Do not delay: Breast cancer and time, 1900-1970

Until the 1960s, the central public health message about breast cancer was that women should not delay seeking medical attention for breast problems. Epidemiological, pathological, public health, and clinical writings, movies , and doctor-patient correspondence are analyzed in order to understand the durability and centrality of this "do not delay" message. Problematic assu mptions about the natural history of cancer, the efficacy of surgery, and i ndividual responsibility for disease contributed to the durability of the " do not delay" message. More important, the message catalyzed or sustained c hanges in the routines of ordinary women, general practitioners, surgeons, and pathologists, which led to the perception that the campaign against can cer was working. Thus a powerful set of reinforcing perceptions and behavio rs maintained the centrality of the "do not delay" campaign until the era o f mammography.