Inside Prevention

Values. Trust. Power. Rizzo reflects on Komen controversy

Our president and CEO Jeanne Rizzo shares with the Breast Cancer Fund community her reflections on the controversy unleashed on Tuesday when Susan G. Komen for the Cure announced it would end its funding of Planned Parenthood's breast-health programs. Your comments are welcome!

Over the last few days, we’ve all watched as the Susan G. Komen for the Cure story broke and exploded. It has consumed my attention and dominated my conversations, as perhaps it has yours too.

I was disappointed by Komen's decision to de-fund Planned Parenthood's breast-health services, as I am whenever women's health and wellness programs are cut. I was concerned about the implications for the breast-cancer-prevention initiatives that Planned Parenthood and the Breast Cancer Fund partner on. My heart went out to the women who rely on Planned Parenthood's breast-health services, to the frustrated Komen supporters, and to those who unleashed their outrage online and in conversations everywhere. And I’m heartened that the outpouring of support for Planned Parenthood's breast-health services is forcing Komen to reconsider its decision.

As the president of the Breast Cancer Fund, this incident has made me think deeply about those who support our work and what they expect from us in return. I believe you expect us to have clear and unwavering values that guide all of our decision-making. I believe you need to trust us to hold true to these values, to be good stewards of your support and to do the most effective work we can to prevent breast cancer. And I believe that you need to have power—you need to know that your voice counts and that you can meaningfully contribute to stopping this disease before it starts.

Values. Trust. Power.

The Breast Cancer Fund’s values are clear and unwavering. We value working for a world in which we live without fear of losing our breasts or our lives as a result of what we’ve eaten, touched or breathed. That’s why we are single-focused in our work to identify and eliminate the environmental causes of breast cancer.

The Breast Cancer Fund works every day to earn your trust. Our work stays true to our mission. We use every dollar donated responsibly. And we value you, our supporters, and invite you to engage with and help shape our work through our events, online communities, volunteer opportunities and more.

The Breast Cancer Fund is committed to giving you the power to prevent breast cancer. In fact, our work is fueled by your power. With your power, we’re making sure that everyone has access to the tools they need to help reduce their risk and protect their families. With your power, we're convincing elected officials and corporations to protect our health and reduce breast cancer risk. With your power, we’re leading the breast cancer movement to move beyond awareness to prevention.

The Breast Cancer Fund is an organization you can count on.

If you know people who are looking for a breast cancer organization they can count on too, please introduce your family, friends and networks to the Breast Cancer Fund. They can visit our website and sign up to receive our emails, join us on Facebook and follow us on Twitter.

And if you're looking for a way to show your continued support for our work, please make a donation today.

Warm Regards,
Jeanne Rizzo, R.N.
President and CEO

Flight risk and radiation

Two days before Thanksgiving, and odds are you're traveling somewhere this week. If an airport is in your immediate future, you may have a new choice to make: full-body radiation scan or the dreaded pat-down.

Particularly if you've been exposed to a lot of radiation in your life (cancer survivors who've had radiation treatment, anyone who's had a lot of X-rays or CT scans, those whose jobs expose them to radiation), you might consider the pat-down.

Ionizing radiation is the best-established environmental cause of breast cancer. What's more, radiation's carcinogenic effects are cumulative over your lifetime. That cumulative concern led a pilots' union earlier this month to advise its members to skip the scan and go for the pat-down.

And while scanners may be considered "safe" by the federal government and FDA if correctly set up, monitored and used, the reality is that even X-ray equipment in health care settings, run by medical professionals, may be miscalibrated, malfunctioning or otherwise deliver an excessive dose of radiation accidentally.

Like the screening process itself, the choice to get a scan or a pat-down is a very personal decision. Whatever you decide is best for you this week, we wish you a happy, healthy Thanksgiving! May you and yours be well.

It's Time for Breast Cancer Prevention Month (Huffington Post, 10/12/2010)

Read Breast Cancer Fund President Jeanne Rizzo's opinion piece on the Huffington Post about why it’s time to move beyond breast cancer awareness to prevention—very timely as we’re all awash in pink this month. Here's an excerpt:

It's that pink time of year again, Breast Cancer Awareness Month. But when virtually every American has been touched by the disease, who among us is not aware of breast cancer? What we need is Breast Cancer PREVENTION Month, and a focus on identifying and eliminating the preventable causes of the disease so fewer people ever have to receive that life-changing diagnosis. What we need is a national breast cancer prevention plan.

We know that 1 in 8 women will be diagnosed with breast cancer, and that no more than 1 in 10 of them has a genetic history of the disease. We know that breast cancer rates have increased dramatically since the 1930s, when the first reliable cancer incidence data were established, and that, strikingly, the increase parallels the proliferation of synthetic chemicals. Today, approximately 85,000 synthetic chemicals are registered for use in the United States, more than 90 percent of which have never been tested for their effects on human health.

(Read the full article.)

Lowering medical radiation risk

Amid growing concern about the cancer risk of improperly administered medical radiation, last month the Food and Drug Administration proposed new guidelines designed to prevent accidental radiation overdoses from the machines used for CT scans, nuclear medicine and fluoroscopy. But at a recent House subcommittee hearing, testimony made it clear the problem is bigger than can be solved by better technology – and that the focus on radiation safety must also include the risks of radiation from routine X-rays.

The New York Times – which in January ran a blockbuster series on radiation overdoses, reported:

Much of the hearing focused on CT scans, which are largely responsible for a sevenfold increase since 1980 in the average lifetime dose of diagnostic radiation. As evidence of their power, an abdominal CT scan “delivers approximately the same radiation as getting 1,500 dental X-rays,” said one witness, Rebecca Smith-Bindman, a professor of radiology, epidemiology and biostatics at the University of California, San Francisco.

Given the dangers of too much radiation, Dr. Smith-Bindman said, it is important that the lowest possible dose be given.

Higher-than-needed doses of radiation are all too common in medical imaging and are often due to inadequate training of personnel and inadequate regulation. Experts estimate that in many procedures the radiation dose could be cut as much as 50 percent without sacrificing image quality. The radiation dose for a mammogram has been reduced from 2 rads in the 1970s to 0.2 rads today, for example. The current law regulating radiology dates from 1981 and made the adoption of professional standards for radiology voluntary.

The Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy (CARE) Act currently in front of Congress would require states to meet minimum standards for quality assurance through licensing and training of radiology professionals. This act, sponsored by the American Society of Radiologic Technologists, would also ensure that patients undergoing all types of radiological procedures would have the same assurance of quality as patients who get mammograms currently do under the provisions of the Mammography Quality Standards Act. Requiring minimum training standards would reduce the need for repeated tests and improve the safety of radiologic procedures, thus reducing the risks of medical radiation.

FDA steps up radiation safety efforts

The terrible irony of medical radiation, be it mammography, X-rays, CT scans or radiation treatment, is that it not only diagnoses and treats cancer, it also causes cancer.

As individuals we weigh the risks vs. benefits. But we have no control over errors in treatment, which it turns out may be more common that anyone really knows. A gripping new series by the New York Times chronicles software flaws, improper training of radiation technicians, miscalibration of equipment and other errors that lead to overradiation, sometimes resulting in the patient's death.

Today the FDA stepped in to tackle CT scans, nuclear medicine and fluoroscopy, which deliver far higher doses of radiation than X-rays or mammograms. The agency's new proposal would require manufacturers to incorporate safeguards in the design of these machines to prevent overradiation.

According to the Times, no single agency oversees medical radiation, accidents are chronically underreported, many workers who have made mistakes during a patient's radiation therapy are still practicing, and, through a rather strict New York law, hospitals that report medical mistakes can have their identity shielded.

While today's news and the Times article focus on acute reactions to excess radiation, the long-term lifetime risk of cancer is also a serious concern -- a concern that we hope the FDA will address in the near future.

Some strides have been made, including the Breast Cancer Fund's successful passage of a California radiation standards law in 2005. Today's FDA announcement is good news, but we have far to go to ensure patients receive the lowest possible dose of radiation.

Cancer from the kitchen? (NY Times, 12/5/09)

Another excellent op-ed from New York Times columnist Nicolas Kristof, this time focusing on the endocrine disruptors in plastics, cosmetics and more that can put us at greater risk for diseases like breast cancer:

The battle over health care focuses on access to insurance, or tempests like the one that erupted over new mammogram guidelines.

But what about broader public health challenges? What if breast cancer in the United States has less to do with insurance or mammograms and more to do with contaminants in our water or air -- or in certain plastic containers in our kitchens? What if the surge in asthma and childhood leukemia reflect, in part, the poisons we impose upon ourselves? (Read complete article.)

Mammography Screening: Are we asking the wrong question?

This week, the U.S. Preventive Services Task Force announced new mammography guidelines, moving the recommended age for women to receive their annual screenings from 40 to 50. Because mammography is one of the few tools available for breast cancer detection, the response from women across the country has been one of overwhelming frustration and anxiety.

With a mission to identify and eliminate the environmental causes of breast cancer, the Breast Cancer Fund has long been concerned about women’s exposures to ionizing radiation, the longest and best-established link to the disease.

The Breast Cancer Fund calls for a change in the national conversation about breast cancer detection, moving away from blanket guidelines and toward an investment in safer and more effective alternatives and in better understanding the causes of the disease.

This is a moment of opportunity to recognize the weaknesses in our current tools and fully invest in breast cancer prevention.

Read the Breast Cancer Fund’s complete position on the new mammography guidelines.

Final weekly roundup: Tips for breast cancer prevention

October has come to an end and so has our tip series for Breast Cancer Awareness Month. But, please remember that these helpful, everyday tips can still be found on the Breast Cancer Fund’s blog. We definitely encourage you to revisit these suggestions, written by Dr. Janet Gray, editor of the Breast Cancer Fund’s 2008 and upcoming 2010 State of the Evidence reports, and to look to the Breast Cancer Fund’s Web site and Facebook page for upcoming healthy living ideas.

Here’s a recap of this week’s tips for prevention:

• Avoid exposures to PAHs, whenever possible –- buy low-emission vehicles, maintain your car and avoid unnecessary exposure to tobacco smoke.
• Include soy and other vegetables in your regular diet, but avoid high-dose supplements of soy derivatives.
• Consult with your medical team to minimize your exposures to radiation –- the longest- and best-established environmental cause of breast cancer.
• Keep toys made with phthalates out of your children’s mouths and hands.
• Avoid use of synthetic hormone replacement therapies (HRT), especially progestin-estrogen combinations.

Taking individual actions toward reducing your everyday exposures to toxic chemicals and radiation is a step in the direction of breast cancer prevention, but stopping this disease before it starts also requires greater accountability by corporations and policymakers to protect our health and the health of our environment. Please continue to join us in important legislative initiatives, such as banning BPA from food and beverage containers, expanding the FDA’s authority to make sure cosmetics are safe, and creating a national health-tracking system to connect disease rates and pollution.

Thank you for taking time throughout October to share these tips with your family and friends. Your help has been a crucial piece in expanding the conversation about breast cancer to include prevention.

Rethink Pink NOW! Saner Solutions to Breast Cancer (Huffington Post)

Blogger/writer Helen Cordes posted an excellent piece on the Huffington Post last week, urging readers to reevaluate our mainstream concepts of breast cancer detection and prevention -- mammography, hormone therapy, diet and exercise -- with links to the Breast Cancer Fund's State of the Evidence report and one of our projects, the Campaign for Safe Cosmetics:

Re-vision Prevention--And We All Win

*Stop using cancer-causers, and tell everyone why. As the leading breast cancer prevention organization Breast Cancer Fund notes, speaking out about prevention is perhaps most important in October, when breast cancer awareness is high. After all, genetic causes account for only 5 to 10% of breast cancers, and while it's unquestionably beneficial to exercise and eat healthy, fitness is no guarantee of escaping breast cancer, which has steadily risen at the same time as the chemical proliferation of the last 40 years.

Read the whole post on the Huffington Post.

Your next mammogram may not be necessary

For forty-somethings: 120,000 doctors want you to stop and think about your next mammogram.

As reported last week in the Washington Post, the American College of Physicians (ACP), the largest medical specialty group in the country representing 120,000 internists, issued new guidelines urging women in their 40’s to consult with their doctors about whether or not to have mammograms.

The ACP believes the risks of mammograms including exposure to radiation, a known breast carcinogen, unnecessary biopsies, surgery and chemotherapy – may outweigh the benefits.

"All we're saying is that women should be informed about the risks and benefits so they can make a decision based on all the facts," said Douglas K. Owens of Stanford University, who chaired the committee that wrote the guidelines.

This flies in the face of the recommendations from the American Cancer Society and the National Cancer Institute. Both recommend mammograms starting at age 40.

BCF was thrilled to see the ACP encouraging women to take an active role in deciding if, when and how often they should schedule their mammograms.

Read the Breast Cancer Fund’s mammography position statement to get more info on radiation, risks, etc.