Her Sister's Keeper

by Judith Warner
Photograph: Photo: Dean Kaufman

Brinker’s new focus involves bringing the Race for the Cure to new nations, partnering with local organizations and serving as the World Health Organization’s Goodwill Ambassador for Cancer Control. She is writing an autobiography, to be released in September. And she is participating in one-on-one efforts to support vulnerable women, visiting, for example, clinics and hospices in India. (At one she met a young woman whose cancer was so advanced that it was visible through her chest and whose overwhelming worry was that she was putting her husband at risk of contagion.) Famously, in October 2009 she brought world attention to her advocacy work with the Egyptian government by lighting the Giza pyramids pink the night before the country’s first-ever Race for the Cure.

Of course, she continues to push hard on problems in the United States, where, she says, there are huge discrepancies in the quality of care received by women at different ends of the socioeconomic spectrum. Despite real advances in the treatment of breast cancer—“When Suzy was diagnosed,” she says, “the five-year survival rate for cancer before it spread from the breast was 74 percent; today that number is 98 percent”—the more things change, the more intolerable it is for her to see that for some women they remain depressingly the same. A few years ago, the Komen home organization in Dallas began to survey women in communities that had the highest mortality rates from breast cancer, and from those results it has initiated programs aimed at delivering targeted services where needs are greatest. In Appalachia, for example, Komen pays for a bus to take women to facilities where they can have mammograms. In Washington, D.C., Komen funded a project aimed at getting faster care for low-income and minority women.

Brinker’s sense of mission has also been inflamed by recommendations issued last fall by an influential panel of government-appointed experts who, breaking with years of accepted medical practice, changed their position advocating regular mammograms for women over 40, instead recommending that routine screening occur only every two years, beginning at 50. The statement—by the U.S. Preventive Services Task Force, a group that carries great weight with doctors, health insurers and legislators—has led Komen to redouble its political advocacy efforts and fight lawmakers in states that may use the guidelines as justification for budget cuts in breast cancer–screening services. “All these fragile people you were able to educate and get them focused on their bodies and show them there’s something they can do . . . and then you get something like that clumsy announcement about changing screening procedures,” Brinker laments. “To me, it’s a crime what’s going on here.”

Brinker’s continued support for annual screening mammograms starting at 40 has put her at odds with a number of other leaders in the breast-cancer advocacy movement, who over the years have arrived at the position that annual mammograms for women in their forties expose them to unnecessary radiation and unneeded treatments. “This is our opportunity to look beyond emotions,” Fran Visco, president of the National Breast Cancer Coalition, said of the new recommendations in November 2009, telling the New York Times that the “independent” and “objective” panel was “the people we should be listening to when it comes to public health messages.”

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