President Jimmy Carter and Early Breast Cancer Detection, an Untold Personal Story
Dear President Carter, 13 November 2017
Shortly after your Inauguration in 1977, you took notice of events that led ultimately to a life-saving technology for women, known as Mammacare. I have here briefly summarized what followed so that you may take some joy knowing that your personal initiative was a signal event advancing science and leading to a safe, universally available method of early breast cancer detection for all women.
In the mid 1970’s at the Gainesville, Florida VA Medical Center, a team of medical scientists and engineers were tasked by NCI to find a safe, universally available method to detect early breast cancer. We gathered a team to quantify the sensitivity of tactile mechanoreceptors in fingers and found that women and clinicians could reliably detect, by hand, very small lesions in breast models and in women after a brief training interval and practice. It was also apparent from the results of our basic studies that the tactile receptors in fingers can accurately and reliably discriminate small, (<=3mm) suspicious tumors from normally lumpy breast tissue. Colleagues at the National Cancer Institute had encouraged us to proceed with the work although when we sought the support of HEW in 1976 to validate and refine the findings, we were discouraged.
Soon thereafter, a colleague of yours from Plains Georgia visited our lab and insisted on personally letting you know about the research, an event that was rapidly followed by a letter from HEW. As you might imagine, a series of conflicting explanations emerged from Washington about why the research, previously set aside by our government was “now” considered worthy of support. A small research grant was then awarded although the greatest source of inspiration for the team was knowing that there was intelligent, caring life in the Oval Office.
In the years that followed many studies of our work now known as Mammacare have confirmed its effectiveness, and a recent, massive Canadian national study of 89,000 women over 25 years, demonstrated conclusively that the hands of trained nurses work as well as x-ray mammograms. Curiously, here in the US, a highly influential federal agency recommends against teaching women how to perform breast self-exams, although, without reservation, Mammacare continues the mission of teaching the skill to nurses, physicians and to women so they can all competently perform the free, safe potentially life-saving exam.
As a fellow former Naval Officer who holds you in the highest esteem, please accept this long delayed, but never forgotten, gratitude for your service to our country and contribution to women who are unaware that they continue to benefit from your remarkable intervention in this matter.
Mark Kane Goldstein, Ph.D.
Senior Scientist and Director