An epidemiology of women's lives: the environmental risk of breast cancer

Abstract

The dominant discourses of breast cancer risk are individualistic and biological, tending to emphasize personal life history, genetic predisposition and ‘lifestyle’ factors. Statutory programmes to reduce risk are correspondingly concerned primarily with early detection, and not with primary prevention of a disease whose incidence rate continues to rise in the UK and the USA. Against this, the breast cancer movement is working to emphasize the collective narrative of breast cancer aetiology, applying an ecological approach to public health protection, and basing its demands on a precautionary approach to environmental hazards. This paper considers how the breast cancer/environment movement in the US and UK asserts the legitimacy of activists’ alternative expertise, and challenges the biomedical foundation of traditional epidemiological practices. Activists’ knowledge claims are, additionally, understood as embodied, lay expertise, predicated in feminist epistemology which has argued that the personal, the subjective and the partial count, and that such situated knowledge makes for stronger science. These dimensions of the breast cancer/environment movement shape what is here termed ‘citizen expertise’, as activists present a ‘transformational vision’ of the physical, political, social and economic environments that currently contribute to breast cancer.