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American Morning
Paging Dr. Gupta: Mammogram Screening Problems
Aired September 17, 2003 - 08:43 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.
SOLEDAD O'BRIEN, CNN ANCHOR: Early detection is the key to fighting breast cancer. But a new study says that breast cancer screening in the U.S. is more prone to false positives than in any other country.
Medical correspondent Dr. Sanjay Gupta joins us from the CNN Center to explain.
Hey, Sanjay, good morning.
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Soledad. False positive meaning that it says that there's cancer when cancer really isn't there. In fact, they went on to say in this particular study interestingly that women who have 10 mammograms have about a 50 percent chance of having one of these false positives. Obviously a bit concerning. Disturbing to a lot of people who are in the mammogram field. A woman who wrote the study, Joanne Alomar (ph), we had a long chat with her yesterday, interestingly, they looked at 32 large studies and they found that women who are living in North America were two to four percentage points more likely to actually have an abnormal mammogram result as opposed to women living elsewhere in the world.
Now that sort of relates to about three to four extra visits per women per year to the doctor with maybe unnecessary anxiety, possible unnecessary biopsies, things like that.
So the question is really, why does this happen? you can see from the screen. In North America women, get screened earlier. A couple things. Means more mammograms if women are getting screened earlier. But also the breasts are more dense at that time, possibly leading to more false positives.
Other countries have more what are called high-volume centers, where they actually do lots and lots of mammograms and learn to weed out these false positives more effectively. And also two doctor review more common in other countries than it is in North America, as well. Dr. Alomar taking pains to remind me of that, as well. The question, really, then, does this translate to a better people ask, if you're getting all these false positives, are you also finding more cancers? That was the most disturbing part about this. The answer is no. They're getting more false positives, but not necessarily detecting more of the cancer. So that's again the results of a pretty large study, looking at 32 existing mammogram studies over about 17 years -- Soledad.
O'BRIEN: Sanjay, if they're saying that high volume centers are basically better because they're getting a better read on these mammograms, and also a two doctor review is better, is there anything that a patient can do, or a prospective patient can do when they go into the doctor's office to make their reading better? The way you're describing it makes it sound like it's entirely in the hands of the doctor.
GUPTA: Well, not entirely. I mean, I think there's a couple of things that have changed, a bit, as well. I think malpractice in this country has also led to this problem to some extent. Failure to diagnose and delay in diagnosis are the biggest malpractice allegations in this country. So people err on the side of false positive. That's one thing.
But also I think you bring up some good tips possibly already, with regards to looking at some of the models in European countries. We look at some tips. Those high-volume facilities are a good thing. Academic centers tend to have higher volume facilities, looking at lots and lots of mammograms, getting better at weeding out false positives.
Also returning to the same place. Try and go to the same place. They can compare your mammograms from year to year much more effectively that way. Get your mammogram after the menstrual cycle. The breast tends to be less dense at that time and makes it less harder to read. And get the mammograms regularly. But I think the most important point here, Soledad, is that most mammograms, even with the -- most mammograms are going to end up being totally normal.
And even if you have a false positive, it's just important to keep these numbers in the back of your mind. There's a good chance it could be a false positive and maybe that will aleve (ph) some of the anxiety.
HEMMER: Dr. Sanjay Gupta, thanks, as always. Sanjay, nice to see 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 September 17, 2003 - 08:43 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SOLEDAD O'BRIEN, CNN ANCHOR: Early detection is the key to fighting breast cancer. But a new study says that breast cancer screening in the U.S. is more prone to false positives than in any other country.
Medical correspondent Dr. Sanjay Gupta joins us from the CNN Center to explain.
Hey, Sanjay, good morning.
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning, Soledad. False positive meaning that it says that there's cancer when cancer really isn't there. In fact, they went on to say in this particular study interestingly that women who have 10 mammograms have about a 50 percent chance of having one of these false positives. Obviously a bit concerning. Disturbing to a lot of people who are in the mammogram field. A woman who wrote the study, Joanne Alomar (ph), we had a long chat with her yesterday, interestingly, they looked at 32 large studies and they found that women who are living in North America were two to four percentage points more likely to actually have an abnormal mammogram result as opposed to women living elsewhere in the world.
Now that sort of relates to about three to four extra visits per women per year to the doctor with maybe unnecessary anxiety, possible unnecessary biopsies, things like that.
So the question is really, why does this happen? you can see from the screen. In North America women, get screened earlier. A couple things. Means more mammograms if women are getting screened earlier. But also the breasts are more dense at that time, possibly leading to more false positives.
Other countries have more what are called high-volume centers, where they actually do lots and lots of mammograms and learn to weed out these false positives more effectively. And also two doctor review more common in other countries than it is in North America, as well. Dr. Alomar taking pains to remind me of that, as well. The question, really, then, does this translate to a better people ask, if you're getting all these false positives, are you also finding more cancers? That was the most disturbing part about this. The answer is no. They're getting more false positives, but not necessarily detecting more of the cancer. So that's again the results of a pretty large study, looking at 32 existing mammogram studies over about 17 years -- Soledad.
O'BRIEN: Sanjay, if they're saying that high volume centers are basically better because they're getting a better read on these mammograms, and also a two doctor review is better, is there anything that a patient can do, or a prospective patient can do when they go into the doctor's office to make their reading better? The way you're describing it makes it sound like it's entirely in the hands of the doctor.
GUPTA: Well, not entirely. I mean, I think there's a couple of things that have changed, a bit, as well. I think malpractice in this country has also led to this problem to some extent. Failure to diagnose and delay in diagnosis are the biggest malpractice allegations in this country. So people err on the side of false positive. That's one thing.
But also I think you bring up some good tips possibly already, with regards to looking at some of the models in European countries. We look at some tips. Those high-volume facilities are a good thing. Academic centers tend to have higher volume facilities, looking at lots and lots of mammograms, getting better at weeding out false positives.
Also returning to the same place. Try and go to the same place. They can compare your mammograms from year to year much more effectively that way. Get your mammogram after the menstrual cycle. The breast tends to be less dense at that time and makes it less harder to read. And get the mammograms regularly. But I think the most important point here, Soledad, is that most mammograms, even with the -- most mammograms are going to end up being totally normal.
And even if you have a false positive, it's just important to keep these numbers in the back of your mind. There's a good chance it could be a false positive and maybe that will aleve (ph) some of the anxiety.
HEMMER: Dr. Sanjay Gupta, thanks, as always. Sanjay, nice to see 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
