The Big Squeeze: A Social and Political History of the Controversial Mammogram(The Culture and Politics of Health Care Work)

In 2009, an influential panel of medical experts ignited a controversy when they recommended that most women should not begin routine mammograms to screen for breast cancer until the age of fifty, reversing guidelines they had issued just seven years before when they recommended forty as the optimal age to start getting mammograms. While some praised the new recommendation as sensible given the smaller benefit women under fifty derive from mammography, many women's groups, health care advocates, and individual women saw the guidelines as privileging financial considerations over women's health and a setback to decades-long efforts to reduce the mortality rate of breast cancer. In The Big Squeeze, Dr. Handel Reynolds, a practicing radiologist, notes that this episode was only the most recent controversy in the turbulent history of mammography since its introduction in the early 1970s. In a book written for the millions of women who face the decision about whether to get a mammogram, health professionals interested in cancer screening, and public health policymakers, Reynolds shows how pivotal decisions made during mammography's initial launch made it all but inevitable that the test would be contentious. He describes how, at several key points in its history, the emphasis on mammography screening as a fundamental aspect of women's preventive health care coincided with social and political developments, from the women's movement in the early 1970s to breast cancer activism in the 1980s and '90s. At the same time, aggressive promotion of mammography made the screening tool the cornerstone of a huge new industry. Taking a balanced approach to this much-disputed issue, Reynolds addresses both the benefits and risks of mammography, charting debates, for example, that have weighed the early detection of aggressively malignant tumors against unnecessary treatments resulting from the identification of slow-growing and non-life-threatening cancers. The Big Squeeze, ultimately, helps to evaluate the ongoing public health controversies surrounding mammography and provides a clear understanding of how mammography achieved its current primacy in cancer screening.

Table of Contents:
Introduction: The Mammography Story1. Timing Is Everything2. First Exposure3. The Aftermath4. A Tale of Two Epidemics5. Age Is Nothing but a Number6. Pulling the Plug on Granny7. The House that Mammography Built8. Overdiagnosis: Mammography's BurdenNotes Index

About the Author :
The late Handel Reynolds MD was a breast radiologist in private practice in Atlanta, Georgia and former Chief of Breast Radiology at Indiana University.

Review :
The Big Squeeze gives a short and interesting view of the social and political history of mammography.... Reynolds... retells the so-called truth of mammography screening, and he gives a balanced view. He devotes a whole chapter to overdiagnosis, the major harm of mammography screening.... I enjoyed reading this book and would highly recommend it to everybody. - Mette Kalager (The Lancet Oncology) Does mammography reduce mortality from breast cancer,and if so, to what degree?... Do benefits of mammography exceed the potential harms? Why and how did the debate shift from a scientific to a political one? The Big Squeeze provides answers to these questions by taking readers on a fascinating and enlightening 50-year journey.... Providing a balanced, objective, in-depth discussion of all aspects of screening mammography, The Big Squeeze will not only be an educational asset for physicians but a book they can feel comfortable in recommending to their patients as well. - Leonard BerlinMD (Journal of the American Medical Association) This book is a quiet call for a more frank discussion of what an 'indispensable tool' mammography is in the fight against breast cancer.... Reynolds takes a critical look at the 'breast cancer epidemic'; the ever-shifting guidelines regarding the age at which women should be screened; confusing interpretations of results; the role of breast cancer activists in promoting mammograms; and the profitable industry that has grown up around mammography.... 'Women need complete and accurate information regarding the risks and benefits,' Reynolds asserts—and this brief, clear volume can be the first step in achieving that goal. (Publishers Weekly)