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American Morning

Reports on Breast Cancer Raise Hopes and Concerns

Aired December 11, 2001 - 08:21   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: Two new reports on breast cancer are raising hopes, and concerns in some cases. There is word of promising research on a new group of breast cancer drugs called aromatase inhibitors. A report suggests they may be more effective than the standard drug, Tamoxifen, in some women.

Now, that news comes on the heels of a study that challenges the conventional wisdom that mammograms are a reliable tool for early detection.

Dr. Susan Love, author of the "Breast Cancer Survival Manual" joins me from San Antonio, Texas this morning. In Los Angeles, we welcome Fran Visco, president of the National Breast Cancer Coalition, herself a breast cancer survivor -- welcome -- delighted to have both of you with us this morning.

FRAN VISCO, NATIONAL BREAST CANCER COALITION: Thank you.

DR. SUSAN LOVE, "BREAST CANCER SURVIVAL MANUAL": Thank you.

ZAHN: Dr. Love, as best you can, try to cut through some of the confusion of this latest study that was printed in a British medical journal. What does it say about the value of mammograms?

LOVE: Well, it's actually not a new study. What they did is they looked at the data from the previous studies, yet again, in a new way. And when they reanalyzed it, they felt that they saw no benefit, whatsoever, from mammography screening.

Now, needless to say, this has caused a lot of controversy, and it's really a little bit on how you look at things. But I think the major message is not whether mammography screening has this effect or that small benefit, but really that we oversell it in a way. I think it's the best we have, but we make it sound like it always works, and it really doesn't. In some women, you may be able to find breast cancer early at a time when it's really curable, but there are many women where it's just not early enough, or it's not good enough at finding cancer at a curable point.

ZAHN: But, Susan, if it can find some cancers that aren't palpable in a self-breast exam, then why wouldn't we encourage women to use this...

LOVE: Well, the problem is... ZAHN: ... and continue to use mammograms?

LOVE: Well, the problem is this concept of early detection may not be entirely true -- the idea that if you could just get small enough, then you can cure the cancer. That's not always true. Some very small cancers can be very aggressive, and other big ones may never do anything. Sort of like a criminal analogy, you know, if you think of cancer as a criminal, and you try to get earlier and try to find the person early in their -- maybe in high school and see if you can divert them from their criminal path, well sometimes it works. But sometimes you get people who, even at that point, are too far gone for you to be able to rehabilitate.

ZAHN: All right. Let's bring Fran into the discussion here. I mean, it seems to anybody listening to this, this morning, they probably are troubled by what they are hearing. You know, they know that mammograms are available, but if they're not reliable, then, you know, why should women subject themselves to these tests? What is the best advice you can give women this morning?

VISCO: Well, we're not ready to tell women not to be screened. Women over 50 should still go for screening mammograms. But what we are very excited about by this debate is that women will begin to understand that mammograms are not the answer to breast cancer, and we have, in fact, oversold that device.

Even the studies that show that mammography reduces mortality in breast cancer, it's not 100 percent reduction. The best studies show 30 percent reduction. But...

(CROSSTALK)

ZAHN: Well, that's not bad odds, is it, Fran?

VISCO: It's not bad, but it's still not 100 percent. But in this country, we've reduced the issue of breast cancer to mammograms -- mammograms and pink ribbons. There is a sense that if every woman gets a mammogram, we will have dealt with the breast cancer crisis, and that is far from the truth.

ZAHN: So what is the truth here, Dr. Love?

LOVE: Well, the truth is...

ZAHN: What else can women do to ensure that they catch these cancers early? I know you said in some cases, when you detect cancer early, it doesn't necessarily mean it will save your life, because some of these cancers are more aggressive than others. But the bottom line, in most of the cases, the earlier you catch it the better off you are, right?

LOVE: In about a third of the cases probably. But I think mammography is the best thing we have right now, and I certainly go and get my mammogram, because if I'm in that group of a third that's going to benefit, you know, I want to have gotten the mammogram. And I would encourage women to do that. But by the same token, we need to realize it's not perfect, and we need to work very hard to get something that's better, something that can find cancer or cells before they are cancer, more like we do with the pap smear.

ZAHN: And, Fran, is that going to be something that's going to happen...

VISCO: Well...

ZAHN: ... in your lifetime and mine?

VISCO: Well, we're working very hard. You know, the National Breast Cancer Coalition is working very hard to demand more federal funding for more quality research to find new methods of detection, find out how to prevent this disease, how to treat it with nontoxic therapies. There's a lot that we don't know about breast cancer, and we have to understand that we need much, much more than mammography.

So this debate is very helpful to moving forward and getting an answer to breast cancer -- very important. We want to be comforted that breast self-exam and mammography finds breast cancer early, and that's all we need to do. It's time that we question those statements. There is no evidence that breast self-exam reduces mortality from breast cancer.

Now, we're questioning the evidence about mammography. That's a good thing. We need to continue to do that, so that we begin to ask the right questions and get the truth for women. Comfort isn't always the truth.

ZAHN: And, Dr. Love, as we begin to ask these right questions and try to seek the truth, just a final word of advice to women in America today, whether they're 40 years or 50 years old.

LOVE: I think women in America need to be encouraged that we really are making some progress and asking questions is progress. And so, getting beyond just this is the answer to all of life's problems. Whenever it's that easy, it's not the answer. We need to be looking very hard to get things that are better, that are earlier, that are really going to work to prevent breast cancer. And that's the way we're going to move forward.

ZAHN: But, Dr. Love, just again, that doesn't mean women should abandon mammograms -- abandon mammograms or self-breast exams. They just need to acknowledge that it's not...

LOVE: Well, I think that...

ZAHN: ... 100 percent sure shot it's going to catch every cancer.

LOVE: They certainly shouldn't abandon mammograms. If they're over 50, they should be getting yearly mammograms. Between 40 and 50, it depends on discussing this with their doctor. Breast self-exam, I think they should certainly tough their body. They don't need to do a whole religious thing, but they do need to be aware of their body. But they also need to be aware that we have to continue to fight for some better things that are really going to find cells before they are cancer, that are really going to give us a chance to prevent breast cancer, because that's where the answers are going to be.

ZAHN: And I can't think of two women who have fought the good fight in this arena. We appreciate both of your joining us today, and we look forward to having you back to keep us posted on any progress that is made. Dr. Susan Love, thank you for your time, and Fran Visco, you're quite a lady to get up at 4:00 o'clock in the morning to join us.

VISCO: Thank you.

ZAHN: So thank you for your time as well -- appreciate it.

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