Less Radical

In 1958, Bernie Fisher participated in the first randomized clinical trial in patients with breast cancer. The trial was a disaster, leading most surgeons to abandon the idea of using chemotherapy to cure more patients. Bernie, however, noticed something different. This put him on a path that would change the course of cancer treatment forever.

When a colleague’s misconduct is discovered, Fisher is forced to resign from the NSABP and becomes the subject of a Congressional investigation. As the walls close in, Fisher fights back. He spends the rest of his life trying to restore his reputation.

Mammograms were introduced fifty years ago. Recommendations for women to have annual screening mammograms began thirty years ago. The hope was that by finding breast cancer early, we could drastically reduce the number of women dying from breast cancer. And in some ways, we have been successful.

The problem with annual screening mammograms is that it is based on the assumption that every breast cancer follows the pattern - progressing from a pre-cancerous lesion to a more aggressive tumor in a logical, linear way.

Today, we know this isn’t true. Yes, some cancers are slow growing. So slow growing that they may not need treatment at all. But others, especially those in young women, grow fast. So fast, in fact, that they develop into masses in between annual mammograms. Or develop in women that are “too young” to be screened.

And why aren’t we doing more to prevent breast cancer from forming in the first place? Why aren’t we finding women at high risk and doing more than just pushing them into radical surgeries?

TLDR: Our current breast cancer screening paradigm is not working. We are doing too much for some women and not enough for others.

Today, I’m talking with two women who think women deserve better than this outdated, one-size-fits-none approach.

Martha Kaley is a breast cancer survivor and founder of Earlier.org: Friends for an Earlier Breast Cancer Detection Test. Martha’s breast cancer was not mammographically detected. She is also tired of the same old debates about what age we should start screening women for breast cancer. Martha has dedicated her life to supporting innovation in earlier detection methods - finding a better test than a mammogram.

Dr. Laura Esserman is a surgeon and professor at University of California - San Francisco. She’s spent her career trying to find less radical ways to treat breast cancer. Now she’s leading a study trying to find the best way to screen women for breast cancer. (Hint: it’s probably not going to be annual mammograms for everyone.)

Screening will never be perfect. It’s not now. But why are we settling? What if we demanded a screening approach that was better than a mammogram?

Do something...