In 2009, an influential panel of medical experts ignited a
controversy when they recommended that most women should not begin
routine mammograms to screen for breast cancer until the age of
fifty, reversing guidelines they had issued just seven years before
when they recommended forty as the optimal age to start getting
mammograms. While some praised the new recommendation as sensible
given the smaller benefit women under fifty derive from
mammography, many women's groups, health care advocates, and
individual women saw the guidelines as privileging financial
considerations over women's health and a setback to decades-long
efforts to reduce the mortality rate of breast cancer.
In The Big Squeeze, Dr. Handel Reynolds, a practicing
radiologist, notes that this episode was only the most recent
controversy in the turbulent history of mammography since its
introduction in the early 1970s. In a book written for the millions
of women who face the decision about whether to get a mammogram,
health professionals interested in cancer screening, and public
health policymakers, Reynolds shows how pivotal decisions made
during mammography's initial launch made it all but inevitable that
the test would be contentious. He describes how, at several key
points in its history, the emphasis on mammography screening as a
fundamental aspect of women's preventive health care coincided with
social and political developments, from the women's movement in the
early 1970s to breast cancer activism in the 1980s and '90s.
At the same time, aggressive promotion of mammography made the
screening tool the cornerstone of a huge new industry. Taking a
balanced approach to this much-disputed issue, Reynolds addresses
both the benefits and risks of mammography, charting debates, for
example, that have weighed the early detection of aggressively
malignant tumors against unnecessary treatments resulting from the
identification of slow-growing and non-life-threatening cancers.
The Big Squeeze, ultimately, helps to evaluate the ongoing
public health controversies surrounding mammography and provides a
clear understanding of how mammography achieved its current primacy
in cancer screening.
Subjects: Health Sciences
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