The Big Squeeze: A Social and Political History of the Controversial Mammogram

Abstract

[Excerpt] The Big Squeeze: A Social and Political History of the Controversial Mammogram chronicles the often turbulent history of screening mammography since its introduction in the early 1970s. This book makes five key points. First, it shows how pivotal decisions during mammography's initial roll-out made it all but inevitable that the test would never be far from controversy. Second, it describes how, at several key points in its history, the establishment of a culture of mammography screening was greatly aided by concurrent social and political forces and movements. Third, it illustrates how politics came to dominate the debate, eventually achieving primacy over science itself. Fourth, The Big Squeeze describes the collateral economy that developed around screening. As mammography was aggressively promoted in the late 1980s to early 1990s, utilization rates rapidly increased. As this occurred, the mundane mammogram became the little pink engine that could, and did, drive the growth of a vast screening-dependent secondary economy. Finally, mammography's burden, overdiagnosis, is considered in the last chapter. Overdiagnosis, the screening detection of cancers that would never otherwise have come to light in the individual's lifetime, is an important yet woefully underdiscussed risk of mammography. This phenomenon is more significant than that, however. Overdiagnosis helped make fighting breast cancer the most favored disease cause and mammography the most favored weapon in the fight.