Allison Bland: Final Project

Mammography and Breast Self Examination in Context
Mammography and self breast examination raise questions about how women mediate their health with medical technologies. To what degree do these diagnostic technologies make women active participants in their health? To what degree are women further excluded from knowledge of their bodies? The dramatic conflicts between the medical community, the advocacy community, and medical researchers places mammography and breast self examination in multiple frames of reference for women. The decades long negotiations to form a consensus in these communities about the validity, frequency, and necessity of these technologies has possibly served to obscure their purpose and utility for women.

By offering a means of detection at the early stages of breast cancer, mammography gave women the opportunity to play a more direct role in their treatment. However, while mammography placed breast cancer detection in the clinical setting, breast self examination was a more democratic technology in that it did not prevent access based on the cost of a doctor’s visit.

The use of early diagnostic tools is centered on a rhetoric of “control”: control of one’s body and health and control of the spread of cancer. Early cancer awareness materials stressed the importance of breast self examination as a means of controlling knowledge of one’s body and the success of stopping cancer in its tracks thanks to early detection.

Mammography also played a role in the breast cancer advocacy that became a powerful voice in the 1990s. Breast cancer advocates pushed for mammography to be covered by insurance companies, lobbying state legislatures to support their cause. Advocates also rallied around the issue of necessary mammograms, which could lead to unnecessary biopsies, fighting the National Cancer Institute and American Cancer Society on their recommendation for mammography for pre-menopausal women.

Comments for Allison:
[insert your comments here…]
JA: Have you tried the National Library of Medicine for sources?

mammo.jpg

Abstract (one paragraph):

My paper will focus on the history of mammography and breast self examination as technologies mediated by culture and ideology. Mammography, a diagnostic imaging tool used for early detection of breast cancer, emerged as a source of authority at the time of the women’s health movement. I am interested in how this technique stood in relation to breast self examination in the context of the women’s health movement, which privileged women’s knowledge of their bodies and health. I will set these techniques against one another, exploring the dynamic that emerged between them as tools of early diagnosis, particularly the “controversy” discourse, in which each technique has been criticized at various points in its history for its value and validity. A main theme in my research will be authority: of images, of technicians, of science, and of self.
Primary sources: briefly describe the primary sources you are using. For example, names of scientific journals, archival collections, popular media coverage, government contracts, interviews, etc.

Annotated bibliography: Briefly describe your most important secondary sources. As you read through them, update the description to create a one-paragraph review of the strengths and weaknesses of this source (from your own perspective).

Egan, Robert L. 1967. The Technical Aspects of Mammography. CA: A Cancer Journal for Clinicians 17: 21-29.

Gardner, Kirsten E. 2006. Early Detection: Women, Cancer, & Awareness Campaigns in the Twentieth-century United States. Chapel Hill: University of North Carolina Press.
This book looks at civilian knowledge of cancer as a phenomenon that came before widespread activism and interest groups.

Gladwell, Malcolm. 2004. The Picture Problem: Mammography, air power, and the limits of looking. The New Yorker, December 13.
This article discusses the expectations we place in images, and how mammography is one example of the ambiguity of this trust in the photographic image.

Joyce, Kelly. 2005. Appealing images: Magnetic resonance imaging and the production of authoritative knowledge. Social Studies of Science 35(3): 437-462.
This article shows how medical images stand in relation to the body and their status as a source of authority.

Lerner, Barron H. 2005. The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America. Oxford: Oxford University Press.
Lerner’s research contributes a great deal to the goals of my paper. This book describes the history of actors in the fight against breast cancer, which is useful to me in that he includes physicians, technicians, and women with the disease in his account.
- 2003. “To see today with the eyes of tomorrow": A history of screening mammography. Canadian Bulletin of Medical History 20 (2): 299-321.
This article examines the social and political history of mammography, rather than as a story of medicine and technology.
- 2002. When statistics provide unsatisfying answers: revisiting the breast self-examination controversy. CMAJ 166 (2).
This article responds to a report questioning the value of BSE, exploring the issue from the side of scientific evidence and women’s self-knowledge. A discussion of both sides of this controversy will be useful to my paper.

Olson, James S. 2005. Bathsheba's Breast: Women, Cancer, and History. Baltimore: Johns Hopkins University Press.
This book discusses the history of mammography within the context of the history of breast cancer.

Shapiro, S., Philip Strax, and Louis Venet. 1966. Evaluation of periodic breast cancer screening with mammography: methodology and early observations. JAMA 195 (9): 731-738.
This article is considered the source of results that gave mammography the authority it has as a diagnostic tool.

Treichler, Paula A., Lisa Cartwright and Constance Penley. 1998. The Visible Woman. New York: NYU Press.
This book uses medical images to explore how technology has played a role in constructing the female body. It will be useful in tying together gender and technology for my paper.

Research obstacles? Briefly note any obstacles you have encountered in terms of finding sources, interpreting data, narrowing or broadening your topic, etc., or any other areas in which you would like help from your peers. We will brainstorm solutions in class and/or in comments on this page.

For primary sources, I will be looking at old guides for breast self examination and mammography. These guides include some images, but if anyone knows where I could find more old mammography images or breast self examination images, that would be helpful.

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