Return to Transcripts main page
CNN Sunday Morning
Interview With Sandra Fryhofer
Aired October 06, 2002 - 07:42 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.
RUDI BAKHTIAR, CNN ANCHOR: Every three minutes, a woman is diagnosed with breast cancer. Early detection is key to survival, but even the experts don't agree on how often a woman should have a mammogram, or how helpful self breast exams are.
Well, joining us to talk more about early detection and treatments, Dr. Sandra Fryhofer.
SANDRA FRYHOFER, DR., INTERNIST: Good morning, Rudi.
BAKHTIAR: Good morning, doctor. Tell me, before we do anything else, let's talk about how common breast cancer is.
FRYHOFER: Well, Rudi, breast cancer is the most commonly diagnosed cancer in woman, however, it's the second leading cause of cancer deaths in women, second only to lung cancer. Two million women already have breast cancer. There are 200,000 new cases each year.
Forty thousand women die each year. And if you look at your lifetime risk, you have a one in eight chance of getting breast cancer and a one in 30 chance of dying from it.
BAKHTIAR: Wow. What are some of the risk factors?
FRYHOFER: Well, the most important risk factor is advancing age. The older we get, the more likely we are to get breast cancer. Certainly a family history's important, especially having a mother or a daughter or a sister with breast cancer.
There are also hormonal factors. Starting your periods really early, late menopause, hormone replacement therapy can increase your risk. Also having your first baby after the age of 30 increases your risk.
But this is real important. Almost 75 percent of breast cancer cases occur in women who have no risk factors, other than just being a woman. So it's really something that every woman needs to be concerned about.
BAKHTIAR: Yes, and now we're hearing all this talk of a new study that says self breast examinations don't do the trick?
FRYHOFER: Well, you know, self breast exams sounds like a great idea. They're simple, they're inexpensive, but many studies have shown they just aren't enough. They're not going to save lives. Now the study you're talking about actually appeared in the Journal of the National Cancer Institute last week. And it looked at about 260,000 women who lived in Shanghai. Half of them got breast exams - were taught how to do breast exams in Hausiten (ph). And what they found is that the women were not able to find these tumors early enough to keep them from dying.
So this study makes it clear that self breast exam is not enough. We still need mammograms.
Now the flip side of this, and this is from the American Cancer Society, about 60 percent of women with breast cancer find their own tumor. And so, these researchers who wrote this study, they said they agreed that if a woman learns how to do a really good diligent exam, does it regularly, that we - and continues to have regular mammograms, it might increase their chances of finding a breast cancer that might pop up in between regular mammography screening, but still, you need to get those mammograms.
BAKHTIAR: Yes, but we've been hearing all this controversy about mammograms, too.
FRYHOFER: There has been a lot of confusion, but you have to understand that numerous experts have looked at this, have reviewed the data. And when you - some of the studies do have some flaws, but when you look at the whole body of evidence, it solidly says that breast cancer can prevent death, that early detection's so important, it increases our chances of getting successfully treated, and it decreases our chance of dying.
And in fact, the U.S. Preventive Task Force just reviewed all this information again. And now, the new guidelines that were just published this last month say that all women, age 40 and over, need to start mammograms every one to two years. Breast exams can help, but mammograms are what save lives and what detects cancers early.
BAKHTIAR: So what are women to do? Self exams still.
FRYHOFER: Well...
BAKHTIAR: I mean, it's better than nothing.
FRYHOFER: ...mammograms, starting at age 40, that's really what's going to keep us from dying. Now I'm still telling my patients to do the breast exams, but they have to understand that the mammograms are what's really going to, you know, keep us from dying, and what really finds it early. And that's what all this is about, early detection, saving lives.
And so, we'll have many more women who are living with breast cancer. And maybe we can decrease that 40,000 deaths a year.
BAKHTIAR: Right. So mammograms still the best way to go, even though there's all this controversy about it.
How about any new treatments to tell us about for breast cancer? FRYHOFER: Well, I think one of the most exciting new treatments is in the way we treat breast cancer. We no longer do the radical surgeries. We now do breast conserving surgeries much more commonly. Also the sentinel node biopsy has been great.
One of the main complications of having breast cancer surgery is the swelling of the arm that many women get after all the lymph nodes are removed. And what they do in the sentinel node biopsy is they actually inject some dye into the tumor, and they see what lymph node it goes to first. They check that lymph node. And if that's free of cancer, they don't have to take out the other nodes.
There are also new treatments that are being developed. We also know that Tamoxifen, which is - have been a mainstay of treatment for the last 25 to 30 years, can also be used to prevent breast cancer in women that are high risk.
So we don't have, you know, the entire answer. There are still women that at dying, but we need more research, but we're really getting a good start in helping to conquer and fight this disease.
BAKHTIAR: Now I know you said get mammograms after age 40. But do people get breast cancer before that? And how early can you get breast cancer?
FRYHOFER: Well, the older you get, advancing age is the main risk factor, but younger women can get breast cancer, too. And certainly in any age, if you find a lump, you need to go talk to your doctor and get it checked out.
Now we've talked about, you know, how great mammograms are. They aren't perfect. They do miss 10 to 15 percent of breast cancers. And there are some false positives. And if you have a false positive, not only is it upsetting, is it anxiety provoking, but it means they're going to have to have additional tests.
But still, early detection - sometimes we actually couple a mammogram with an ultrasound, to see if the mass is solid or cystic. A solid mass is more concerning. A simple cyst is probably just filled with fluid and we don't worry about those as much.
BAKHTIAR: Great, thank you. Good information, good stuff to know, Dr. Sandra Fryhofer, thank you for joining us this morning.
BAKHTIAR: Thanks, sweetie.
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 October 6, 2002 - 07:42 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
RUDI BAKHTIAR, CNN ANCHOR: Every three minutes, a woman is diagnosed with breast cancer. Early detection is key to survival, but even the experts don't agree on how often a woman should have a mammogram, or how helpful self breast exams are.
Well, joining us to talk more about early detection and treatments, Dr. Sandra Fryhofer.
SANDRA FRYHOFER, DR., INTERNIST: Good morning, Rudi.
BAKHTIAR: Good morning, doctor. Tell me, before we do anything else, let's talk about how common breast cancer is.
FRYHOFER: Well, Rudi, breast cancer is the most commonly diagnosed cancer in woman, however, it's the second leading cause of cancer deaths in women, second only to lung cancer. Two million women already have breast cancer. There are 200,000 new cases each year.
Forty thousand women die each year. And if you look at your lifetime risk, you have a one in eight chance of getting breast cancer and a one in 30 chance of dying from it.
BAKHTIAR: Wow. What are some of the risk factors?
FRYHOFER: Well, the most important risk factor is advancing age. The older we get, the more likely we are to get breast cancer. Certainly a family history's important, especially having a mother or a daughter or a sister with breast cancer.
There are also hormonal factors. Starting your periods really early, late menopause, hormone replacement therapy can increase your risk. Also having your first baby after the age of 30 increases your risk.
But this is real important. Almost 75 percent of breast cancer cases occur in women who have no risk factors, other than just being a woman. So it's really something that every woman needs to be concerned about.
BAKHTIAR: Yes, and now we're hearing all this talk of a new study that says self breast examinations don't do the trick?
FRYHOFER: Well, you know, self breast exams sounds like a great idea. They're simple, they're inexpensive, but many studies have shown they just aren't enough. They're not going to save lives. Now the study you're talking about actually appeared in the Journal of the National Cancer Institute last week. And it looked at about 260,000 women who lived in Shanghai. Half of them got breast exams - were taught how to do breast exams in Hausiten (ph). And what they found is that the women were not able to find these tumors early enough to keep them from dying.
So this study makes it clear that self breast exam is not enough. We still need mammograms.
Now the flip side of this, and this is from the American Cancer Society, about 60 percent of women with breast cancer find their own tumor. And so, these researchers who wrote this study, they said they agreed that if a woman learns how to do a really good diligent exam, does it regularly, that we - and continues to have regular mammograms, it might increase their chances of finding a breast cancer that might pop up in between regular mammography screening, but still, you need to get those mammograms.
BAKHTIAR: Yes, but we've been hearing all this controversy about mammograms, too.
FRYHOFER: There has been a lot of confusion, but you have to understand that numerous experts have looked at this, have reviewed the data. And when you - some of the studies do have some flaws, but when you look at the whole body of evidence, it solidly says that breast cancer can prevent death, that early detection's so important, it increases our chances of getting successfully treated, and it decreases our chance of dying.
And in fact, the U.S. Preventive Task Force just reviewed all this information again. And now, the new guidelines that were just published this last month say that all women, age 40 and over, need to start mammograms every one to two years. Breast exams can help, but mammograms are what save lives and what detects cancers early.
BAKHTIAR: So what are women to do? Self exams still.
FRYHOFER: Well...
BAKHTIAR: I mean, it's better than nothing.
FRYHOFER: ...mammograms, starting at age 40, that's really what's going to keep us from dying. Now I'm still telling my patients to do the breast exams, but they have to understand that the mammograms are what's really going to, you know, keep us from dying, and what really finds it early. And that's what all this is about, early detection, saving lives.
And so, we'll have many more women who are living with breast cancer. And maybe we can decrease that 40,000 deaths a year.
BAKHTIAR: Right. So mammograms still the best way to go, even though there's all this controversy about it.
How about any new treatments to tell us about for breast cancer? FRYHOFER: Well, I think one of the most exciting new treatments is in the way we treat breast cancer. We no longer do the radical surgeries. We now do breast conserving surgeries much more commonly. Also the sentinel node biopsy has been great.
One of the main complications of having breast cancer surgery is the swelling of the arm that many women get after all the lymph nodes are removed. And what they do in the sentinel node biopsy is they actually inject some dye into the tumor, and they see what lymph node it goes to first. They check that lymph node. And if that's free of cancer, they don't have to take out the other nodes.
There are also new treatments that are being developed. We also know that Tamoxifen, which is - have been a mainstay of treatment for the last 25 to 30 years, can also be used to prevent breast cancer in women that are high risk.
So we don't have, you know, the entire answer. There are still women that at dying, but we need more research, but we're really getting a good start in helping to conquer and fight this disease.
BAKHTIAR: Now I know you said get mammograms after age 40. But do people get breast cancer before that? And how early can you get breast cancer?
FRYHOFER: Well, the older you get, advancing age is the main risk factor, but younger women can get breast cancer, too. And certainly in any age, if you find a lump, you need to go talk to your doctor and get it checked out.
Now we've talked about, you know, how great mammograms are. They aren't perfect. They do miss 10 to 15 percent of breast cancers. And there are some false positives. And if you have a false positive, not only is it upsetting, is it anxiety provoking, but it means they're going to have to have additional tests.
But still, early detection - sometimes we actually couple a mammogram with an ultrasound, to see if the mass is solid or cystic. A solid mass is more concerning. A simple cyst is probably just filled with fluid and we don't worry about those as much.
BAKHTIAR: Great, thank you. Good information, good stuff to know, Dr. Sandra Fryhofer, thank you for joining us this morning.
BAKHTIAR: Thanks, sweetie.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
