Out the picture window above her desk on the UCLA campus, where she runs one of the largest and most ambitious breast centers in the country, the undulating ridgeline of the Bel-Air hills strikes Dr. Susan Love as looking like nothing so much as, well, breasts.
Love has become, in the past few years, the country's best-known advocate for the breast--a nationally known surgeon, author and inspired rabble-rouser in the accelerating grass-roots movement aimed at training more federal attention and money on understanding and preventing breast cancer.
The disease will strike 200,000 women in the United States this year. Some 47,000 will die from it. The overall rate of death has remained unchanged for decades, while the incidence has marched upward. If all women lived to age 85, a whopping one in nine would currently come down with breast cancer.
In 1990, Love co-founded the National Breast Cancer Coalition, a federation, now, of more than 180 support and advocacy groups demanding more money for breast-cancer research, a say in the direction of that research and a coordinated national strategy for research, prevention and treatment.
Since then, federal funding has jumped sharply--by Love's count, fourfold. And in October, President Bill Clinton announced that the Administration would develop a national action plan for breast cancer. Later this month, Love will co-chair a meeting in Washington to lay the groundwork for the plan.
Love, 45, hardly fits the surgeon stereotype. Tight brown curls frame an accessible, humorous face. Dressed in navy-blue slacks, a white lab coat and pearls, she sat through much of an hour-long interview at the UCLA Breast Center last week, elbows on knees, chin resting in palms, totally engaged.
On one lapel of her lab coat was pinned a button that reads, "Keep abreast. Get a second opinion." Behind her on the windowsill was a framed photograph of Love and Helen Cooksey, who has been her partner for 11 years, and their five-year-old daughter, Katie.
Question: \o7 To what extent is our ignorance about breast cancer traceable to the fact that it's a women's disease?\f7
Answer: It's a combination of things. For one, breast cancer is difficult to figure out. We know something causes breast cancer but we don't know what it is. Could it be environmental, a virus, hormones? We don't know.
But another aspect, of course, is that it's a women's disease. I don't think the researchers are misogynists; I think if you're sitting there with a small pot of money, you will spend it on what you fear. And if you're a middle-aged white male, it's more likely to go to heart disease than breast cancer . . . . The reason we don't know more about breast cancer is that the people making the decisions didn't care enough about finding out those answers.
Q: \o7 What should determine how much federal research money goes to a disease? How many people it kills? How little is known about it? Who lobbies loudest?\f7
A: How much is known about it is obviously important. More women die of lung cancer, but we know how to eliminate the vast majority of lung cancers. Whereas breast cancer, we don't have a clue. So that's one aspect of why more money should go into breast cancer. Another reason is that it is killing a large number of women.
I get a little bit annoyed at people who say, "You're trying to politicize research!" That's baloney. It's always been political. It just was a matter of whose politics was calling the shots. People are upset because now the women are getting angry and they want their politics reflected in where the research dollar is spent. I think that's totally appropriate.
From the beginning, the Breast Cancer Coalition has never tried to pit one disease against the other, but rather has always said we want a bigger pie. We don't want a bigger piece, we want a bigger pie. And indeed, most research money for breast cancer this year--the big increase--is Department of Defense money. This isn't money taken from one cancer to another; it was taken from the B-1 bomber.
Q: \o7 But even with a bigger pie, somebody ends up not getting what they want. Who should that be?\f7