IN 1935, 26.2 out of every 100,000 Women died of Breast Cancer. That was a long time ago, of course, when life expectancy for women was sixty-four years. Americans now live longer, which means that diseases of the elderly are more common. Although breast cancer affects many young women, it is still principally a disease of middle and old age--the median age at diagnosis is sixty-four. Statisticians must adjust raw data about incidence and mortality to compensate for underlying demographic shifts. In 1992, the latest year for which figures are available, the adjusted rate of mortality was 26.2 women per 100,000--the same as in 1935. (The death rate rose a bit from 1986 to 1989 and declined by about the same amount from 1989 to 1992.) Since 1935 medicine has seen improvements in surgical technique and anesthesia, and the introduction of mammography, radiation therapy, and chemotherapy, along with an enormous jump in general medical knowledge. But all this progress has had no effect on the chances that an individual woman will die of breast cancer. To my way of thinking, the constancy of the death rate in the face of rising incidence and aggressive treatment is a strong hint that we need to approach the disease in another way. ( Davi Plotkin)