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American Morning

New Study on Mammography Provokes Controversy

Aired December 10, 2001 - 09:09   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: We're going to move on to a study that is provoking an awful of controversies. It's a new study of mammograms that challenges much of the conventional wisdom accumulated over the past 25 years.

Our Medical Correspondent Elizabeth Cohen joins us now from Atlanta to put this matter into context. Good morning. I know a lot of women are stunned to read this, this morning, because we've been told, along with mammograms and self-breast exams, that's the best way to detect cancer. What does this study show?

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Well, what the study does, Paula, is it looks at some other studies that have been done over the years, particularly these two studies. One in Sweden and one in Canada that said, you know what, we've looked at tens of thousands of women and found that those who have mammograms and those who didn't died of breast cancer at approximately the same rate, so that would make one say, well, gee, if women who had mammograms and women who didn't died of breast cancer at the same rate, then what's the point of, as you can see here in these pictures, going through the discomfort, the minimal risk of the radiation of a mammogram.

What's the point of doing that, if it's not going to prevent someone from dying of breast cancer? Well, all I can say about this is that experts have said today in the United States to me in interviews, you know what, those are two studies that show that, but there are dozens of studies that show that mammograms are actually very helpful and that they do prevent women from dying of breast cancer, because it allows doctors to get to breast cancer at a much earlier stage.

For example, before mammograms become routine in the United States in the 1980's, the average size of a breast cancer that doctors would find at first would be about a third larger than the size of the tumors that are found now. So, in other words, the mammograms are helping the doctors find the breast cancer at a much smaller size, so that it's much easier to treat. Now, no one says that mammograms are perfect. They do miss some breast cancers, especially in younger women, and they do flag some tumors as being cancers that aren't actually cancers, which means the woman has to go have a biopsy and all that, really for nothing in the end.

However, they say that despite these imperfections that this is what we have now. The best we have now. The -- most of the experts you would ask, if not all of them, would say mammograms are still the way to go. We're working on perfecting them. We're working on getting, for example, good M.R.I. -- Magnetic -- Magnetic Resonance Imaging for breast cancer. We're working on better techniques, digital mammographies, but right now, mammography is what we've got, and we're sticking with it -- Paula.

ZAHN: The other disturbing part of this study is this suggestion: if mammograms track an early cancer, it leads to -- what do they say, increased number of mastectomies, and also the suggestion that if you need radiation treatment following a mastectomy it might lead to more cardiovascular disease. What is the reaction from doctors you've spoken to?

COHEN: Doctors that I've spoken to today say, Paula, it is still the best idea to get a mammogram. They are, in fact, very worried that this study that was in the Lancet recently, which is a medical journal out of England, will make women have a second thought about a mammogram, and they say that's a terrible idea.

For example, you said maybe women would have more mastectomies if they have mammogram. Well, if that is, indeed, true, well, maybe they should have had those mastectomies, and that's one thing that the study didn't really address. Yes, they had more mastectomies, but maybe that's a good thing, because they had cancer in their breast, and the breast needed to be removed. So, that's kind of a funny statistic, and you certainly wouldn't want to base any kind of clinical advice on that.

But again, what the doctors say is that the bottom line is that far more studies show that mammographies help doctors treat cancer at a much earlier stage. It helps them spot it at much earlier stage. So, even if there are these two studies, there are far more that show the opposite, and doctors right now, are passionately arguing about which studies are better.

ZAHN: But, the bottom line, from your perspective, is that this should not discourage women from going in and having the mammograms when they're told they should. Most women in America are supposed to have a base line at the age of 40.

COHEN: Exactly, and that advice does not change at all. I mean, the authorities in the United States, those are the National Cancer Institute, the National Academy of Sciences, the American Cancer Society. They have not budged one inch based on this study. They still say mammograms are the way to go, and these two studies do not change that at all.

ZAHN: Well, I'd love for you to continue following this, because I think, as you would acknowledge, when these studies come out, it's a great disservice, I think, to women and all patients when the information is so contradictory.

COHEN: Exactly. The information is contradictory, and what happens is that science, by its very nature, is a debate. It's a back and forth, and what happens is that when we talk about this on television, is that people hear about it, so that your average person gets to hear these doctors debating back and forth, even though the advice remains the same for your average patient.

ZAHN: All right. Elizabeth Cohen. Thanks for helping sift through some of the confusion here this morning. Appreciate that update.

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