The breast cancer controversy. A natural experiment.

The number and types of breast lesions treated surgically at the Flower and Fifth Avenue Hospitals during the period from November 1974 through February 1976, increased sharply in monthly incidence as compared with the period from January 1973 through October 1974. This increase was attributable to public awareness of breast cancer because of the publicity given to its occurrence in the wives of the President and Vice-President. However, the consequent increase in mammography and breast surgery was not accompanied by any improvement in the stage characteristics of the breast cancers treated. The proportion of prognostically unfavorable stage II cases with involvement of four or more axillary nodes was undiminished, while the proportion of stage 0 and stage I cases was not increased among breast cancers diagnosed since Nov 1, 1974.