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American Morning
Study Questions Utility of Self Breast Exams
Aired October 02, 2002 - 08:44 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PAULA ZAHN, CNN ANCHOR: Some medical news now for you that probably is going to anger a lot of women out there. Startling new report says that breast self-exams are not saving lives because women are not able to detect tumors early enough. The study might change the way breast cancer prevention is handled around the world.
Dr. Sanjay Gupta joins us now from Atlanta to explain. You have got a lot of explaining to do, Sanjay. I mean, first we are told mammograms don't save lives, you know, what was supposed to be an early detection method, and now this. What are women supposed to do?
GUPTA: Well, I'll tell you, there is no doubt that it's confusing and conflicting to some extent. Let me just go through a couple of facts with you, and then we will get into the whole thing about the breast self exams.
First of all, there is a lot of confusion out there, Paula, despite all of the reporting that has been out there, or maybe because of all the reporting.
Let's look at a Harris Poll survey that actually asked women age 20 to 39 about mammograms, about breast cancer. Thirty-three percent still believe that mammograms actually prevent breast cancer. That is not true.
Fifteen percent incorrectly think mammograms treat breast cancer, even further from the truth. Over 50 percent of young women don't perform monthly breast self exams. We are going to talk more about that. And 1/3 of women do not believe something can be done to reduce their risk of breast cancer.
So you can see, despite that, there has been a lot of confusion about mammograms, as we talked about, but also now about breast self exams. What we are talking about, Paula, is a new study that looked at 266,000 women in Shanghai, and actually separated them into two groups. One group was taught how to do best self exams. One group was not taught how to breast self exams.
And over 10 to 11 years, they found a couple -- they asked a couple of questions and they found a couple of answers. One was do these breast self exams actually reduce the risk of breast cancer, number one.
And number two, does it actually reduce the mortality associated with breast cancer. And the answer to both of those questions was no. Breast self exams as a stand alone tool do not reduce the risk of breast cancer or the deaths associated with it -- and that is startling and remarkable new information. As you know, Paula, for a long time before mammograms, breast self exams is all there was. But now, with mammograms, people are using this message to say mammograms are even that much more important.
ZAHN: But the bottom line, you have got doctors quoted in number of articles this morning, from Sloan-Caterin (ph), a highly respected cancer hospital saying, Wait a minute, this doesn't mean that self breast exam is of no value, but teaching the method as a broad public health measure may not be as useful in some countries where you don't have mammograms, and some of these other techniques of picking up cancer early on. How many women have you met, doctor, who have picked up their own cancers, once they have become palpable by a self breast exam? You and I know them.
GUPTA: That is right. No doubt. It is hard to argue with those anecdotal reports. A woman who finds a lump. It ends up being cancer, she finds it early. It prolongs her life. No one can argue with those measures.
Paula, it's important to separate, though, individual cases from nations as a whole, and the question becomes, does it on average reduce your risk of dying from breast cancer? Does it on average reduce your risk of getting breast cancer. And the answer, at least according to this study is no.
But what you said is absolutely right. It doesn't mean that it should be completely abolished as a tool. But what it -- I think the message is that it shouldn't be used instead of mammography. Because you know how to do a self breast exam, doesn't mean that mammography is no longer important. It doesn't mean that a clinician breast exam is no longer important.
But really look at it as sort of a trifecta. A mammography, clinician breast exam, and self breast exam. What people have said more than anything else is that while self-breast exams does not necessarily indicate increase your chance of finding a cancer, although it might. What it does is makes you more aware of actually going to your doctor to get the breast exams, getting your mammography. If you're thinking about it from the age of 20, when they recommend self breast exams, there is a greater likelihood that you are actually going to follow up when you get older.
ZAHN: But you and I both know the reality of this. When people hear about this study, this will probably discourage them from doing a self breast exam, and I am reading here what a doctor said this morning, that should not happen, but they should understand it is not the be-all, it is not the end-all. Keep on doing it, but supplement it with what you're saying, with a mammogram and further examination.
GUPTA: Yes, I think the message is really important, Paula. No one is saying absolutely don't do self breast exams any more. It's important to give women the data, but also to say, listen, self breast exams aren't as good a tool, maybe, as we thought they were. But here is the important point -- don't -- if you know that, don't forget about your mammograms, don't forget about your clinician breast exams. Those are more important, those work better. So, just because you are doing self breast exams as well as you may think you are doing them, still get those other two things. They are really important, they are the best we got. Those are the things that actually reduce the risk of dying from breast cancer.
ZAHN: But it -- once again, doing a self breast exam doesn't hurt anything at all.
(CROSSTALK)
ZAHN: I mean, once again, I know dozens of women who have picked up their own cancers through self breast exam, and you tell them, and you look them straight in the eye today and say, hey, they're telling you didn't save your life. They are going, Oh, yes? Right.
GUPTA: No, and you know, I will tell you, Paula, there is a doctor side of this, and there is a public policy side of this. Let me just say that from a doctor's standpoint, you're absolutely right. From a public policy standpoint, it's easy to say, listen, there is no harm in teaching breast self exam. What some public policy advocates argue is that -- and actually, you spend more time teaching self breast exams instead of doing a good clinician exam, that might actually be harmful.
Instead, we should spend our resources towards actually doing those clinician breast exams, getting the mammographies. Self breast exam is a good thing to do, but our resources would be better spent towards those other two things.
ZAHN: Well, you have won my respect again today, because I think you have helped us understand the broader picture here.
GUPTA: Thanks, Paula. It was tough.
ZAHN: Thanks, Sanjay. Yes. Well, we all learned something.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired October 2, 2002 - 08:44 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PAULA ZAHN, CNN ANCHOR: Some medical news now for you that probably is going to anger a lot of women out there. Startling new report says that breast self-exams are not saving lives because women are not able to detect tumors early enough. The study might change the way breast cancer prevention is handled around the world.
Dr. Sanjay Gupta joins us now from Atlanta to explain. You have got a lot of explaining to do, Sanjay. I mean, first we are told mammograms don't save lives, you know, what was supposed to be an early detection method, and now this. What are women supposed to do?
GUPTA: Well, I'll tell you, there is no doubt that it's confusing and conflicting to some extent. Let me just go through a couple of facts with you, and then we will get into the whole thing about the breast self exams.
First of all, there is a lot of confusion out there, Paula, despite all of the reporting that has been out there, or maybe because of all the reporting.
Let's look at a Harris Poll survey that actually asked women age 20 to 39 about mammograms, about breast cancer. Thirty-three percent still believe that mammograms actually prevent breast cancer. That is not true.
Fifteen percent incorrectly think mammograms treat breast cancer, even further from the truth. Over 50 percent of young women don't perform monthly breast self exams. We are going to talk more about that. And 1/3 of women do not believe something can be done to reduce their risk of breast cancer.
So you can see, despite that, there has been a lot of confusion about mammograms, as we talked about, but also now about breast self exams. What we are talking about, Paula, is a new study that looked at 266,000 women in Shanghai, and actually separated them into two groups. One group was taught how to do best self exams. One group was not taught how to breast self exams.
And over 10 to 11 years, they found a couple -- they asked a couple of questions and they found a couple of answers. One was do these breast self exams actually reduce the risk of breast cancer, number one.
And number two, does it actually reduce the mortality associated with breast cancer. And the answer to both of those questions was no. Breast self exams as a stand alone tool do not reduce the risk of breast cancer or the deaths associated with it -- and that is startling and remarkable new information. As you know, Paula, for a long time before mammograms, breast self exams is all there was. But now, with mammograms, people are using this message to say mammograms are even that much more important.
ZAHN: But the bottom line, you have got doctors quoted in number of articles this morning, from Sloan-Caterin (ph), a highly respected cancer hospital saying, Wait a minute, this doesn't mean that self breast exam is of no value, but teaching the method as a broad public health measure may not be as useful in some countries where you don't have mammograms, and some of these other techniques of picking up cancer early on. How many women have you met, doctor, who have picked up their own cancers, once they have become palpable by a self breast exam? You and I know them.
GUPTA: That is right. No doubt. It is hard to argue with those anecdotal reports. A woman who finds a lump. It ends up being cancer, she finds it early. It prolongs her life. No one can argue with those measures.
Paula, it's important to separate, though, individual cases from nations as a whole, and the question becomes, does it on average reduce your risk of dying from breast cancer? Does it on average reduce your risk of getting breast cancer. And the answer, at least according to this study is no.
But what you said is absolutely right. It doesn't mean that it should be completely abolished as a tool. But what it -- I think the message is that it shouldn't be used instead of mammography. Because you know how to do a self breast exam, doesn't mean that mammography is no longer important. It doesn't mean that a clinician breast exam is no longer important.
But really look at it as sort of a trifecta. A mammography, clinician breast exam, and self breast exam. What people have said more than anything else is that while self-breast exams does not necessarily indicate increase your chance of finding a cancer, although it might. What it does is makes you more aware of actually going to your doctor to get the breast exams, getting your mammography. If you're thinking about it from the age of 20, when they recommend self breast exams, there is a greater likelihood that you are actually going to follow up when you get older.
ZAHN: But you and I both know the reality of this. When people hear about this study, this will probably discourage them from doing a self breast exam, and I am reading here what a doctor said this morning, that should not happen, but they should understand it is not the be-all, it is not the end-all. Keep on doing it, but supplement it with what you're saying, with a mammogram and further examination.
GUPTA: Yes, I think the message is really important, Paula. No one is saying absolutely don't do self breast exams any more. It's important to give women the data, but also to say, listen, self breast exams aren't as good a tool, maybe, as we thought they were. But here is the important point -- don't -- if you know that, don't forget about your mammograms, don't forget about your clinician breast exams. Those are more important, those work better. So, just because you are doing self breast exams as well as you may think you are doing them, still get those other two things. They are really important, they are the best we got. Those are the things that actually reduce the risk of dying from breast cancer.
ZAHN: But it -- once again, doing a self breast exam doesn't hurt anything at all.
(CROSSTALK)
ZAHN: I mean, once again, I know dozens of women who have picked up their own cancers through self breast exam, and you tell them, and you look them straight in the eye today and say, hey, they're telling you didn't save your life. They are going, Oh, yes? Right.
GUPTA: No, and you know, I will tell you, Paula, there is a doctor side of this, and there is a public policy side of this. Let me just say that from a doctor's standpoint, you're absolutely right. From a public policy standpoint, it's easy to say, listen, there is no harm in teaching breast self exam. What some public policy advocates argue is that -- and actually, you spend more time teaching self breast exams instead of doing a good clinician exam, that might actually be harmful.
Instead, we should spend our resources towards actually doing those clinician breast exams, getting the mammographies. Self breast exam is a good thing to do, but our resources would be better spent towards those other two things.
ZAHN: Well, you have won my respect again today, because I think you have helped us understand the broader picture here.
GUPTA: Thanks, Paula. It was tough.
ZAHN: Thanks, Sanjay. Yes. Well, we all learned something.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
