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New American Cancer Society Recommendations for Women

Aired May 15, 2003 - 13:44   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.


KYRA PHILLIPS, CNN ANCHOR: Breast cancer is a disease that could kill almost 40,000 American women this year alone. So how do you avoid becoming a statistic? Well, the American Cancer Society is out with new and more specific guidelines. Our medical correspondent, Elizabeth Cohen joins us here with more. Tell us.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Well, part of these guidelines, I think, will surprise many women who thought that what they were supposed to be doing was examining their breasts every month. Well, now, the American Cancer Society has some new guidelines out there. The first part of it is they say that these exams are an option, that it is acceptable not to do them, and they say the reason for this is that studies are conflicting as to whether these exams actually help detect cancers early or not.

They do say that women should be aware of how their breasts feel and look so that they can report any changes to their doctor. Now, this is a little bit of a confusing piece of advice here. I think the bottom line of what the American Cancer Society is trying to say is that they say that women should be aware of how their breasts feel and look, and that there may be other ways other than a breast self- examination to do that, and that is why they say that exam is an option, but that there is no reason not to do a breast self- examination.

Let's take a look at some of the other findings from the American Cancer Society. They also say that women should get their first mammogram at age 40. They say the evidence is stronger than ever that mammograms help detect cancer, and that high-risk women, those with a genetic predisposition or strong family history of breast cancer should start at age 30 and talk to doctors about possibly getting an MRI or an ultrasound. Those are two technologies which have, in some studies, found to be much better than mammograms.

PHILLIPS: All right. So basically, the best way to go -- I mean, more the better, right? This three-prong approach when you talk about a mammogram, the clinical exam, and a self-exam, is that what we should start focusing on now, as other techniques are being investigated?

COHEN: Well, what they're saying now is mammograms. Got to have your mammograms and got to have your clinical breast examination, having your doctor or your clinician examine your breasts, but what they're saying is that breast self-examination may not be as crucial as once thought, and that is sort of one way to boil it down. As the American Cancer Society says, they say now they feel that it is an option, that it is not a required, if you will, part of breast cancer prevention.

PHILLIPS: All right. We are going to talk a little bit more on this controversy. Thank you, Elizabeth Cohen, very much.

Recently, there has been a debate about just how effective those self-breast exams are. Some people believe they are a vital part of the battle against breast cancer. Others are more skeptical, and say that by the time a woman can feel a lump, it may be too late. We have two guests with our thoughts on this topic.

Right now, we are waiting to hear from Dr. Susan Love. She is the author of a book on breast health. She is going to be joining us from our Los Angeles bureau, but with us now is Lyn Wasserman, founder of a breast cancer support network called Breast Friends. She has also battled the disease herself. Lyn is right next to me here in Atlanta. We will begin with you as we wait for Dr. Love to get miked up and ready to go. Good to see you.

LYN WASSERMAN, BREAST FRIENDS: Very good to see you, Kyra.

PHILLIPS: Well, you are very much against what is happening here and this fight -- or not really a fight, but this theory that you don't need to do a self-breast exam. Tell me why. I know you have strong opinions about this.

WASSERMAN: I have very strong opinions about it. I come from looking at it as a two-time survivor of breast cancer. Both times, I found my breast cancer using breast self-examination. I shudder to think, had I not been instructed in breast self-examination, and not given it much thought, and been dissuaded from -- the medical profession and media in general, not to do it, or reported by media in general that the medical professionals are this way and that way about it, just how much I would have done it.

And if I hadn't done it, and hadn't found these things, I shudder to think how fast they might have grown. My first breast cancer was at age 35. So it might have been a very aggressive one, it's hard to say how much worse it would have been had I not found it and gotten treatment right away.

PHILLIPS: Had you ever had a mammogram?

WASSERMAN: I had had a mammogram for fibrous breasts at about 27, but I was working for a hospital and it was available to me, and it was one of those things -- I was a person who was around medicine all the time, so it made sense for me to do it. And even then, I had no idea whether I had any breast cancer in my family or not. Only recently have I found out male cousin that had breast cancer. But without all of that, without me already being in the medical arena in some way, where I have access to that information, who knows whether I would have gone and had that mammogram.

PHILLIPS: Well, how often do women come into your organization and say, Oh, my gosh, it saved my life, it was the self-breast exam?

WASSERMAN: I can tell you that each time we revisit this particular issue, and we've revisited it a lot in the last three or four years, we get tons of call all the time, and e-mail -- "How dare they say this, because we found our breast lumps this way, and this is why it saved our life."

If I had not got in and seen -- felt this thing and gone in to see my doctor, I probably never would have touched my breast, and who knows how big it would have gotten. We get calls all the time and lots of outrage when these studies come out.

PHILLIPS: All right. As we wait for Dr. Love to get hooked up in Los Angeles, Elizabeth Cohen, let's bring you back in and talk more, add a little more perspective the other side. You listen to stories like Lyn Wasserman, and you think, how can you come out and say, especially the American Cancer Society and say, Don't worry about it. You don't have to do it.

COHEN: Right. And the American Cancer Society does acknowledge -- they say that yes, there are many stories like this, and even studies that say that breast self-examination does help, but they point to a large study that was done in the past year in Shanghai, where they took a group of women, told them how to do breast self- examinations and told them to do them, and then another group of women who did not do the self-exams and they found that the cancer rates were similar in the two groups. So, there are many doctors out there who say, Look, if a big study shows that it doesn't help, why should we be telling women to do this? Plus, they also say many women don't do it, or they do it poorly and they feel guilty that either they're not doing it, or that they don't know how to do it very well, and we don't want to make those women feel like they're being neglectful of their own health, when they say -- I mean, the critics here will say there's not a lot of good, scientific evidence that these exams help. That's what one side of this says.

PHILLIPS: Well, I'm also being told that we're not able to get Dr. Susan Love, author of "Dr. Susan Love's Breast Book," up in Los Angeles, so I'm going to tell you, when I talked to her, and I was reading some of her thoughts, she is a big supporter of this ductal lavage, which is her theory. She thinks we should be concentrating on the cell research versus concentrating on self-exams. What do you know about that, and what can you tell us about this research?

WASSERMAN: I know one thing about ductal lavage, it is an option for women under 40. Unfortunately, it's not as prevalent -- it's not as -- I'm looking for the word now, sorry.

KAGAN: Well, explain to us what it is.

WASSERMAN: Well, essentially, and I'm not an expert on this and I apologize. Basically, what they do is they actually go in and remove cells from the tiniest ductal structures in your breast, and they are able to see in the cell at a cellular level if there is any propensity or any problems with breasts cancer cells at a very, very, very small size, and it's one way to be able to catch this, even more -- even earlier, and I know of one physician here in Atlanta that is doing it, and unfortunately, there is not a lot of physicians in the country who are trained to do it. I am hoping that that is changing. The last time I talked to her, there weren't a whole lot of physicians doing it and being trained on it, but it is a very effective tool. It is also a particularly effective tool for women who are under 40 who have very little for them to use for early detection.

PHILLIPS: Well, meanwhile, we have to go with what we know, and that's mammograms and seeing our doctors...

WASSERMAN: And that is a very good point, Kyra. We have to go with what we know and what we have. So before everybody goes out there -- and I'm speaking to all of you as a survivor, and I'm speaking to you as survivors and women -- before you decide that this is not worth it, remember, until they come up with something better, this is what we've got, and it's up to you to decide, it's your choice.

Are you going to take a road where you're not going to give yourself every opportunity to find something that could cause you great pain -- if you don't find it fast enough, great heartache? And that's really coming from my heart and coming from a survivor's standpoint, not a support person, but someone who's gone through this, and whose family has gone through this twice.

PHILLIPS: And I have interviewed you many a time, and I know you, you live here in Atlanta, and I know how much passion you have. Lyn Wasserman, thank you so much.

WASSERMAN: You are very welcome.

PHILLIPS: Elizabeth Cohen, thank 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 May 15, 2003 - 13:44   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
KYRA PHILLIPS, CNN ANCHOR: Breast cancer is a disease that could kill almost 40,000 American women this year alone. So how do you avoid becoming a statistic? Well, the American Cancer Society is out with new and more specific guidelines. Our medical correspondent, Elizabeth Cohen joins us here with more. Tell us.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Well, part of these guidelines, I think, will surprise many women who thought that what they were supposed to be doing was examining their breasts every month. Well, now, the American Cancer Society has some new guidelines out there. The first part of it is they say that these exams are an option, that it is acceptable not to do them, and they say the reason for this is that studies are conflicting as to whether these exams actually help detect cancers early or not.

They do say that women should be aware of how their breasts feel and look so that they can report any changes to their doctor. Now, this is a little bit of a confusing piece of advice here. I think the bottom line of what the American Cancer Society is trying to say is that they say that women should be aware of how their breasts feel and look, and that there may be other ways other than a breast self- examination to do that, and that is why they say that exam is an option, but that there is no reason not to do a breast self- examination.

Let's take a look at some of the other findings from the American Cancer Society. They also say that women should get their first mammogram at age 40. They say the evidence is stronger than ever that mammograms help detect cancer, and that high-risk women, those with a genetic predisposition or strong family history of breast cancer should start at age 30 and talk to doctors about possibly getting an MRI or an ultrasound. Those are two technologies which have, in some studies, found to be much better than mammograms.

PHILLIPS: All right. So basically, the best way to go -- I mean, more the better, right? This three-prong approach when you talk about a mammogram, the clinical exam, and a self-exam, is that what we should start focusing on now, as other techniques are being investigated?

COHEN: Well, what they're saying now is mammograms. Got to have your mammograms and got to have your clinical breast examination, having your doctor or your clinician examine your breasts, but what they're saying is that breast self-examination may not be as crucial as once thought, and that is sort of one way to boil it down. As the American Cancer Society says, they say now they feel that it is an option, that it is not a required, if you will, part of breast cancer prevention.

PHILLIPS: All right. We are going to talk a little bit more on this controversy. Thank you, Elizabeth Cohen, very much.

Recently, there has been a debate about just how effective those self-breast exams are. Some people believe they are a vital part of the battle against breast cancer. Others are more skeptical, and say that by the time a woman can feel a lump, it may be too late. We have two guests with our thoughts on this topic.

Right now, we are waiting to hear from Dr. Susan Love. She is the author of a book on breast health. She is going to be joining us from our Los Angeles bureau, but with us now is Lyn Wasserman, founder of a breast cancer support network called Breast Friends. She has also battled the disease herself. Lyn is right next to me here in Atlanta. We will begin with you as we wait for Dr. Love to get miked up and ready to go. Good to see you.

LYN WASSERMAN, BREAST FRIENDS: Very good to see you, Kyra.

PHILLIPS: Well, you are very much against what is happening here and this fight -- or not really a fight, but this theory that you don't need to do a self-breast exam. Tell me why. I know you have strong opinions about this.

WASSERMAN: I have very strong opinions about it. I come from looking at it as a two-time survivor of breast cancer. Both times, I found my breast cancer using breast self-examination. I shudder to think, had I not been instructed in breast self-examination, and not given it much thought, and been dissuaded from -- the medical profession and media in general, not to do it, or reported by media in general that the medical professionals are this way and that way about it, just how much I would have done it.

And if I hadn't done it, and hadn't found these things, I shudder to think how fast they might have grown. My first breast cancer was at age 35. So it might have been a very aggressive one, it's hard to say how much worse it would have been had I not found it and gotten treatment right away.

PHILLIPS: Had you ever had a mammogram?

WASSERMAN: I had had a mammogram for fibrous breasts at about 27, but I was working for a hospital and it was available to me, and it was one of those things -- I was a person who was around medicine all the time, so it made sense for me to do it. And even then, I had no idea whether I had any breast cancer in my family or not. Only recently have I found out male cousin that had breast cancer. But without all of that, without me already being in the medical arena in some way, where I have access to that information, who knows whether I would have gone and had that mammogram.

PHILLIPS: Well, how often do women come into your organization and say, Oh, my gosh, it saved my life, it was the self-breast exam?

WASSERMAN: I can tell you that each time we revisit this particular issue, and we've revisited it a lot in the last three or four years, we get tons of call all the time, and e-mail -- "How dare they say this, because we found our breast lumps this way, and this is why it saved our life."

If I had not got in and seen -- felt this thing and gone in to see my doctor, I probably never would have touched my breast, and who knows how big it would have gotten. We get calls all the time and lots of outrage when these studies come out.

PHILLIPS: All right. As we wait for Dr. Love to get hooked up in Los Angeles, Elizabeth Cohen, let's bring you back in and talk more, add a little more perspective the other side. You listen to stories like Lyn Wasserman, and you think, how can you come out and say, especially the American Cancer Society and say, Don't worry about it. You don't have to do it.

COHEN: Right. And the American Cancer Society does acknowledge -- they say that yes, there are many stories like this, and even studies that say that breast self-examination does help, but they point to a large study that was done in the past year in Shanghai, where they took a group of women, told them how to do breast self- examinations and told them to do them, and then another group of women who did not do the self-exams and they found that the cancer rates were similar in the two groups. So, there are many doctors out there who say, Look, if a big study shows that it doesn't help, why should we be telling women to do this? Plus, they also say many women don't do it, or they do it poorly and they feel guilty that either they're not doing it, or that they don't know how to do it very well, and we don't want to make those women feel like they're being neglectful of their own health, when they say -- I mean, the critics here will say there's not a lot of good, scientific evidence that these exams help. That's what one side of this says.

PHILLIPS: Well, I'm also being told that we're not able to get Dr. Susan Love, author of "Dr. Susan Love's Breast Book," up in Los Angeles, so I'm going to tell you, when I talked to her, and I was reading some of her thoughts, she is a big supporter of this ductal lavage, which is her theory. She thinks we should be concentrating on the cell research versus concentrating on self-exams. What do you know about that, and what can you tell us about this research?

WASSERMAN: I know one thing about ductal lavage, it is an option for women under 40. Unfortunately, it's not as prevalent -- it's not as -- I'm looking for the word now, sorry.

KAGAN: Well, explain to us what it is.

WASSERMAN: Well, essentially, and I'm not an expert on this and I apologize. Basically, what they do is they actually go in and remove cells from the tiniest ductal structures in your breast, and they are able to see in the cell at a cellular level if there is any propensity or any problems with breasts cancer cells at a very, very, very small size, and it's one way to be able to catch this, even more -- even earlier, and I know of one physician here in Atlanta that is doing it, and unfortunately, there is not a lot of physicians in the country who are trained to do it. I am hoping that that is changing. The last time I talked to her, there weren't a whole lot of physicians doing it and being trained on it, but it is a very effective tool. It is also a particularly effective tool for women who are under 40 who have very little for them to use for early detection.

PHILLIPS: Well, meanwhile, we have to go with what we know, and that's mammograms and seeing our doctors...

WASSERMAN: And that is a very good point, Kyra. We have to go with what we know and what we have. So before everybody goes out there -- and I'm speaking to all of you as a survivor, and I'm speaking to you as survivors and women -- before you decide that this is not worth it, remember, until they come up with something better, this is what we've got, and it's up to you to decide, it's your choice.

Are you going to take a road where you're not going to give yourself every opportunity to find something that could cause you great pain -- if you don't find it fast enough, great heartache? And that's really coming from my heart and coming from a survivor's standpoint, not a support person, but someone who's gone through this, and whose family has gone through this twice.

PHILLIPS: And I have interviewed you many a time, and I know you, you live here in Atlanta, and I know how much passion you have. Lyn Wasserman, thank you so much.

WASSERMAN: You are very welcome.

PHILLIPS: Elizabeth Cohen, thank 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