This is an article about breast cancer—but you should read it anyway. Because the news isn't bad, far from it: More than 232,000 American women will be diagnosed with the disease this year, and the American Cancer Society estimates that nearly 90 percent of patients will survive to the all-important five-year mark, thanks to treatment methods that are improving all the time and public-awareness campaigns that have made early diagnosis of breast cancer the norm rather than the exception. New tools, like genetic testing, and laws to enhance and expand screening are empowering women to make decisions, whether bold or by the book, about their health and quality of life. The debate now is over how much we really need to know about our cancer risk—and if, perhaps, we're being too vigilant and too aggressive about treatment. As with so many conversations about health, the best way to start is by asking the right questions.
It's the mantra of all medicine: The sooner you find a problem, the better. While doctors once taught their patients to conduct multistep self-exams to discover small lumps in their breasts (an education effort that didn't actually improve outcomes, according to recent analysis), today's high-tech imaging devices pick up microscopic changes in breast tissue, allowing treatment to begin before a tumor is even a lump.
Yet there's another maxim that also rings true these days: Too much of a good thing can be bad for you. Even as diagnosis and treatment have steadily improved, breast cancer has become a disease of plenty—plenty of expensive tests, plenty of new and confusing information, and plenty of people sharing their emotional, and scary, stories. "We're overdiagnosing, overtreating, and inadvertently frightening people into doing things they perhaps don't need to do," says Laura Esserman, a breast-cancer surgeon and the director of the Carol Frank Buck Breast Care Center at the University of California, San Francisco (UCSF).