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American Morning

Are Mammograms Ineffective?

Aired January 25, 2002 - 07:37   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: The big question at this hour: Are mammograms ineffective? About 30 million American women a year have a mammogram, but a debate has been raging over the past few months on the effectiveness of (UNINTELLIGIBLE) test, leaving many women to decide for themselves as to what is best.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: I just think that until they say that they are absolutely useless and/or harmless, you know, it might be worthwhile doing anyway.

UNIDENTIFIED FEMALE: I would still go, because there's a lot of things that tell you one thing or another, but after 10 years, they tell you something else. So I think you should still go and check it out.

UNIDENTIFIED FEMALE: I trust it, because, you know, you do your own self-examination and you go by what they tell you. What else are you going to do?

(END VIDEO CLIP)

ZAHN: Well, just yesterday, a group of scientists has challenged the recommendations of the National Cancer Institute, which advices women over the age of 40 to undergo regular tests. The NCI quickly responded, saying it sticks with its pro-mammogram stance.

CNN medical correspondent Dr. Sanjay Gupta joins us now to help us sort this all out -- good morning, Doctor.

Dr. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Paula.

ZAHN: I've got to tell you, the confusion surrounding this debate, I think, is a great disservice to women. Let's cut to the chase here. You now have the National Cancer Institute, despite what this independent study shows, saying that women should in fact have mammograms, because it's the best early indicator of cancer. What's wrong with that?

GUPTA: That's right. I think, Paula, that is the bottom line after all is said and done. But if could just break down things a little bit for you, and for myself, because this is a very controversial issue, and I've been thinking about it and talking to a lot of people about this for a while now.

First of all, a panel of experts did go back and look at some of the data. Now, the data that we're talking about that cited the virtues of mammograms, a lot of those studies are from the '70s and '80s, back when you could actually study the utility of mammograms. They went back and found some flaws in the way those studies were conducted. They did not say that the overall conclusions were wrong ultimately, but that the way the studies were conducted, there may have been some flaws.

Now, having said that, they found that the mammograms did continue to detect cancers early, but the overall mortality rate -- death rate may not have changed as a result of that. First of all, certainly the studies were conducted back in the '70s and '80s. It doesn't necessarily mean the conclusions were wrong, but just that the way that the studies were conducted, again, may have been flawed. They may not have had enough radiologists look at the studies. They may not have followed the women out long enough, things like that. The studies may be could have been done a little bit better, but again, it doesn't mean that the conclusions were wrong.

Second of all, these studies were from the '70s and '80s. Paula, as you mentioned earlier, a lot has changed since then in terms of treatment primarily, hormonal therapy, chemotherapy. The outcomes and survivals based on this early detection and the biopsy techniques have improved so much that the outcomes may be as good, if not better, than those studies cited before.

And finally, it would be really hard to do a new trial regarding mammograms today, Paula. The simple question might be, well, why don't we just study it and put this issue to rest? The problem is in order to do a controlled trial, actually looking at the utility of mammograms vs. not mammograms, you would have to have a bunch of women not get mammograms as recommended by the NCI now, and no doctor, no breast cancer surgeon, no cancer specialist would recommend that. So bottom line, Paula, as you said, continue to get the mammograms. Maybe the studies were flawed 20 to 30 years ago, but it doesn't mean that the conclusions aren't correct.

ZAHN: But Dr. Sanjay Gupta, I mean, I've got to tell you, this just angers so many women. The bottom line, again, is that the earlier you catch your cancer, the better your chances are of survival, right?

GUPTA: That's right. That's right, and certainly, again, the therapies continue to change. The technologies continue to advance, so the benefit may continue to improve as a result of that. Absolutely, early detection equals better survival.

ZAHN: I just want to close off very quickly with that e-mail from Lisa Lee (ph), Dr. Gupta, who says: "Don't rule out mammograms for your yearly exams. There are instances where they work. I was diagnosed with breast cancer two years ago. The spot was only 3 centimeters. If it had not been caught by the mammogram, I would not be alive today." And I have to tell you we got hundreds of those kinds of responses yesterday. So do you want everybody to stick with the NCI guidelines, go in and get those mammograms, right?

GUPTA: Continue to get the mammograms. Paula, the one thing that I will add as well is that it doesn't mean that as a medical community we shouldn't continue to strive to do better, better imaging techniques, better screening techniques, all of those sorts of things continue to need to improve, but for now, absolutely stick with the mammograms.

ZAHN: They're not the beat all, end all, but certainly a powerful start.

GUPTA: Absolutely.

ZAHN: Dr. Sanjay Gupta, thanks.

GUPTA: Thank you.

ZAHN: Appreciate that house call.

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