Screening for Breast Cancer with Mammography is a Cochrane systematic review originally published by Peter Gøtzsche and Karsten Jørgensen in 2001 and updated multiple times by 2013. In the 2013 article, the authors discuss the reliability of the results from different clinical trials involving mammography and provide their conclusions about whether mammography screening is useful in preventing deaths from breast cancer. Mammography is an X-ray technique used to detect abnormalities in breast tissue, such as breast cancer, which affects about twelve percent of women in the world and has a significant risk of mortality. The authors concluded that mammography screenings reduced breast cancer mortality, but resulted in problems such as overdiagnosis and overtreatment of screened women. The article Screening for Breast Cancer with Mammography contributed to the then ongoing controversy about the usefulness of mammography and provided accessible information about mammograms in seven languages.

Breast cancer affects about 12% of women in the US. Arguably, it is one of the most advertised cancers. Mammography became a popular tool of breast cancer screening in the 1970s, and patient-geared guidelines came from the American Cancer Society (ACS) and the US Preventative Task Force (USPSTF). This research focuses on ACS guidelines, as they were the earliest as well as the most changed guidelines. Mammography guidelines changed over time due to multiple factors. This research has tracked possible causes of those changes. Research began with an extensive literature search of clinical trials, the New York Times and the Washington Post archives, systematic reviews, ACS and USPSTF archives.

In 1913, journalist Samuel Hopkins Adams published “What Can We Do About Cancer? The Most Vital and Insistent Question in the Medical World,” hereafter “What Can We Do About Cancer,” in Ladies’ Home Journal. Cancer is a disease that is the result of abnormal cell division in different parts of the body, such as the breasts or the cervix. During that time, many women did not discuss or disclose early symptoms of reproductive cancers, such as breast lumps and abnormal vaginal discharge, out of shame or disgust. Thus, people often considered cancer to be a taboo topic. “What Can We Do About Cancer?” provides a representation of what people in the early 1900s thought to be the early warning signs of cancer in women. Although, as of 2021, researchers have made advancements that have increased the scientific understanding of cancer and how it develops, Adams’ article provided women in the US during the 1900s with recommendations on early methods of cancer detection.

From 1963 to 1982, researchers in New York City, New York, carried out a randomized trial of mammography screening. Mammography is the use of X-ray technology to find breast cancer at early stages. The private insurance company Health Insurance Plan of Greater New York, or HIP, collaborated with researchers Sam Shapiro, Philip Strax, and Louis Venet on the trial. The researchers’ goal was to determine whether mammography screening reduced breast cancer mortality in women. The study included sixty thousand women aged forty to sixty-four. Half of the women received two annual breast examinations that involved mammography, a breast exam, and an interview. The rest of the women were not invited for annual examinations. After follow up, the researchers found that of the women who received the examinations, thirty percent fewer died from breast cancer than the women who did not receive any examinations. The HIP trial was one of the first large-scale clinical trials to provide evidence that mammography screenings helped prevent breast cancer deaths in women.

Mary-Claire King studied genetics in the US in the twenty-first century. King identified two genes associated with the occurrence of breast cancer, breast cancer 1 (BRCA1) and breast cancer 2 (BRCA2). King showed that mutated BRCA1 and BRCA2 genes cause two types of reproductive cancer, breast and ovarian cancer. Because of King’s discovery, doctors can screen women for the inheritance of mutated BRCA1 and BRCA2 genes to evaluate their risks for breast and ovarian cancer. King also demonstrated the genetic similarities between chimpanzees and humans and helped to identify victims of human rights abuses using genetics. King's identification of the BRCA genes and their relationship to breast and ovarian cancer, both reproductive cancers, has allowed physicians to screen thousands of women for the genes and for those women to choose to undergo preventative cancer treatment to lower their risk of cancer.

Stafford Leak Warren studied nuclear medicine in the United States during the twentieth century. He used radiation to make images of the body for diagnosis or treatment and developed the mammogram, a breast imaging technique that uses low-energy X-rays to produce an image of breasts. Mammograms allow doctors to diagnose breast cancer in its early and most treatable stages. Warren was also a medical advisor to the Manhattan Project, the US government’s program to develop an atomic bomb during World War II, and he was responsible for the health and safety aspects of the Trinity Test, the first atomic bomb test in the US. Warren’s invention of the mammogram has allowed physicians to diagnose breast cancer in women during its most treatable stages, preventing deaths due to breast cancer.

Nancy Goodman Brinker founded the largest breast cancer organization in the US, Susan G. Komen for the Cure, during the twentieth century. In 1982, Brinker created the organization, Susan G. Komen for the Cure, in memory of her sister, who had died of breast cancer two years earlier. During the early twentieth century, breast cancer was socially stigmatized, very few people discussed the disease, and there were limited treatment options available for those diagnosed with the disease. Breast cancer is one of the most prevalent forms of cancer and it affects almost 12 percent of women worldwide. In 1983, Brinker created the Susan G. Komen Race for Cure, a fundraising and awareness event for breast cancer. The organization provides funding for research, advocacy, and programs related to breast cancer. In the early 2000s, Brinker served as the US Ambassador to Hungary and, later, as the US Chief of Protocol. In 2009, US president Barack Obama awarded her the Presidential Medal of Freedom, the nation’s highest civilian honor. In 2017, Brinker serves as the Chair of Global Strategy at Susan G. Komen for the Cure and as the World Health Organization’s Goodwill Ambassador for Cancer Control. Brinker’s activism in the field of breast cancer raised awareness, public attention, funding, and support for women affected by breast cancer.

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