2020: NBCC’s Breast Cancer Deadline

The National Breast Cancer Coalition (NBCC) has worked for years to promote evidence-based medicine and to ensure that scientific information about breast cancer reaches women, informs policy, and impacts the direction of research. On September 20th NBCC raised the stakes. The coalition set a deadline to end breast cancer by 2020. Eradication is the goal.

The eradication of breast cancer is not a new idea. Numerous breast cancer organizations, research programs, treatment centers, and policy agendas have mission statements that specify cure(s), or the end of breast cancer, or the dream of a future without breast cancer, as their primary objectives. Hope for an eventual medical miracle has fueled the fund-raising of billions of dollars with this end in mind. Unfortunately, the goal has never been realized. And until now, there has never been a deadline.

In an NBCC white paper, the coalition explains why society needs to make a radical shift in its approach to breast cancer. Drawing together statistics and information from widely respected sources, the paper specifies that incidence rates continue to rise; advances in treatment are incremental at best; and, although our understanding of breast cancer has increased in the past forty years, little has changed for the diagnosed. In addition, what has changed can sometimes be more harmful than beneficial.

For instance, NBCC recognizes that there are more treatment options particularly in the realm of pharmaceuticals. The Food and Drug Administration (FDA) has approved over 60 drugs for breast cancer, and there are over 100 more drugs in the pipeline. The drugs given to patients are not necessarily based on unequivocal evidence of benefit or significant increases in survival. Of the more than 1500 breast cancer clinical trials currently recruiting patients, the majority are investigating the combining and dosages of existing drugs rather than the development of new treatment modalities.

This approach to drug manufacturing is not unique to breast cancer. Marcia Angell, of the Department of Social Medicine at Harvard Medical School, and former editor of the New England Journal of Medicine, reported in Big Bucks, Big Pharma that only 14 percent of the FDA’s newly approved drugs between 1998 and 2004 were actually new chemical compounds. However, oncology drugs represent the largest share of the global drug market, and sales are projected to grow at a compounded annual rate of 12 to 15 percent, reaching $75 to $80 billion by 2012. The growth of the oncology market relies on breast cancer treatment to ensure continued profits.

In addition to pharmaceuticals, NBCC points out that most of the diagnosed receive some kind of surgery whether or not their condition is life threatening. The treatment of stage zero breast conditions such as ductal carcinoma in situ (DCIS) clarifies this concern. DCIS does not produce symptoms and is not likely to progress to invasive breast cancer. The long-term survival rate is nearly 100 percent regardless of treatment. In 2002, however, 26 percent of patients diagnosed with DCIS were treated with mastectomy, and other treatments included lumpectomy, radiation, chemotherapy, and hormone therapy such as tamoxifen. Since the condition is not life threatening, the risks associated with surgery, radiation damage, side effects, anxiety, ongoing radiation from regular mammography, and increased medical costs call the benefits of treating this condition into question. [See also my previous post “1 in 8”– Fear Mongering and the Probability of Developing Breast Cancer.]

In terms of diagnosis, routine mammography screening has been the standard protocol and “early detection” the rallying call for the American Cancer Society’s National Breast Cancer Awareness Month. Mammograms frequently provide insufficient information to reach clear conclusions about the presence of tumors, and suspicious areas on a mammogram may or may not indicate cancer. According to the Institute of Medicine, 75 percent of all positive mammograms, upon biopsy, were “false-positives” (i.e., did not show the presence of cancer), and mammograms on average miss 25 to 40 percent of tumors that actually are cancerous. NBCC states that “evidence of actual mortality reduction is conflicting and continues to be questioned…If mammography has had any impact on mortality, it is certainly a very small one.” Relatedly, DCIS is almost always detected by mammograms, contributing to concerns about the role and efficacy of screening mammography.

Finally, NBCC argues that small reductions in mortality overall do not signify adequate progress in the war on breast cancer. Data from the National Cancer Institute do indicate that the last twenty years have seen a slight decline in breast cancer mortality overall. Whereas 117 women died of breast cancer every day in 1991, this number is 110 per day in 2010. The coalition points out though, that “If we continue making progress at the current rate, it will take more than 500 years to end breast cancer.” That’s a long time when some 40 thousand women and increasing numbers of men die from the disease each year.

All of this indicates that the dream of eradication is only a dream unless we take a radically new approach. What does the new approach look like? The details of the 2020 deadline are forthcoming. Generally speaking, NBCC says this:

“This effort will require a critical look at research and healthcare priorities, financial incentives, funding mechanisms and advocacy efforts. It will require a concentrated strategy to expand quality, evidence- based care. It must embrace unprecedented coordination, information sharing and accountability. It will require individuals and institutions to cooperate in new ways and to an extent never before considered.”

I look forward to seeing the details and learning about who is on board with this unprecedented effort. In the meantime, I admire NBCC’s audacity, commitment, and call for change. NBCC states emphatically:

“By calling for an end to breast cancer by 2020, NBCC is calling for the end of business as usual. We have no desire to increase awareness of breast cancer, or to continually increase funding for research. Indeed, our foremost goal is to bring about the demise of the organization by accomplishing its mission.”

Loud and clear, NBCC. Now, let’s join the hundreds of thousands of advocates, survivors, medical doctors, scientists, policy makers, journalists, and concerned citizens who see the forest for the trees. The clock is ticking!

For more information about NBCC and the 2020 Deadline read the executive summary and go to stopbreastcancer.org.

Be Sociable, Share!

4 comments to 2020: NBCC’s Breast Cancer Deadline

  • Thank you for your comments. I am an 18 year survivor and am on the NBCC Board for
    13 yrs–also the Alamo Breast Cancer Foundation for 17 yrs.

  • Thank you for commenting. You’ve witnessed some major changes in advocacy during that time, I’m sure. Here’s hoping for some more change.

  • Joan

    This sounds like a very exciting and bold plan. I would like nothing better than to see the end of breast cancer in 2020. As a 24 year survivor, I have been working with women for that long and still no end in sight. I look forward to learning more about this initiative so my organization can go out of business as well.

"women urged to get screened because it might save their lives. But that’s only 1 possible outcome, and it’s the least likely one" @cragcrest cutt.ly/jei8WJr

“Pink Ribbon Blues”

Paperback includes a new Introduction on fundraising controversies and a color insert with images of, and reactions to, the pinking of breast cancer (2012).

Praise » 

Flyer »

Press Release »

Hardback Cover »

Paperback Cover »

Request Review Copies »

Order the Paperback »


"Seeing clearly through the pink haze" Toronto Sun

*Sad face*: Being happy does not help you live longer" New Scientist

How should we address breast cancer when norms continually change? The Guardian

Your Fun 'No Bra Day' Photos Are Overshadowing Terminal Breast Cancer Patients Broadly

Backlash against “pinkwashing” of breast cancer awareness campaigns BMJ

Breast Cancer to Rise 50 Percent by 2030? Hey, Not So Fast! Health News Review

Breast Cancer: The Flaws in the Cause iafrica.com

How to Make the Biggest Impact With Your Breast Cancer Donations Money

The Very Pink, Very Controversial Business of Breast Cancer Awareness Racked

NFL, Pink Ribbons Not Enough to Win over Women CNN

3 Questions We Need to Answer for Breast Cancer Awareness Month Chronicle of Philanthropy

The problem with National Breast Cancer Awareness Month Women's Health Magazine

Pink Ribbon Envy: Living with an Uncool Cancer The Nib

A Year After Bombings, Some Say 'Boston Strong' Has Gone Overboard NPR, All Things Considered

Canadian Mammogram Study KCRW, NPR Affiliate

Time to Debunk the Mammography Myth CNN

Breast Cancer: Awareness, Activism & Pinkwashing NPR Charlotte

Buying Pink Al Jazeera's The Stream Watch »

The Pink Backlash Orlando Sentinel

Why Jolie's Test Costs So Much CNN

Preventative Mastectomies: Disease and Deception BlogTalkRadio

Angelina Jolie and the 'Breast Cancer Gene' KCRW

Our Feel-Good War on Breast Cancer The New York Times Magazine.

The Story Behind the Pink Ribbon Campaign Sisters Talk Radio

WISH Interview Women's International Summit for Health

Making Cancer About The Patient, Not The Body Part CBS Pittsburgh

Sexy breast cancer campaigns anger many patients USA Today

The perils of pink The Daily

Komen pink campaign creates breast-cancer blues for some Dallas Morning News

A yellow flag for the NFL's pink New York Daily

Gayle Sulik named #7 in SharecareNow’s Top 10 Online Influencers in Breast Cancer

Breast cancer cancer causes so easily derailed Philly Inquirer

Komen Charity Under Microscope for Funding, Science Reuters

The Fight Against Cancer - And Abortion? Salon.com

Susan G. Komen For the Cure defunds Planned Parenthood. In Deep with Angie Coiro

Amid Breast Cancer Month, Is there Pink Fatigue? NPR's All Things Considered

How is Breast Cancer Culture Undermining Women's Health? America’s Radio News Network

Pink Ribbon Culture and Breast Cancer The Kojo Nnamdi Show

The Big Business of Breast Cancer
Marie Claire

Does Breast Cancer Awareness Month Crowd Out Other Diseases? Slate

Pink Inc. Has Many Starting to See Red The Sacramento Bee

Get Your Pink Off Ottawa Citizen

Komen Pink Ribbons Raise Green and Questions USA Today