dr. susan love's breast book, the physicians who provided breast cancer treatments were generally men. love said that some male physicians tended to impose their own values on women, such as recommending mastectomy to older women because, being past the age of child bearing and breastfeeding, they no longer "needed" their breasts. the women's health movement promoted mutual aid, self-help, networking, and an active, informed role in the patient's health care. since the end of the breast cancer wars, feminists have again objected to the breast cancer culture's treatment of women with breast cancer as little girls who need to be obedient to authority figures, cooperative, pleasant and pretty. achievements of the breast cancer movement social progress breast cancer has been known to educated women and caregivers throughout history, but modesty and horror at the consequences of a largely untreatable disease made it a taboo subject. the breast cancer movement, which developed in the 1980s and 1990s out of 20th century feminist movements and the women's health movement, has mostly removed those taboos through its modern advocacy and awareness campaigns. educated, empowered patients at the beginning and middle of the 20th century, breast cancer was usually discussed in hushed tones, as if it were shameful. as an example, the new york times refused to publish an advertisement for a breast cancer support group in the early 1950s, stating that it would not print either the word breast or the word cancer. later, however, several celebrities publicly disclosed their own health challenges, and the resulting publicity reduced the stigma. one of the first was shirley temple black, the former child star, who announced her diagnosis in 1972. in october 1974, betty ford, the wife of the then-president of the united states, openly discussed her breast cancer diagnosis and mastectomy. two weeks later, the wife of the then-vice president also had a mastectomy for breast cancer. the next year, journalist rose kushner published her book, breast cancer: a personal history and investigative report, which she had written while recovering from a modified radical mastectomy. more recently, angelina jolie has also come forward publicly regarding her experience surrounding her diagnosis and treatment, which managed to raise public awareness of the issue significantly. in one study, when a survey of women was taken following jolie's announcement, awareness rose by 4% among those women surveyed. the media reported these women's health and their treatment choices, and even invited some to appear on talk shows to discuss breast cancer frankly. the breast cancer movement has resulted in widespread acceptance of second opinions, the development of less invasive surgical procedures, the spread of support groups, and other advances in patient care. the movement successfully separated diagnostic biopsy from mastectomy surgery; before about 1980, it was common to perform the biopsy and, if a quick review of tissues indicated a probable need, a mastectomy in the same surgery. the one-step surgery prevented women from seeking different opinions about their treatment, and sent them into the surgery without knowing whether their breasts would be removed that day. in response to women's concerns over lymphedema after routine removal of lymph nodes during mastectomy, the more limited approach of sentinel node biopsy was developed. advocacy efforts also led to the formal recommendation against the routine use of the halsted radical mastectomy in favor of simple mastectomies and lumpectomies. the breast cancer movement has supported practical, educational, emotional, and financial care for women with breast cancer. support groups, individual counseling opportunities, and other resources are made available to patients. educational interventions using written material and brief one-to-one interaction about breast checking behaviour, breast cancer symptoms and age-related risk have the potential to increase breast cancer awareness in older women, over a sustained period of time. increased resources for treatment and research supporting breast cancer detection and treatment was seen as a distinctively pro-woman stance popular among public official. this has resulted in better access to care. for example, in much of the united states, low-income women with breast cancer may qualify for taxpayer-funded health care benefits, such as screening mammography, biopsies, or treatment, while women with the same income, but another form of cancer or a medical condition other than cancer, do not. breast cancer advocates have successfully increased the amount of public money being spent on cancer research and shifted the research focus away from other diseases and towards breast cancer. breast cancer advocates also raise millions of dollars for research into cures each year, although most of the funds they raise is spent on screening programs, education and treatment. most breast cancer research is funded by government agencies. the high level of awareness and organized political lobbying has resulted in a disproportionate level of funding and resources given to breast cancer research and care. favoring breast cancer with disproportionate research may have the unintended consequence of costing lives elsewhere. in 2001 uk mp ian gibson said, "the treatment has been skewed by the lobbying, there is no doubt about that. breast cancer sufferers get better treatment in terms of bed spaces, facilities and doctors and nurses". risks of over-awareness causes of death among women: breast cancer is the cause of death of 2% of women. source: who (2004) deaths from breast cancer (2%) deaths from heart disease or stroke (32%) deaths from other cancers (10%) other (56%) awareness has also led to increased anxiety for women. early detection efforts result in overdiagnosis of precancerous and cancerous tumors that would never risk the woman's life (about one-third of breast cancers diagnosed through screening programs), and result in her being subjected to invasive and sometimes dangerous radiological and surgical procedures. in recent years, the definition of breast cancer has expanded to include non-invasive, non-cancerous conditions like lobular carcinoma in situ (lcis) and pre-cancerous or "stage 0" conditions like ductal carcinoma in situ (dcis). despite the now-regretted decision to use the word carcinoma in these relatively common conditions (almost a quarter of "breast cancer" diagnoses in the us), they are not life-threatening cancers. women with these conditions are promoted as breast cancer survivors due to the fear they experienced before they became educated about their condition, rather than in respect of any real threat to their lives. this effectively increases the market size for breast cancer organizations, medical establishments, pharmaceutical manufacturers, and the makers of mammography equipment. women fear dying from breast cancer more than dying from heart disease, even though, as of 2006, eleven times as many women died from heart disease and stroke as from breast cancer. according to cardiologist lisa rosenbaum, this may be because women "view heart disease as the consequence of having done something bad, whereas to get breast cancer is to have something bad happen to you". an emphasis on educating women about lifestyle changes that may have a small impact on preventing breast cancer often makes women feel guilty if they do develop breast cancer. some women decide that their own cancer resulted from poor diet, lack of exercise, or other modifiable lifestyle factor, even though most cases of breast cancer are due to non-controllable factors, like genetics or naturally occurring background radiation. adopting such a belief may increase their sense of being in control of their fate. increased awareness inadvertently increases victim blaming. women who resist screening mammography or breast self-exams are subjected to social pressure, scare tactics, guilt, and threats from some physicians to terminate the relationship with the patient. similarly, the emphasis on early detection results in many women wrongly blaming themselves if their cancer is not detected at an early stage. the promotion of research to make screening programs find ever more cancers is also criticized. one-third of diagnosed breast cancers might recede on their own. in addition to efficiently finding most deadly cancers, screening programs also find most non-life-threatening, asymptomatic breast cancers and pre-cancers, and miss some fast growing, aggressive, dangerous cancers. according to h. gilbert welch of the dartmouth institute for health policy and clinical practice, "i'm certainly not asking anyone to stop getting mammograms. i am asking my profession to tell women the truth about overdiagnosis". welch said that research on screening mammography has taken the "brain-dead approach that says the best test is the one that finds the most cancers" rather than the one that finds dangerous cancers. clinicians have responded that they are unwilling to consider the possibility of leaving potential deadly cancers alone because it is "far-riskier" than the alternative. eric winer, director of the breast cancer program at dana-farber cancer institute in boston, says, "i don't know anyone who offers women the option of doing nothing". further complicating the issue of early diagnosis is the fact that it is currently impossible to distinguish malicious cancers from benign ones. otis brawley, a top official for the american cancer society, says that "even if we overdiagnose 1 in 5, we have numerous studies showing that by treating all these women, we save a bunch of lives". for instance, a 2011 cochrane review showed a sample of mammogram screening programs resulted in a 15% reduction in mortality rate despite over-diagnosis, indicating that mammography programs save lives regardless of over-diagnosis. conflicts of interest in organizations some critics say that breast cancer awareness has transformed the disease into a market-driven industry of survivorship and corporate sales pitches. corporate marketing machines promote early detection of breast cancer, while also opposing public health efforts, such as stricter environmental legislation, that might decrease the incidence rate of breast cancer. these critics believe that some of the breast cancer organizations, particularly the highly visible susan g. komen for the cure, have become captive companies that support and provide social capital to the breast cancer industry, including pharmaceutical companies, mammography equipment manufacturers, and pollution-causing industries, as well as large corporations, creating or exacerbating other problems. for example, ford motor company ran a "warriors in pink" promotion on their ford mustang sports car, which critics say was intended to sell cars and counter the bad publicity the company received by reducing its workforce by tens of thousands of people, causing many of them to lose their health insurance, rather than to prevent or cure breast cancer. a ford spokesperson acknowledged that the objective of the promotion was to "do good works throughout the community and derive some marketing exposure at the same time", but said that over the promotion's 15 years the company had donated $100 million and that the company continued the program during the automotive industry crisis of 2008–2010 because "it's part of our dna now." ford believes that the recipient of the funds, susan g. komen for the cure, benefited because ford helped it reach "people who might not have thought of this organization before or may be supporting other organizations". however, the primary sponsors are part of the breast cancer industry, particularly cancer drug makers like astrazeneca, bristol-myers squibb, and novartis. because the national breast cancer organizations are dependent on corporate sponsorships for survival, this situation may represent a conflict of interest that prevents these organizations from representing the needs of current and future people with breast cancer when those needs conflict with the profit-making motives of the corporate sponsors. the structure of the breast cancer movement may allow large organizations to claim to be the voice of women with breast cancer, while simultaneously ignoring their desires. some breast cancer organizations, such as breast cancer action, refuse to accept funds from medical or other companies they disapprove of. environmental breast cancer movement most of the money raised by advocates is spent on increasing awareness, cancer screening, and existing treatments. only a small fraction of the funds is spent on research, and less than 7% of the total research funding provided by breast cancer organizations goes to prevention. instead, most of the charities fund research into detection and treatment. advocates like breast cancer action and women's health issues scholar samantha king, whose book inspired the 2011 documentary pink ribbons, inc., are unhappy that relatively little money or attention is devoted to identifying the non-genetic causes of breast cancer or to preventing breast cancer from occurring. the mainstream breast cancer culture has been criticized for focusing on detecting and curing existing breast cancer cases, rather than on preventing future cases. as a result, screening mammography is promoted by the breast cancer culture