Looking at Key Ideas
“Mammography is a low-dose X-ray procedure that allows visualization of the internal structure of the breast. Mammography is highly accurate, but like most medical tests, it is not perfect. On average, mammography will detect about 80-90% of the breast cancers in women without symptoms.” (Maitra 175)
The key words presented by Maitra, et. al., are mammography, X-ray, perfect(ion), and cancer. These are the ideas scientists fixate on in the context of mammographic science, as well as within the context of radiological science. What is said here is plain: mammography is not perfect, but it has statistics for success in detecting one of the deadliest diseases to humans (cancer). Beyond that, however, are loaded rhetorical questions, including the effectiveness of the procedure, medical insurance coverage of the procedure, who gets to have the procedure done and whether radiological tests should be done on humans.
Looking through the scientific lens, the acknowledgement that mammography is a) a low-dose exposure to radiological systems and b) highly accurate speaks loudly to its purpose and the effectiveness of medical evolution. With an understanding that mammographies were not the first way doctors determined unusual developments in the breast, the statistics posed are a testament to medical success in its development. Rationally, this assumes that this advancement is positive: it has benefitted women who may have been unbeknownst to their breast cancer development until is was “too late” to treat it without a masectomy. Therefore, the development of the mammogram is necessary and increasing its accuracy is a necessitated goal due to the potential of eradicating later stages of this type of cancer.
From a humanist, and slightly more deconstructionist, view, the question of ethics in tampering with nature arises. Use of X-ray is not a natural occurrence whereas cancer development is part of life for the human species. Performing a test to “treat” a natural condition is violating the principles of evolution (or religion, depending on one’s view). Allowing doctors to scan women’s bodies for diseases is problematic in this case because it prohibits a natural cycle from fulfilling itself. Through this lens, using science to detect an ailment only inhibits people from living their lives fully. By stigmatizing cancer - which is clearly being done here because the development must be “detected” prior to other “symptom” development, connoting cancer with disease rather than natural development - doctors are using the human body for sheer exploration rather than focusing on the psychological impact this knowledge (as attached to a negative stigma) has on the person diagnosed with breast cancer.
It is in this debate that the larger picture forms. In a modern society with increased life expectancy and quality of life, it is the equivalent of a sin to not diagnose people with life-threatening diseases such as breast cancer in women (rationalist). In a society fixated on defining and discovering the problems in life, screening for ailments has a greater negative psychological impact than is being considered, causing those diagnosed - some of which are false negatives or positives - in the process to alter their perspective on life significantly due to a test (humanist).
“Mammography screening reduces breast cancer mortality for women aged 39 to 69 years; data are insufficient for older women. False-positive mammography results and additional imaging are common. No benefit has been shown for clinical breast examination or breast self-examination.” (Nelson 727)
Interestingly, Nelson, et. al., looked at women within a specific age range to determine the impacts of mammograms discussed. This contextualizes the argument significantly, limiting the scope of women potentially living with breast cancer and those who may continue to receive mammograms despite study suggestions. By expanding the recommended age to 39, the authors suggest that previous studies are wrong in their findings that women under 50 do not benefit as greatly from mammograms as those past that age - this also counters arguments posed by Maitra suggesting radiation exposure is linked to breast cancer development in the younger age group. Rhetorically, this effective in persuading women to look more closely at varied research because it notes statistics and data are still lacking and being developed. What this says about science is that it is always changing and evolving, suggesting potential paradigm shifts in the way medicine and preventative treatment is looked at in its weighing of costs and benefits.
Also of note from Nelson, et. al., is the use of "common" in describing false positives. Whereas studies like Maitra's indicate this phenomenon as over-diagnosis, these authors emphasize it as frequent. This implies protection of women who may have small abnormalities in their breast tissue or did not have a perfect screening the first go round. The blatant disregard for language alluding to over-diagnosis highlights a positive way of looking at these diagnoses, refracting attention away from potential (and determined) harms associated with such diagnoses.
The identification of clinical and self-examination as lacking benefit also points to a rhetorical reflection of possibilities to preventing breast cancer. By stating that there is no added good from these other procedures, Nelson, et. al., imply that mammography is the only scientifically proven way of detecting breast cancer early enough to reduce mortality rates (the most commonly noted goal of researchers in the field). Rhetorically, this appeals to logos: breast cancer starts small and must only be able to be seen in the tissue at its earliest stages; therefore, use of technology (mammograms) is necessary to prevent breast cancer development and related deaths. It is an inherent enthymeme that pulses through our society to insist that technology is the only and best (rational) answer to scientific problems. In this way, Nelson, et. al., sport a rationalist argument.