Peggy Orenstein & “Our Feel-Good-War on Breast Cancer”

In full disclosure, this was a class assignment. Yet the article I had to analyze was so well- written and argued that I thought someone might enjoy reading my response. I’m hoping to pursue a degree in medical anthropology in grad school someday, so these are the kinds of things–biomedicine, biotechnology, health movements, the “dark side” of the medical industry–that interest me. 

Dear Editor Lindgren,

I recently encountered Peggy Orenstein’s article “Our Feel-Good-War on Breast Cancer” in the pages of your magazine. As I read through the article, I found myself nodding vigorously in agreement. I have always been skeptical of the “Go Pink” campaign in its many iterations, but was unable to articulate my unease.

Orenstein does an admirable job of explaining the consequences of a breast cancer health movement whose primary focus is awareness. Women in the United States are indisputably more aware of the purported importance of screenings and mammograms, as well as breast  cancer itself. Yet this knowledge has not translated into empowerment or even a meaningful reduction in death rates. Instead, Orenstein argues that the deleterious effect of this awareness movement has been scaring women of all ages into viewing breast cancer as  something inevitable and perceiving their breasts as little more than potential harbors of  cancer.

In her book The Vulnerable Empowered Woman, Dubriwny unfortunately discovers that many contemporary public health campaigns—from “Go Red” to genetic testing for the BRCA2 gene—have similar negative outcomes. Arguing that “visibility comes at the cost  of…potential political implications,” Dubriwny demonstrates that being overinformed is just as dangerous as being underinformed. Thus the compelling example Orenstein that offers of a woman who was diagnosed with fibrocystic breast disease in her mid-30s, had four breast surgeries and recurring cases of “early cancer,” before finally undergoing a double mastectomy. Feminist and political empowerment are absent from this scenario, and  biomedicine and mammograms play a central role. As Dubriwny puts it, such a narrow focus parallels a shift away from consideration of “more complicated social factors” that may lead to chronic disease. The result is an apolitical movement that does more to frighten its  followers than inspire them to push for change.

While Orenstein offers a provisional explanation for the popularity of the “Go Pink!” movement, she does not consider the importance of the commodification of health. Instead, she argues that the preoccupation with targeting women early is linked to a cultural fear of death. This is certainly likely, but there are more malevolent forces at work.

Consider another recent example that emerged from the domain of women’s health: Sarafem. This pink and lavender tablet was ostensibly introduced in the early 2000s, though in reality it is a re-branded version of Prozac, an antidepressant discovered by a large pharmaceutical company in 1974. With the patent on Prozac set to expire in 2001, the makers of the drug were eager to offset a drop in profits and embarked on a lengthy marketing campaign. This campaign was targeted toward women who suffered from a controversial illness known as premenstrual dysphoric disorder (PMDD). Sarafem was magically introduced as the unique drug suitable to treat PMDD. Greenslit has unpacked the economic motivations behind the launch of Sarafem, and has argued that “the development of drug treatments for PMDD is simultaneously thedecision that PMDD exists.” In other words, what might have previously been considered a normal course of PMS had been pathologized by a pharmaceutical company in order to boost profits and extend the life of a lucrative drug.

Cynical as I am, I cannot help but view the push for women to receive mammograms with greater regularity and at an increasingly younger age as an outgrowth of the  commodification of health—and specifically, the rise of biomedical interventions targeted toward an increasingly pathologized female body. Who, exactly, profits from all of these mammograms? Orenstein does not discuss the cost of this diagnostic assessment in her article, but it is clear that early screenings do carry an economic boost for the hospitals in question. While mammograms are typically covered by insurance for women over the age of 40, the push for women to begin getting screened in their 30s and even earlier extends the length of time that the medical industry can profit off of one woman’s preoccupation with breast cancer. An uninsured mammogram can cost several hundred dollars out-of-pocket; so again, who is being targeted, and who is being left out?

This is not to mention the awesome growth of nonprofit and research agencies dedicated to breast cancer detection and treatment. Orenstein seems stunned by the $472 million that the Susan G. Komen foundation raised in 2011. This nonprofit, which has been one of, if  not the most vocal advocate of earlier breast cancer screenings, is responsible for the employment of thousands and plays a powerful national role. The clarion call for mammograms has, in other words, spawned an entire nonprofit industry. Once established, these behemoths, with their focus on awareness, become more and more difficult to contradict—even if the messages they promulgate ultimately do more harm than good.

Orenstein has doubtless begun an earnest and necessary conversation. But examining why movements such as “Go Pink!” and “Go Red!” are so popular will require an assessment of the underlying political, social, and economic forces at work.

Thank you for your time and consideration.

Works Referenced

Dubriwny, Tasha. The Vulnerable Empowered Woman: Feminism, Postfeminism, and Women’s Health. New Brunswick: Rutgers University Press, 2013.

Greenslit, Nathan. “Depression and Consumption: Psychopharmaceuticals, Branding, and New Identity Practices.” Culture, Medicine and Psychiatry 29: 477-501, 2005.

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