Score 1 for Freedom of Speech; Score 0 for Breast Cancer

Today I got a press release from one of my least favorite breast cancer organizations: Keep-A-Breast, the folks that brought you those annoying I ♥ Boobies bracelets. I've written about this before. There are so many things wrong with Keep-A-Breast it's hard to know where to begin. There is, of course, the whole issue of the blithe sexualization of breast cancer, a disease that, trust me, is anything but sexy (hey, Baby, want to see my mastectomy? I didn't get to "keep a breast," dang it). I wrote back in 2010 about how the fetishizing of breasts comes at the expense of the bodies, hearts and minds attached to them.  What disturbs me more, though, is the way that focusing on a youth demographic--especially early detection in a youth demographic--is doing a disservice to the cause of breast cancer. Campaigns like this (as I said in last year's piece, "Our Feel-Good War Against Breast Cancer")  are usually motivated by caring and grief: the woman who began Keep-A-Breast lost a friend to breast cancer in her 20s. But focusing on early detection--that  is not going to reduce young women's death rates from the disease. Keep-A-Breast urges girls to perform monthly self-exams as soon as they begin menstruating. Though comparatively small, these charities raise millions of dollars a year — Keep A Breast alone raised $3.6 million in 2011. Such campaigns are often inspired by the same heartfelt impulse that motivated Nancy Brinker to start Komen: the belief that early detection could have saved a loved one, the desire to make meaning of a tragedy.

Yet there’s no reason for anyone — let alone young girls — to perform monthly self-exams. Many breast-cancer organizations stopped pushing it more than a decade ago, when a 12-year randomized study involving more than 266,000 Chinese women, published in The Journal of the National Cancer Institute, found no difference in the number of cancers discovered, the stage of disease or mortality rates between women who were given intensive instruction in monthly self-exams and women who were not, though the former group was subject to more biopsies. The upside was that women were pretty good at finding their own cancers either way.

Beyond misinformation and squandered millions, I wondered about the wisdom of educating girls to be aware of their breasts as precancerous organs. If decades of pink-ribboned early-detection campaigns have distorted the fears of middle-aged women, exaggerated their sense of personal risk, encouraged extreme responses to even low-level diagnoses, all without significantly changing outcomes, what will it mean to direct that message to a school-aged crowd?

Young women do get breast cancer — I was one of them. Even so, breast cancer among the young, especially the very young, is rare. The median age of diagnosis in this country is 61. The median age of death is 68. The chances of a 20-year-old woman getting breast cancer in the next 10 years is about .06 percent, roughly the same as for a man in his 70s. And no one is telling him to “check your boobies.”

“It’s tricky,” said Susan Love, a breast surgeon and president of the Dr. Susan Love Research Foundation. “Some young women get breast cancer, and you don’t want them to ignore it, but educating kids earlier — that bothers me. Here you are, especially in high school or junior high, just getting to know to your body. To do this search-and-destroy mission where your job is to find cancer that’s lurking even though the chance is minuscule to none. . . . It doesn’t serve anyone. And I don’t think it empowers girls. It scares them.”

Did you hear the big news? Earlier this week the Supreme Court declined Easton Area School District's appeal to ban Keep A Breast i love boobies! bracelets in their schools. Below is an excerpt of a response blog I wrote on how I felt. Although this is a huge victory for freedom of speech for students everywhere and Keep A Breast we know our fight isn't over. We still need your support to keep educating young people on the importance of breast cancer prevention. I hope you will consider making a donation right now. Will you support Keep A Breast?