Working from the inside out: implications of breast cancer activism for biomedical policies and practices.

Much has been written about women with breast cancer: about women's lifestyles and reproductive strategies as possible risk factors for the disease, factors which impede or facilitate women's participation in mammography screening, ways to involve women in treatment decision-making, and women's ability to cope with breast cancer diagnoses. Seldom do these accounts examine breast cancer from the perspective of women with the disease. This essay presents material from an ethnographic study in the United States to explore the ways that women have come forward as informed consumers and activists working to make biomedical practices more responsive to the needs of women with breast cancer. Insofar as breast cancer activists reflect the concerns of a predominantly white, middle class constituency, however, additional questions are raised concerning their constructions of breast cancer and the problematics of treatment.