Analysis of “Breast Cancer Education and Awareness Requires Learning Young Act of 2009” (EARLY Act)
It is laudable that Congress continues to care deeply about breast cancer and strives to address it. However, it is vital that Congressional action is the right action that helps and does not harm the public and is a responsible use of federal funding and outreach. Unfortunately, the bill at issue is based on several false premises, contains incorrect information, and will not achieve these goals. The bill is addressed to a population of women in whom breast cancer is rare, and presumes we know what to tell these women about prevention, risk reduction and early detection. We do not. If we believe a public campaign to this population is important, we need scientific inquiry to find the answers to these questions before we launch any public campaign.
Our concerns center on the following:
1.) That breast cancer in women under 40, an admittedly rare occurrence, necessitates a broad public health campaign and education in secondary schools and universities;
2.) That we know what women should do to prevent or lower their risk of breast cancer;
3.) That breast self examination and clinical breast examination are effective in saving lives in this age group;
4.) That ethnicity is sufficient to trigger genetic counseling and testing
5.) That there are significant differences in what we know and what we should tell women under 40 years old versus over 40 years old.
The above concerns certainly justify a review of this legislation to determine if there are better, more scientifically-based ways to address the need to reduce incidence and mortality from pre-menopausal breast cancer. As a survivor who was diagnosed with breast cancer at an early age, I can say I had no family history, received regular breast screening, had a healthy diet and lifestyle and was a long distance runner, but still managed to get the disease. Pre-menopausal breast cancer is a much different type than the more common breast cancer diagnosed in post-menopausal women.
Its not only important to base public health messages about breast cancer risk on the best scientific evidence, its wrong to send mixed messages to women about whether they can prevent pre-menopausal breast cancer or instill a sense of guilt that they could have controlled the outcome.