Risk,prevention and the breast cancer continuum: The NCI,the FDA,health activism and the pharmaceutical industry

This article examines the contested process through which the drug tamoxifen is being reconstituted as a form of breast cancer risk reduction, healthy women are being reconstituted as risky subjects, and breast cancer is being reconstituted as a continuum. Drawing on medicalization theory but extending it to incorporate the growing significance of risk and the pharmaceutical industry, I argue that an adequate theorization of contemporary processes of medicalization requires that we broaden our focus from patients, physicians and medical systems to the policies, practices, and relationships of the pharmaceutical industry, the medical research community, drug regulatory agencies, and non-governmental organizations involved in health-related activism. In this article I focus on four key sites of controversy and contestation: (1) the clinical trial that tested tamoxifen on healthy women; (2) the supplemental new drug application approval process; (3) the direct-to-consumer marketing campaign; (4) and the counter-campaign organized by women's health groups.