Waking Dreams of the Perfect Breast Cancer Prevention Drug

Photo of a lilac-breasted roller by Flickr users Arno & Louise, used under a Creative Commons license. If you came here for a lovely photo of black-and-white breasts set off by orange Sungold tomatoes, too bad; I got annoyed at too many late-night hits from visitors seeking boobie pictures, which is not what Kittywampus is about, and so I took down the original breast photo. However, this fella's lilac breast is quite gorgeous in its own right.

So the other night I woke up in the wee hours and started thinking about breast cancer and how to prevent it. Now, the obvious rational approach is right living, on the individual side, and a much cleaner environment, when it comes to collective strategies. On the first score, I eat my veggies and I'm no lush (though also not the teetotaler that the latest study suggests all women should be). As for tidying up the environment? Unlikely in my lifetime, especially when it comes to those persistent estrogen-like plastic and pesticide compounds that are a likely driver of rising breast cancer rates.

But the great thing about half-delirious insomniac thoughts at 4 a.m. is that you don't have to be rational. And so I started fantasizing about an ideal drug to prevent breast cancer. Clearly, Tamoxifen and its cousins that induce menopause-from-hell symptoms don't come close to fitting the bill; they're harsh enough that they're only used in women at high risk. But if you only intervene after cancer is diagnosed, the current slash/burn/poison approach leaves women maimed, debilitated, and in constant fear of recurrence.

My vision was a substance that every woman could take, at least once she was pretty sure she was done with childbearing and thus wouldn't be using her breasts to feed anyone. It goes without saying that the ideal drug would be free of side effects. (I know, I know, but it was 4 a.m., so humor me.)

You'd want a drug that would stop mutations in their tracks before the rogue cells had a chance to replicate. And you'd need to deliver it to the location where those mutations are most likely to arise: the milk factory. Since virtually all breast cancers start either in the milk-transporting ducts or the milk-producing lobules, that's where you'd want to intervene. (I'm not discounting a third variant, inflammatory breast cancer, but that seems like a biologically different beast.)

You'd want a substance that would penetrate through the first layers of cells and selectively knock out any abnormal ones. Maybe it would induce apotosis; maybe it would stop such cells from reproducing; maybe it would just smother the bad guys. Whatever its mechanism, the key thing is that it would travel straight to the ducts and lobules and then act locally rather than systemically.

As anyone who's nursed a child knows, the milk factory has an amazing capacity to ramp up and, well, expand. And this is where such a drug could satisfy the prerogatives of vanity as well as health: If it acts locally by permeating the ducts and lobules, why couldn't it simultaneously cause them to inflate prettily? I'm not talking about mimicking the porn-star silicon look. I'm just suggesting that this ideal drug could cause a little bit of non-milk fluid to be retained. You'd get a little of the size and perkiness that pregnancy produces - but now without a belly eclipsing the boobs.

The great thing about this two-in-one function is that the drug would sell itself. Its developers would be reap wealth and good karma. Women would stick religiously to the dosage schedule.

The only downside? Plastic surgeons would be hanging around soup kitchens.