Breast screening and the individual: there’s no such thing as a purely personal decision.

But they should, if they haven’t. 

 

Anthropology is the study of what makes us human – biology, a touch of evolution, (Dulux colour card, next to 'primeval soup’) a bit of tool use and then family, culture and kinship, the kind of thing that binds us all together or tears us all apart.

 

Sociology studies industrialised societies in particular and the way human activity is organised within them e.g. employee/employer relations, distribution of money and power, lay versus expert understanding or how groups are formed and organised. These could be armed forces, football supporters, political parties or those pernicious class and gender structures. To that heap (not a sociological concept but the collective noun for them is beyond me) I’m adding the breast cancer lobby, which must have been up to something majorly sociological (see – no real grip of the subject) in how women are socialised into thinking in a special way about breast cancer and, as a sub set of that, breast screening.

 

The breast cancer lobby express their human side by creating pseudo kinship structures, through common experience and searching for shared meanings which aids recruitment of members. Then there are small p-political and big P-Political structures to recruit allies. Members have special knowledge and experience. Allies support and reinforce members in this.

 

There are taboos. Women with breast cancer and the charities who represent them a special status and protection from criticism. Breasts are certainly fetishised ‘objects’. So is cancer. And so is breast screening. A triple whammy of ‘special’ power. Lob in ‘how to be female’ and there’s even more special attributes of power, constructed  kinship, group membership and expected behaviour in the mix.

 

Breast screening is so special it can alter the course of the future, though if anyone is following the debate in the medical literature it’s pretty difficult to see where exactly the balance of opinion lies and to what extent women’s futures are changed in either positive and negative ways by breast screening.

 

I’ve been wondering about my own behaviour and thinking in relation to breast screening, after I took what seemed, and still seems, to me, to be the entirely rational decision not to undergo breast screening when offered my first appointment earlier this year. This was a personal decision (can’t call it private as I blogged about it) based on my understanding of the supposed public health benefits, the ropey explanation of risks – that deficiency itself a sociological phenomenon – and a bit of fuzzy logic to make it all apply to me as an individual.  

 

I realise I’m happy to mention my non-screened status or discuss it with most friends but I get very edgy when around other friends who have breast cancer or whose mothers or sisters do – and I still have that edginess posting this. So my decision against screening, whilst entirely mine in one sense, also has a meaning that I evidently feel extends far beyond me.

 

I don’t fit my group. Or I fit in some other group, but I don’t know what it is.

 

Breast cancer is thrust upon women who have it and I seem to be thumbing my nose at it, pushing it and them away, with what may look like posturing, risk taking behaviour. Maybe I seem as if I am relishing being free to do as I please, or I’m taunting them with it. There’s a meme, spread by all breast cancer case studies ‘I’m telling my story so other women don’t have to go through what I went through’, which always ends up with the women advising all of us to go for screening. And I am apparently responding. ‘Well, nope, thanks, but breast cancer is your problem, not mine.’

 

I don’t feel I’m taking a cavalier attitude to my health or their experience. But they might. To me the benefits were unclear and the risks more concerning so, for me, the decision to go for screening could have been the cavalier one. I’ve had jolts of feeling as if I’m rubbing some other women’s noses in it or I’m a gender traitor for not taking up an option that women campaigned for, or that I’m not understanding how to be a real woman.

 

I own my edginess. I know what I’m ‘supposed’ to do. But underpinning this is, I think, my failure to agree with placing breast cancer where I’m told in the ranking of the 'thing' most likely to get me or the 'thing' women fear. My assessment of my healthy life still has breast cancer in there, but it is along with and also behind several other possible unhappy ends.

 

Breast cancer doesn’t feel more ‘my’ cause than any of the others which have swept several women from my life, and from their's, either prematurely or at great age.

 

Maybe that is the source of my sneaky unease. I’m sure about my own reasoning but worried about it too, as it feels wrong. It transgresses the construct – the triad of breast cancer, screening and being a women – though my feelings aren’t ambiguous enough for me, it seems, to risk a breast screening appointment and restore the status quo.

 

I was juggling and continue to juggle with more than just medical facts. 

 

So I wonder if other women do the same but make a different choice? For some women, going for breast screening may have almost nothing to with their own health, or understanding of cancer but is instead a gesture of solidarity – so breast screening is not about them at all but is a way of proving their breast cancer awareness or commitment to the cause, securing their status as a woman ‘against’ breast cancer.

 

Could breast screening be the equivalent of a signature on a pledge, rather than going for a health appointment? Is that one of the subconscious reasons why campaigning breast cancer charities remain so positive about it, 'urging' (their word, not mine) women to go? Breast screening has got away from them. It is now a key 'Call to Action' and it is nearly impossible to contemplate discussing the risks properly if the result is women may be less inclined to go. This would hurt women with breast cancer, who will continue, one feels, to lead the charge in favour of it. 

 

There is no such thing as a purely personal decision for, or against, breast screening. Either action has implications and meanings which go far wider.