- The Washington Times - Tuesday, July 21, 2009

A seemingly harmless breast cancer awareness bill is proving once again that, in Congress, few things are as simple as they appear.

The bill, intended to fund a public education campaign and research on breast cancer in women younger than 45, was introduced four months ago at an emotional news conference sponsored by Sen. Amy Klobuchar, Minnesota Democrat, and Democratic Rep. Debbie Wasserman Schultz of Florida. The latter recently had waged her own battle with the disease at age 42.

But it wasn’t long before the proposal sparked a raging debate among advocacy groups about the effectiveness of teaching women ages 15 to 45 about the disease, given the scant science surrounding breast cancer in young women and their low risk of contracting it.

Several mainstream cancer organizations have said that such an awareness campaign, if not properly designed, could do more harm than good.

“There’s just no evidence to indicate that such a campaign would result in less breast cancer or fewer deaths from breast cancer,” said Dick Woodruff, director of federal relations for the American Cancer Society’s Cancer Action Network. “But there are serious concerns that it will lead to a lot of unnecessary anxiety.”

In Washington, it’s not an uncommon story - especially when politics bumps up against a medical dispute.

“With every piece of legislation … there’s always controversy,” Ms. Klobuchar said.

The bill would, among other things, fund a public campaign run by the Centers for Disease Control and Prevention (CDC) to teach young women how to detect and prevent breast cancer. It would encourage clinical and self-exams, more genetic counseling and lifestyle changes to reduce the risk of breast cancer.

The American Cancer Society is officially neutral on the bill, though its chief medical officer warned in a letter to a volunteer that it “can actually cause harm” if written incorrectly.

Some say that too much anxiety resulting from such a campaign, along with excessive screening in young women, could result in a lot of false positives and unnecessary biopsies - an invasive procedure to determine whether a growth is malignant.

Others fear that the bill could lead to unwarranted and drastic preventive measures.

The debate over the education campaign highlights how little is known about breast cancer in younger women.

Though the stakes are relatively small - the bill would allocate $36 million over four years for a variety of initiatives - advocates say they don’t want to go down this path without the right information.

National Breast Cancer Coalition officials have voiced concerns, writing that the “messaging about what to do about this disease raises exceedingly complex questions, many of which we do not yet have answers to.”

But Ms. Klobuchar said in an interview that people should have more faith that doctors won’t perform unnecessary surgery and that the CDC will stick to the facts to educate people about the disease.

“I think what will really happen is, it will be targeted education in groups that are more likely to get it,” she said, referring specifically to blacks and Ashkenazi Jews such as Mrs. Wasserman Schultz, who are advised to get screened at an earlier age.

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