Page:United States Statutes at Large Volume 107 Part 3.djvu/795

 PROCLAMATION 6600—SEPT. 30, 1993 107 STAT. 2733 tional Cancer Institute—has launched important studies to assess the extent to which changes in diet and the use of the drug tamoxifen, which is effective in treating breast cancer, can prevent the development of this disease in women who are at increased risk. The Woman's Health Trial is an exciting, innovative undertaking that aims to change dietary habits so that less fat is consumed and more fruits, vegetables, and fiber are added to our diet each day. There is some evidence to suggest a link between breast cancer and fat in the diet, at least for older women. What we hope to leam from this study is how best to help women change their eating habits and, thus, protect themselves, not only from breast cancer, but also from other cancers and conditions that are related to diet. While there is much to be said about this disease, one important message must reach everyone: Women should form a partnership with their health care providers for the early detection of breast cancer, a key component of our nationwide program to reduce the toll of this disease. Research has shown that screening mammography, used together on a regular basis with a clinical breast exam and monthly breast self-examination, can reduce deaths from this disease by onethird or more for women over 50. I am pleased that the Federal Government has been a leader in authorizing payment for screening mammography for women enrolled in Federal health care programs. It is also reassuring that insurance companies have followed suit, recognizing that the benefits of early detection far outweigh its costs. As we look to create a health care system in America that works for all people, we must be certain that we emphasize such preventative techniques as regular screening for breast cancer. We face a major public education challenge in breast cancer awareness. Every woman must be reassured that she can become a partner with the health care system in ensuring that should she develop breast cancer, it will be found and treated early. Through education programs, women come to understand what actions they can take to prevent cancer. To be sure, success depends on providing the public with understandable, credible messages—^but that is only half of the story. Unless every woman can be assured access to affordable medical care, including mammography and physicians' services to help in the detection of small ttunors, public education campaigns will not be effective. In spite of the best efforts of the health care community to encourage prevention and early detection, we know that thousands of women, nonetheless, will develop breast cancer, and many of them will die from it. Thus, the search to find effective treatments must continue, as must efforts to find effective therapies that have a minimal impact on the quality of a woman's life. We have come a long way from the time when extensive surgery was a woman's only treatment option for breast cancer. Limipectomy followed by radiation therapy is a treatment approach that helps many women avoid disfiguring surgery. Many women now receive treatment with chemotherapy to shrink a tumor before surgery is done so that the breast can be spared; others receive chemotherapy after surgery to augment the primary treatment. While we still have much to leam, the rate at which our knowledge has increased is remarkable. We must build on past successes and continue our commitment to basic research. True progress will require that we not waver in this commitment.

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