From Publishers Weekly
Sure to be controversial, this prodigiously researched medical and cultural history examines deeply held views on the treatment of breast cancer, particularly the societal embrace of a "war on cancer" rather than an emphasis on prevention. Lerner (a physician and medical historian at Columbia's College of Physicians and Surgeons), whose mother developed breast cancer, focuses, in large part, on the rise and fall of the radical mastectomy pioneered by surgeon William Halsted. To prevent what he theorized was the centrifugal spread of cancer to the lymph nodes, Halsted determined that it was necessary to remove not only the breast but also the nodes and two chest-wall muscles, leaving the patient feeling disfigured and with serious side effects. Lerner details the arguments that many in the scientific community made against this eventually discredited theory and against radical mastectomy, including those advanced by surgeon George Crile. Crile favored less aggressive operations and disagreed with the cancer establishment's relentless publicity campaign for early detection. He and others were convinced that it was the biology of the cancer, rather than how early it was diagnosed, that determined whether or not a tumor would metastasize. Barron also explores the strong impact the 1970s women's movement had on cancer treatment, with women demanding more information from physicians and input into their treatment options. Provocative and highly engaging, Lerner's book presents an important contribution to medical history; moreover, he offers insights into areas that most books about breast health and disease do not probe. Illus. Agent, Michele Rubin. (May)Forecast: A controversial book on a hot-button issue, this may not be widely read, but it will be widely discussed.
Copyright 2001 Cahners Business Information, Inc.
From Library Journal
Military metaphors have long been used in promoting breast cancer awareness, prevention, and treatment. In The Breast Cancer Wars, Lerner (medicine, Columbia Univ.) presents a remarkably readable understanding of distinctly American attitudes toward the disease and the ways in which American culture and society have influenced its treatment. Restricting his history to the 20th century, with a focus on the years from 1945 to 1980, Lerner begins by describing surgical pioneer William Halsted's radical mastectomy in a medical and historical context. Halsted's treatment was considered by some to be not radical enough and later, as the century progressed, was thought far too extensive. Lerner deftly profiles breast cancer survivors, celebrity spokeswomen, surgeons, and researchers and even makes the concept of randomized controlled trials (RCTs), first introduced in the United States in 1971, understandable to the lay reader. There are a few minor problems in this extensively researched and annotated book some medical terminology, which could be more extensively defined in the glossary, is explained in parentheses, and concerns over the environmental causes of breast cancer are mentioned only in passing. Ellen Leopold's A Darker Ribbon (LJ 10/1/99) covered a similar time period using a feminist, activist approach. Lerner's book is essential for women's studies and history of medicine collections, but no public or academic library could go wrong in adding it to its collection. (Index not seen.) Martha E. Stone, Treadwell Lib., Boston
Copyright 2001 Reed Business Information, Inc.