Contemporary attempts to predict and manage the ethical, legal, and social consequences of the new genetic knowledge have generally framed the issues as novel ones, separate from the historical context of particular diseases and of earlier technological innovation. This project will trace the history of ideas and practices and especially controversies surrounding breast cancer risk in this century. It will place the seemingly novel issues raised by the genetics revolution in the historical context of earlier ideas and developments in breast cancer, screening, and prevention. The project is focused on the ways in which two diagnostic technologies screening mammography and genetic testing emerged, diffused, interacted with medical and social thought and values, and provoked controversy. The central research questions are: What are the factors that have led to the dramatic shift in beliefs about, and practices surrounding, breast cancer risk over the past fifty years? What have been the consequences? The investigator will focus on key comparisons, transitions, and developments in the history of breast cancer risk which have produced visible, significant, and stable social responses. They will collect and examine a broad range of primary and secondary material that might yield clues to the changing perception of breast risk and its consequences. This project's underlying hypothesis is that the contemporary controversies over the proper ways to incorporate genetic testing in clinical practice, establish the meaning of genetic information, conduct research with human subjects, and protect the privacy of individuals undergoing or contemplating genetic testing are largely the result of unresolved conflicts among competing values and interests (in addition to the more evident problem of scientific uncertainty). One goal of this historical project is to make these conflicting values and interests explicit, and thus allow them to be debated and resolved. The investigator predicts that the project will contribute to better integration of genetic knowledge in clinical and public health practices.
| Aronowitz, R A (2001) Do not delay: breast cancer and time, 1900-1970. Milbank Q 79:355-86, III |
