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American Morning

Breast Exams

Aired May 16, 2003 - 09:34   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.


FREDRICKA WHITFIELD, CNN ANCHOR: For years, we've been told that monthly self-examinations can help to detect breast cancer. There are still some reverberations now after the American Cancer Society has advised something very different. It is now issuing new guidelines that say self-exams are optional, that there is conflicting information about whether self-exams actually help to detect cancers early. The cancer society says women should be aware of how their breast look and feel.
Earlier, I spoke with Dr. Larry Norton, chief of medical oncology at Memorial Sloan Kettering Cancer Center here in New York, and I asked him how the new recommendations are being received.

(BEGIN VIDEOTAPE)

DR. LARRY NORTON, MEM. SLOAN KETTERING CANCER CENTER: We have to remember, there is a big difference between the size of the cancer you can pick up on a mammogram or on a breast self-examination.

On a mammogram, you pick up cancers that are this tiny, whereas on breast self-examinations, the average size is this big, and that's a huge difference in cancer size, and it can make a huge difference in prognosis.

WHITFIELD: So is that a medical mistake?

NORTON: Well, I think people have to see this as a good sign. It means that our means of diagnosing breast cancer is getting much more sophisticated. In the days when we didn't have mammography, and people didn't have access to mammography, a breast self-exam was a very important part of the total picture of breast health. But now we are evolving better ways of diagnosing small breast cancers, and so although breast self-examination is still important, it's not as important as some of these other things, and that's what the American Cancer Society is emphasizing.

WHITFIELD: But are you worried it's been discouraged? Women are told that this habit that they've had once a month of doing self- breast exams is no longer needed, that it's not even effective?

NORTON: My personal view is it's still a good idea, and I still encourage people to do it. It's a good idea to know what your breasts feel like, to know if there are any changes, and call it to the attention of the doctor. I've seen patients who've had normal mammograms, who somewhere in that year do feel a lump and bring it to the attention of their health professional, and it does make a difference. So it's still important to do, in my view, but nevertheless, the emphasis really is on other means of diagnosing breast cancer now, particularly mammography, and I think that's the real meaning of these guidelines.

WHITFIELD: Mammograms are encouraged for women over 40 unless they're considered high risk.

NORTON: That's right.

WHITFIELD: But then what about the younger women, who have been conditioned to believe, that doing self-breast exams will at least help in some way of early detection.

NORTON: Well, it might. That's the important term, it might. The evidence is not strong one way or the other. But we recognize as scientists, this is a very hard thing to study. It's very hard to take a woman and say you're going to go into a randomized trial, and you're been randomized not to examine your breasts. It's impossible to do that, just the information that there is a trial to have a greater tendency to examine their breasts.

So in the absence of good solid, scientific information, it's appropriate to say that it can be or not done, although my personal view is to say it's still a very good idea.

WHITFIELD: 250,000 Chinese women were among the test study group. Is that a fair test group when looking at American women, different diets, different environs?

NORTON: It very well might not be, and that's why it's optional. That's why it's not -- the recommendation is not saying that it is discouraged, that women still can do this. That piece of information is a piece of information, but you're right, how applicable that is to the American public is not at all clear. The incidence of breast cancer is much higher here than it is in China, for example. The diet is different. The anatomy is different often.

So it is appropriate to say that the answer is not all in, and when the answer is not all in, if you have evidence based recommendations, you can't say the evidence supports breast self- examination.

But again, I still think it's a good idea in a total package of breast help. I want to emphasize that the field is changing very fast, and there are newer techniques that are coming into the forefront that look very exciting. Magnetic resonance imaging, called MRI, for example, is now actually being recommended for women at high risk. And soon, we may recommend it for others. And those kinds of tests, I think will help enormously and will make breast self- examination unnecessary.

(END VIDEOTAPE)

WHITFIELD: Dr. Larry Norton of the Sloan Kettering Cancer Center here in New York. His recommendation, however, to his patients will still be that it is advisable to do self-breast exams.

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 16, 2003 - 09:34   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
FREDRICKA WHITFIELD, CNN ANCHOR: For years, we've been told that monthly self-examinations can help to detect breast cancer. There are still some reverberations now after the American Cancer Society has advised something very different. It is now issuing new guidelines that say self-exams are optional, that there is conflicting information about whether self-exams actually help to detect cancers early. The cancer society says women should be aware of how their breast look and feel.
Earlier, I spoke with Dr. Larry Norton, chief of medical oncology at Memorial Sloan Kettering Cancer Center here in New York, and I asked him how the new recommendations are being received.

(BEGIN VIDEOTAPE)

DR. LARRY NORTON, MEM. SLOAN KETTERING CANCER CENTER: We have to remember, there is a big difference between the size of the cancer you can pick up on a mammogram or on a breast self-examination.

On a mammogram, you pick up cancers that are this tiny, whereas on breast self-examinations, the average size is this big, and that's a huge difference in cancer size, and it can make a huge difference in prognosis.

WHITFIELD: So is that a medical mistake?

NORTON: Well, I think people have to see this as a good sign. It means that our means of diagnosing breast cancer is getting much more sophisticated. In the days when we didn't have mammography, and people didn't have access to mammography, a breast self-exam was a very important part of the total picture of breast health. But now we are evolving better ways of diagnosing small breast cancers, and so although breast self-examination is still important, it's not as important as some of these other things, and that's what the American Cancer Society is emphasizing.

WHITFIELD: But are you worried it's been discouraged? Women are told that this habit that they've had once a month of doing self- breast exams is no longer needed, that it's not even effective?

NORTON: My personal view is it's still a good idea, and I still encourage people to do it. It's a good idea to know what your breasts feel like, to know if there are any changes, and call it to the attention of the doctor. I've seen patients who've had normal mammograms, who somewhere in that year do feel a lump and bring it to the attention of their health professional, and it does make a difference. So it's still important to do, in my view, but nevertheless, the emphasis really is on other means of diagnosing breast cancer now, particularly mammography, and I think that's the real meaning of these guidelines.

WHITFIELD: Mammograms are encouraged for women over 40 unless they're considered high risk.

NORTON: That's right.

WHITFIELD: But then what about the younger women, who have been conditioned to believe, that doing self-breast exams will at least help in some way of early detection.

NORTON: Well, it might. That's the important term, it might. The evidence is not strong one way or the other. But we recognize as scientists, this is a very hard thing to study. It's very hard to take a woman and say you're going to go into a randomized trial, and you're been randomized not to examine your breasts. It's impossible to do that, just the information that there is a trial to have a greater tendency to examine their breasts.

So in the absence of good solid, scientific information, it's appropriate to say that it can be or not done, although my personal view is to say it's still a very good idea.

WHITFIELD: 250,000 Chinese women were among the test study group. Is that a fair test group when looking at American women, different diets, different environs?

NORTON: It very well might not be, and that's why it's optional. That's why it's not -- the recommendation is not saying that it is discouraged, that women still can do this. That piece of information is a piece of information, but you're right, how applicable that is to the American public is not at all clear. The incidence of breast cancer is much higher here than it is in China, for example. The diet is different. The anatomy is different often.

So it is appropriate to say that the answer is not all in, and when the answer is not all in, if you have evidence based recommendations, you can't say the evidence supports breast self- examination.

But again, I still think it's a good idea in a total package of breast help. I want to emphasize that the field is changing very fast, and there are newer techniques that are coming into the forefront that look very exciting. Magnetic resonance imaging, called MRI, for example, is now actually being recommended for women at high risk. And soon, we may recommend it for others. And those kinds of tests, I think will help enormously and will make breast self- examination unnecessary.

(END VIDEOTAPE)

WHITFIELD: Dr. Larry Norton of the Sloan Kettering Cancer Center here in New York. His recommendation, however, to his patients will still be that it is advisable to do self-breast exams.

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