chronicles the development of government-supported and private funding for breast cancer research in recent years and, in particular, the critical role that breast cancer advocates, including many breast cancer survivors, have played in obtaining increased funding for such research.
The author is explicit about her agenda: the medical community does an inadequate job of diagnosing and treating breast cancer, largely owing to a lack of research funding because it is overwhelmingly a women's disease. The medical community is blamed for a "civilized conspiracy that had hobbled medicine's progress against breast cancer since the mid-1800s" by using ineffective treatments and not supporting research as vigorously as was done for "men's diseases." Stabiner gives no data to support her contention that prostate cancer research, for example, has been better funded than breast cancer research. I found it difficult to countenance claims that patients chose lumpectomy over mastectomy as "a political issue—a symbol of liberation from a male-dominated medical establishment . . . " The possibility that physicians think their treatments have some efficacy or that women might choose breast conservation to preserve their body image is given short shrift vis-à-vis the political agenda. While one may disagree with Stabiner's political outlook, she does raise perceptive points regarding the politics of health care delivery, such as the fact that although women are much more informed and involved in their own treatment decisions, insurance companies and health maintenance organizations are placing more constraints on health care choices.
Breast CancerTo Dance With the Devil: The New War on Breast Cancer—Politics, Power, and People. JAMA. 1998;279(2):163-164. doi:10.1001/jama.279.2.163-JBK0114-2-1