Betty Ford was determined not to keep her breast cancer a secret from the American public when she was diagnosed 50 years ago during her time as first lady. As she later remarkedlucky688, “One day I appeared to be fine, and the next day I was in the hospital for a mastectomy. It made me realize how many women in the country could be in the same situation.”
Mrs. Ford’s candor about her disease — and her subsequent treatment — was a momentous event at a time when breast and other cancers were shrouded in silence and shame. She received over 50,000 pieces of mail at the White House. But her cancer story was far from straightforward. Critics challenged Mrs. Ford, a renowned feminist, for allowing her treatment choices to be dictated by men. And while Mrs. Ford’s case became a clarion call for early detection of breast cancer, we know today that this strategy is not universally beneficial. As with many stories of celebrity illness, Mrs. Ford’s was inspirational but more complicated than usually told.
Mrs. Ford’s tumor, a lump in her right breast, was detected by her doctor during a routine physical examination on Sept. 26, 1974. She was 56 years old. The consulting surgeon at Bethesda Naval Hospital, William Fouty, recommended a traditional radical mastectomy — a disfiguring operation in which a surgeon removed the affected breast as well as the underarm lymph nodes and chest wall muscles on the side of the cancer.
A few renegade surgeons and some women with breast cancer had recently begun to question the logic behind this standard of care, arguing that for more localized cancers, smaller operations, especially ones that left the chest wall muscles in place, were equally good. The right to choose one’s own treatment was becoming a cause among a growing number of feminist breast cancer activists. Although Dr. Fouty mentioned the other options to Mrs. Ford, he also discouraged them. She believed him and later said that she did not seriously consider any alternative.
Upon learning this, one activist, the journalist Rose Kushner, called the White House to try to get Mrs. Ford to reconsider her invasive procedure. Ms. Kushner reached the presidential speechwriter Milton Friedman but intensely disliked his reply. “I am sorry,” he told her. “The president has made his decision.” The fact that the choice was conveyed as the president’s infuriated Ms. Kushner. Incidentally, two days after Mrs. Ford’s surgery, a seminar was held at the nearby National Cancer Institute in which early data from a clinical trial comparing radical mastectomy and a smaller operation for early-stage breast cancer revealed that there was no difference in patient outcomes.
As far as her diagnosis went, Mrs. Ford’s case was not an example of the benefits of finding cancer early. Her tumor was found incidentally on a physical examination, not from a mammogram, and the cancer had already spread to her lymph nodes. Mrs. Ford probably survived her cancer (she died in 2011 at age 93) because she received an early version of chemotherapy.
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