From missiles to mammograms

In 2002, I heard about “From missiles to mammograms” for the first time. Susan Blumenthal, assistant surgeon general of the US, was a speaker at the breast cancer conference in Bucharest, Romania that I was attending along with a small group from Western Serbia.

While I don’t remember exactly what she said, I do remember vividly grasping the idea that being named assistant surgeon general had made it possible for her to talk directly with the head of the CIA. And that ability to communicate led to an amazing result.

Because, deeply concerned about old-style mammography’s limitations at a time when breast cancer was surging, she had something she wanted the CIA to work on – to improve early detection of breast cancer by applying the same top secret imaging technologies it used in space exploration and military purposes.

Since the 1980s as a research physician for the US government, Dr. Blumenthal had been warning that womens’ health was not being taken as seriously as mens’ health. Many health studies looked only at male patients, assuming that the results for women would be the same. (The inimitable Alison Armstrong, who works to help men and women understand each other, calls this assuming that women are just ‘hairy men’.)

Marcus Aurelius, Pexels

“Her advocacy helped convince the federal government to spend significant new money on women’s health concerns, including breast cancer research,” says “During the 1990s, Blumenthal played a key role in these new efforts as the assistant surgeon general and director of the government’s new Office of Women’s Health.”

That office coordinated a $4 billion dollar budget across the Health and Human Services department, “developing many novel cross cutting initiatives that moved women’s health and the career development of women in medicine and science to the forefront of our country’s health care agenda and worked with other countries to do the same.”

While living and working in Uzice, Serbia, I had met a small but inspiring group of women, including surgeons, who worked to find and help women who were diagnosed with breast cancer. This was not easy – such stigma was attached to a cancer diagnosis then that they had to meet women at arts centres and the homes of the married Orthodox priests. Women did not want to go to a health centre because then everyone would know about their illness, and that was seen as shameful.

Hearing that there was going to be a conference on breast cancer next door in Romania, I decided to invite some of the womens’ group to attend. They couldn’t attend but I decided I could bring the information back to them. And there was a lot of it – from new research, advocacy by the Susan G. Komen Foundation, and learning how the spouses of members of Congress used social contacts to spread breast cancer awareness to many other countries.

But the ‘missiles to mammograms’ program fascinated, and Susan Blumenthal was a key part of it.

Early in 1994, she suggested that the intelligence community should “investigate how algorithms developed for missile detection and the monitoring of foreign military developments might be applied to detecting breast cancer.” In July 1994, the CIA’s Office of Research and Development asked the National Information Display Laboratory to prepare a background paper describing advanced image-processing techniques that might be applied to mammography.

I remember Dr. Blumenthal talking about how delighted the agency’s researchers were to be working on a project that they could talk about in public. And there was a lot of discussion, including in the US Congress, which was interested in the “New frontiers in breast cancer imaging: from missiles to mammogram” project developed by Blumenthal’s women’s health office.

“After all, if we can see missiles 20,000 miles away in distant skies and with the Hubble telescope see the surface of Mars, then surely we should be able to detect small lesions in women’s breasts right here on Earth,” she told Congress in 1997. “So we reached out to the CIA and DOD and have been working with them over the past 2 years to transfer their imaging technologies used for missile and target recognition to improve the early detection of breast cancer.”

Technology developed to analyze satellite imagery which aligned and compared digital x-ray images over time to identify changes turned out to be “particularly helpful in diagnosing breast cancer in women under 50, where diagnosis is particularly difficult,” the CIA said.

By aligning mammograms taken at different times and subtracting matching features so as to leave only the changes between the two images, attention was drawn to any suspicious region, dramatically increasing early detection.

This was not the only work on harnessing military technology for civilian purposes. At about the same time, universities and private firms were competing to develop a digital mammography device. Federal researchers at the Lawrence Livermore National Laboratory were working to develop the first prototype under a $3.28 million Department of Energy grant. The researchers envisioned sophisticated detectors directly recording the X-ray image in digital form, using sensitive light sensors often employed in defense surveillance, space exploration and top-of-the-line camcorders. The project was hailed as a prime example of how defense conversion programs can apply military technology to productive civilian uses in the post-Cold War era.

But what I remember most of all from that Bucharest conference and the women in Uzice, I think, is the power and generosity of women working together, creatively and in a bipartisan way, to make life better for each other. For all of us – mothers, daughters, granddaughters, fathers, sons, grandsons – this is the health dividend that peace brings.

How Missile Detection Technology Helps Fight Breast Cancer. Central Intelligence Agency, Oct. 1, 2018

Missile technologies may offer weapon against breast cancer. USIA, Feb. 1, 1996.

Hearings before a subcommittee of the committee on appropriations, US Senate, 105 Congress, first session, special hearings Feb. 5, 1997, Washington, DC. 

Scientists enlist StarWars tech in battle against breast cancer. Chicago Tribune, Nov. 28, 1993.

Cover image: Breast Cancer Awareness Month in the Philippines, 2022. SwarmCheng, Wikimedia.