ABSTRACT
It was in the heyday of a new genetic determinism when the two breast cancer genes BRCA 1 and BRCA 2 were postulated in the early 1990s. At the time, the new genetics epitomized what Mike Fortun analyzed as ‘futural, promissory economy’ (Fortun 2008: 20). Biomedical scientists prepared the public for the revolution of biological knowledge that they envisioned with the sequencing of the human genome, including radical changes in the understandings of disease and new therapeutic avenues. The health sciences also prepared for the new technologies and data that emerged from human genome research. In epidemiology, for example, there was widespread optimism that strong associations between genetic polymorphisms and disease were about to be discovered and confirmed at the population level. This held especially for cancer, which was already conceived of as a mostly genetic disease, not only in terms of hereditary components, but also at the molecular level, with DNA mutation understood as the first step in the development of a tumour. Tackling these mechanisms of carcinogenesis at their molecular origin – DNA mutations – epidemiologists expected that genetics would open what they called the ‘black box’ between exposure and disease. Earlier biomedical models described tumour development as initiated by DNA mutation causing ‘uncontrolled cell proliferation’, followed by ‘cancer promotion’ depending on further carcinogenic agents. Scientists envisioned that variation in genetic sequence, such as single nucleotide polymorphisms (SNPs) might even prove to be the main epidemiological determinants of cancer at the population level.
