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Paging Dr. Gupta: Battling Breast Cancer

Aired October 31, 2002 - 11:35   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.


DARYN KAGAN, ANCHOR; And in the last hour week, we told you about some of the latest developments in the battle against breast cancer. We are going to continue with that topic this hour. In fact, have you sent a lot of e-mail to us, and so it's time for the answers. For that, we bring back our medical correspondent Dr. Sanjay Gupta, and also one of his colleagues from Emory University, Dr. Otis Brawley, with Emory University and school of medicine here in Atlanta.
Doctors, good morning to the both of.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning.

And I should mention that Dr. Brawley is a professor of medicine oncology and epidemiology. So this...

KAGAN: That's a guy we want to have to page to answer our questions. We talk but breast cancer a lot, but certainly, it really has been in the news a lot lately, especially with all the controversy over mammograms, and a lot of people have been sending in questions, specifically wanting to know sort of, what is the bottom line now on mammograms? We've heard a lot of controversy over that.

DR. OTIS BRAWLEY, EMORY UNIVERSITY SCHOOL OF MEDICINE: Yes, tremendous controversy. Now, I believe we should tell people exactly what we know, what we don't know and what we believe.

KAGAN: We have seven clinical trials, all of which have some flaws to them, but all of which suggest that screening women ages 50 to 70 decreases the death rate by somewhere between 15 and 30 percent. We can argue what the decrease is, but there is some benefit age 50 to 70. So it's a shame per women who is 50 to 70 not to get a mammogram.

Now women in their 40s, we have never really looked at that in a good clinical trial well. And one can also say, what's so special but being 50?

Personally, I believe any woman in her 40s who wants to get a mammogram really ought to be able to get a mammogram and really ought to get a mammogram, but for women in their 50s and 60s, it's really a shame about if they don't get mammography in two years.

KAGAN: I started to hear of getting mammograms at 35. What's the age?

BRAWLEY: Yes, yes, there was a time when many of the respected medical organizations recommended a baseline mammogram at age 35, and then started getting mammograms at age 40, getting it every one to two years at age 40. Almost all organizations have backed off from the recommendation for a mammogram at age 35. There has been a lot of publicity about it, but over the last 10 years, virtually everybody who recommended it has stopped recommending it.

KAGAN: Got it.

GUPTA: I should point out before we ask our first e-mail question, the reason they don't start to get mammograms at the age of 20 is the collective radiation could be a problem.

BRAWLEY: That is right.

GUPTA: One in eight women are affected by breast cancer. Let's Get to the first question, "I discovered a lump under my right arm. I called immediately for an appointment, but the first available one isn't for three weeks. If it's cancer, isn't time valuable? How do I cope for three weeks not knowing?"

This woman is trying to get her appointment. She is concerned about breast cancer. It's hard to see doctors.

BRAWLEY: Yes, the scientist in me says that a three-week wait really isn't too long. However, I understand the apprehension, I understand the concern. I would suggest to that woman, try to talk to her doctor or try to get a referral to someone who can see her sooner.

KAGAN: The next question comes from Dancy in Sleepy Hallow, new York, and she writes, "I've read that breast feeding reduces a woman's chances of getting breast cancer. Is that true, and how much does it reduce the chances? Does it matter how long breast feeding continues?"

BRAWLEY: Yes, I have read the same studies, and there are studies that suggest that breast cancer is reduced in women who breast feed.

However, the benefit isn't that great. I really think that breast -- there is a lot of good reasons to do breast feeding.

KAGAN: For the baby?

BRAWLEY: For the baby. I would not breast feed to reduce the risk of breast cancer. I would breast feed for the baby's health.

GUPTA: Right, certainly not for eight years like the case that we have been hearing about.

KAGAN: A different story.

GUPTA: The next question, this is up my alley, talking about surgeons, "Why, why do doctors always say, 'Let's watch it' when a lump is found? I have friends who are now dead because doctors said, 'Let's watch it.' Why not go ahead and remove the lump immediately."

BRAWLEY: There are a lot of lumps out there, and quite honestly, every time we operate, every time we do a procedure to remove a lump, that is a surgery, and you can cause a great deal of harm. And quite honestly, if we removed every lump, we would do much more harm than good.

KAGAN: This a question a lot of women who have had mammograms would like to know, "Why is not there more research done to support more early detection methods? I understand that there is a company in the Boston area that has been working on a blood test that detects certain proteins linked to breast cancer."

BRAWLEY: Well, I can't speak specifically to that. But I will tell you, I believe the National Institute of Health and the National Cancer Institute is doing a lot of work in breast cancer, early detection, and detection of other cancers as well.

Now quite honestly, if they had more money, they certainly could spend more money and we could do a lot more. But there is honestly a lot of work being doing in infrared imaging and MRI imaging, as well as genetic testing, as well as looking for blood proteins.

KAGAN: One more, number six, Catherine from New Jersey, "Is it correct that there is a higher probability that cancer will develop in a dense breast rather than a less dense one?"

I guess I would add to that, what makes a dense breast? What's the density factor?

BRAWLEY: There are some people who have breast tissue which is more dense, it's darker on a mammogram. It actually makes the mammogram harder to rig. There are some studies to suggest that women with dense breasts are at greater risk for breast cancer, not at extreme greater risk.

Yes, there is this issue, and it's unfortunate that it's really harder to read a mammogram in a woman who has dense breasts, and by the way. As women age, frequently, their breasts will get less dense, and that's one of reason that mammographies is better in an older woman versus a younger woman.

But if that -- irrespective of what the density of a woman's breasts. is she really needs to look at what her age is and make that decision about mammography.

KAGAN: What about breast implants?

BRAWLEY: Breast implants also make it harder to read a mammogram, certainly doesn't increase the risk of breast cancer, but makes it harder to do early detection.

GUPTA: I think we have time for one more, and this is an interesting question actually, "Does breast cancer hurt? Can you actually feel tumors by feeling a pain?"

BRAWLEY: That's really important. There is some breast cancers that hurt; there are some breast cancers that don't hurt. It's an important question, because we frequently see patients who have delayed going to the doctor for months because they had a painful lump in their breasts, and there is this perception in a lot of the people, if it hurts, it's not cancer. That's not true, breast cancer can hurt. Breast cancer can also be painless.

KAGAN: Great. Very good. Great information.

BRAWLEY: My pleasure.

KAGAN: Dr. Otis Brawley, Dr. Sanjay Gupta, thank you so much, appreciate it. Answer a lot of questions, and on behalf of women out there, I thank both of you.

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 31, 2002 - 11:35   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DARYN KAGAN, ANCHOR; And in the last hour week, we told you about some of the latest developments in the battle against breast cancer. We are going to continue with that topic this hour. In fact, have you sent a lot of e-mail to us, and so it's time for the answers. For that, we bring back our medical correspondent Dr. Sanjay Gupta, and also one of his colleagues from Emory University, Dr. Otis Brawley, with Emory University and school of medicine here in Atlanta.
Doctors, good morning to the both of.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning.

And I should mention that Dr. Brawley is a professor of medicine oncology and epidemiology. So this...

KAGAN: That's a guy we want to have to page to answer our questions. We talk but breast cancer a lot, but certainly, it really has been in the news a lot lately, especially with all the controversy over mammograms, and a lot of people have been sending in questions, specifically wanting to know sort of, what is the bottom line now on mammograms? We've heard a lot of controversy over that.

DR. OTIS BRAWLEY, EMORY UNIVERSITY SCHOOL OF MEDICINE: Yes, tremendous controversy. Now, I believe we should tell people exactly what we know, what we don't know and what we believe.

KAGAN: We have seven clinical trials, all of which have some flaws to them, but all of which suggest that screening women ages 50 to 70 decreases the death rate by somewhere between 15 and 30 percent. We can argue what the decrease is, but there is some benefit age 50 to 70. So it's a shame per women who is 50 to 70 not to get a mammogram.

Now women in their 40s, we have never really looked at that in a good clinical trial well. And one can also say, what's so special but being 50?

Personally, I believe any woman in her 40s who wants to get a mammogram really ought to be able to get a mammogram and really ought to get a mammogram, but for women in their 50s and 60s, it's really a shame about if they don't get mammography in two years.

KAGAN: I started to hear of getting mammograms at 35. What's the age?

BRAWLEY: Yes, yes, there was a time when many of the respected medical organizations recommended a baseline mammogram at age 35, and then started getting mammograms at age 40, getting it every one to two years at age 40. Almost all organizations have backed off from the recommendation for a mammogram at age 35. There has been a lot of publicity about it, but over the last 10 years, virtually everybody who recommended it has stopped recommending it.

KAGAN: Got it.

GUPTA: I should point out before we ask our first e-mail question, the reason they don't start to get mammograms at the age of 20 is the collective radiation could be a problem.

BRAWLEY: That is right.

GUPTA: One in eight women are affected by breast cancer. Let's Get to the first question, "I discovered a lump under my right arm. I called immediately for an appointment, but the first available one isn't for three weeks. If it's cancer, isn't time valuable? How do I cope for three weeks not knowing?"

This woman is trying to get her appointment. She is concerned about breast cancer. It's hard to see doctors.

BRAWLEY: Yes, the scientist in me says that a three-week wait really isn't too long. However, I understand the apprehension, I understand the concern. I would suggest to that woman, try to talk to her doctor or try to get a referral to someone who can see her sooner.

KAGAN: The next question comes from Dancy in Sleepy Hallow, new York, and she writes, "I've read that breast feeding reduces a woman's chances of getting breast cancer. Is that true, and how much does it reduce the chances? Does it matter how long breast feeding continues?"

BRAWLEY: Yes, I have read the same studies, and there are studies that suggest that breast cancer is reduced in women who breast feed.

However, the benefit isn't that great. I really think that breast -- there is a lot of good reasons to do breast feeding.

KAGAN: For the baby?

BRAWLEY: For the baby. I would not breast feed to reduce the risk of breast cancer. I would breast feed for the baby's health.

GUPTA: Right, certainly not for eight years like the case that we have been hearing about.

KAGAN: A different story.

GUPTA: The next question, this is up my alley, talking about surgeons, "Why, why do doctors always say, 'Let's watch it' when a lump is found? I have friends who are now dead because doctors said, 'Let's watch it.' Why not go ahead and remove the lump immediately."

BRAWLEY: There are a lot of lumps out there, and quite honestly, every time we operate, every time we do a procedure to remove a lump, that is a surgery, and you can cause a great deal of harm. And quite honestly, if we removed every lump, we would do much more harm than good.

KAGAN: This a question a lot of women who have had mammograms would like to know, "Why is not there more research done to support more early detection methods? I understand that there is a company in the Boston area that has been working on a blood test that detects certain proteins linked to breast cancer."

BRAWLEY: Well, I can't speak specifically to that. But I will tell you, I believe the National Institute of Health and the National Cancer Institute is doing a lot of work in breast cancer, early detection, and detection of other cancers as well.

Now quite honestly, if they had more money, they certainly could spend more money and we could do a lot more. But there is honestly a lot of work being doing in infrared imaging and MRI imaging, as well as genetic testing, as well as looking for blood proteins.

KAGAN: One more, number six, Catherine from New Jersey, "Is it correct that there is a higher probability that cancer will develop in a dense breast rather than a less dense one?"

I guess I would add to that, what makes a dense breast? What's the density factor?

BRAWLEY: There are some people who have breast tissue which is more dense, it's darker on a mammogram. It actually makes the mammogram harder to rig. There are some studies to suggest that women with dense breasts are at greater risk for breast cancer, not at extreme greater risk.

Yes, there is this issue, and it's unfortunate that it's really harder to read a mammogram in a woman who has dense breasts, and by the way. As women age, frequently, their breasts will get less dense, and that's one of reason that mammographies is better in an older woman versus a younger woman.

But if that -- irrespective of what the density of a woman's breasts. is she really needs to look at what her age is and make that decision about mammography.

KAGAN: What about breast implants?

BRAWLEY: Breast implants also make it harder to read a mammogram, certainly doesn't increase the risk of breast cancer, but makes it harder to do early detection.

GUPTA: I think we have time for one more, and this is an interesting question actually, "Does breast cancer hurt? Can you actually feel tumors by feeling a pain?"

BRAWLEY: That's really important. There is some breast cancers that hurt; there are some breast cancers that don't hurt. It's an important question, because we frequently see patients who have delayed going to the doctor for months because they had a painful lump in their breasts, and there is this perception in a lot of the people, if it hurts, it's not cancer. That's not true, breast cancer can hurt. Breast cancer can also be painless.

KAGAN: Great. Very good. Great information.

BRAWLEY: My pleasure.

KAGAN: Dr. Otis Brawley, Dr. Sanjay Gupta, thank you so much, appreciate it. Answer a lot of questions, and on behalf of women out there, I thank both of you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com