by Patrick Borgen, M.D.

And so we kick off another October – Breast Cancer Awareness Month in the United States.   

There have been 36 Octobers since President Richard Nixon signed into law Public Bill 92-218. This landmark piece of legislation was ratified by the 92nd Congress and would become known as simply the National Cancer Act.

In this legislation, the government declared war on cancer and predicted, naively, that we could eliminate the problem in 10 years.

In a move that was uniquely American, it was assumed that throwing enough money at the problem would make the problem go away. This bill did not establish the National Cancer Institute — that organization came into existence with the passage of the National Cancer Act of 1937

What has happened since 1971? For starters, the disease increased in incidence by fully 1 percent per year between 1975 and 1990. There is much debate about what drove this increase, but in particular environmental factors (both diet and exposure to exogenous estrogens) and reproductive factors (such as the age at first full-term delivery) have been implicated in the increase.

The numbers are staggering. Over the past three and a half decades, 6,480,000 women have faced a diagnosis of breast cancer and well over 1,240,000 women have died of the disease. More women have died of breast cancer since the signing of the National Cancer Act than all American lives lost in all the wars we have ever fought from the Civil War to the current Iraq conflict.

Why have we not seen more progress against this disease?

First and foremost, it is important to think of breast cancer not as a single disease but rather as a large complex family of diseases. Progress has been made against a number of specific disease family members — in some cases, remarkable progress. The classification system for breast cancer is increasingly complex and the number of diagnostic and treatment options can seem overwhelming.

The practical solution to this problem for patients and doctors is a multidisciplinary approach to each patient. The core team consists of a surgical oncologist, medical oncologist, radiation oncologist, radiologist and pathologist — each of whom has specialized expertise in breast cancer.

In the future in this space, I’ll address controversies such as genetic testing, the role of MRI, novel approaches to surgery such as the nipple sparing mastectomy and others.

Breast cancer is at once the great American tragedy and the great American victory. It is a personal disease that takes women from partners and mothers from children. It does not respect racial, cultural or economic boundaries. Breast cancer is an ancient disease and a formidable enemy — one that can adapt to our treatments quickly and efficiently.

But what about the victory? Is there good news? Yes. The survival rate from breast cancer has jumped almost 2 percent per year since 1990. Our group has shown that this is due to both earlier detection and better treatments.

At the very core of both advances are the thousands of women who advocate for breast cancer funding. Earlier this week at a large Manhattan restaurant, the National Breast Cancer Coalition had a gala event in celebration of women who have made a difference in this fight. In attendance were a number of notable women, including Sheryl Crow and Faith Hill and House Speaker Nancy Pelosi.

Pelosi, the highest ranking elected woman in the history of the United States, told the audience that our federal funding for breast cancer research was just over $2 billion dollars per year. The thunderous applause was silenced when she went on to add that we spend this amount of money every two weeks in Iraq.

This year, more than 40,000 women will die of breast cancer. Many of these deaths are preventable through early detection and improved treatments. We must continue to make this disease a priority — at the federal, corporate and grass-roots level. Knowledge is power.

Patrick Borgen, M.D., is director of the Brooklyn Breast Cancer Project at the Maimonides Cancer Center in Brooklyn, N.Y.

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  • Jeffrey Dach MD October 23, 2007 at 10:09 am

    October should also be called Iodine Supplement Awareness Month, since Iodine is the key to breast cancer prevention.
    Fibrocystic Breast Disease, the Iodine Deficiency Connection
    A good friend of ours just went through an ordeal with breast cancer. The incidence of breast cancer has increased to 1 in 8 women, with 4,000 new cases weekly.
    You might ask, could there be a preventive measure which is safe, cheap and widely available that has been overlooked?
    The answer is YES , and it’s the essential mineral, Iodine, which was added to table salt in 1924 as part of a national program to prevent Goiter. It turns out that this same Iodine in table salt is the key to breast cancer prevention as proposed by the following list of prestigious doctors:
    Guy Abraham, MD, Robert Derry MD PHD, David Brownstein MD, George Flechas MD, Donald Miller, M.D.
    Dr. B.A. Eskin published 80 papers over 30 years researching iodine and breast cancer, and he reports that iodine deficiency causes breast cancer and thyroid cancer in humans and animals. Iodine deficiency is also known to cause a pre-cancerous condition called fibrocystic breast disease.
    W.R. Ghent published a paper in 1993 which showed iodine supplementation works quite well to reverse and resolve fibrocystic changes of the breast, and this is again the subject of a current clinical study.(Can J Surg. 1993 Oct;36(5):453-60.)
    Despite its obvious potential, not much has been done with Iodine treatment over the past 40 years in the United States. Since iodine isn’t patentable and is therefore unlikely to be profitable to market, there is no money to fund studies for “FDA approval”. However, FDA approval is not required since Iodine is already an additive to table salt at the supermarket.
    For more information see my newsletter
    Jeffrey Dach MD