Online NewsHour: Debate over Mammography-- January 24, 1997

MAMMOGRAM DEBATE

JANUARY 24, 1997

TRANSCRIPT

Should women under the age of 50 routinely get mammograms for early detection of breast cancer? National experts conferred this week,but the cost/benefit debate remains unresolved. A background report is followed by a discussion between health experts and Charlayne Hunter-Gault.

A RealAudio version of this NewsHour segment is available.
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CHARLAYNE HUNTER-GAULT: There's no debating that breast cancer will claim the lives of nearly 44,000 women this year. An estimated 10,000 of those will be women who were diagnosed in their forties, making breast cancer the leading killer for this age group of women. The issue of how best to detect the disease among that age group has long been a subject of controversy, now intensified by a report from a government panel yesterday. We'll join the debate right after this backgrounder.
DOCTOR: We have a little mass here which did turn out to be a breast cancer. This was not noticeable on self-examination.
CHARLAYNE HUNTER-GAULT: Mammograms or X-rays of breast tissue are one way to detect breast cancers. Cancer researchers agree that women over 50 clearly benefit from mammograms and that women under 40 don't. But for those in the middle, between 40 and 49, medical experts have flip-flopped with advice for two decades. For example, in 1977, the National Cancer Institute and the American Cancer Society agreed that women in their 40's should have yearly mammograms if they have a family history of breast cancer.
But in 1980, the American Cancer Society urged a first-time mammogram by age 40 and then said women should consult their doctors about whether to have annual tests. Then in 1983, the cancer society reversed itself and called for mammograms every one or two years for women in their 40's. Then ten years later, the National Cancer Institute set off a firestorm of controversy by declaring that the experts no longer agreed on the need for regular mammograms. The American Cancer Society objected and continued to call for regular testing.
Yesterday, a panel of doctors convened by the National Institutes of Health announced their findings, saying the evidence supporting mammograms for younger women isn't sufficient to make a recommendation. The panel said that women, themselves, should make the decision.
DR. LEON CORDIS, Chairman, Mammogram Consensus Panel: We believe that the best recommendation that we can make is to provide women with the best and highest quality information about the potential risks and benefits of mammographic screening in the 40's so that women in that age group can take this information and with the aid of a physician or other health care provider or other counselor consider how these data, how the information on risk and benefit, translate for themselves.
CHARLAYNE HUNTER-GAULT: The panel's refusal to endorse mammograms drew sharp criticism from health professionals and others who worry that more women will die from breast cancer if fewer of the tests are done. That concern was echoed by two congresswomen today.
DEL. ELEANOR HOLMES NORTON, (D) Washington, D.C.: I do not question the difficult science that confronted the panel. What I do question is their decision to err on the side of risk.
DOCTOR: We'll fill out this requisition. I'll give it to the nurse down the hall, and then we'll get your mammogram booked.
CHARLAYNE HUNTER-GAULT: The debate over mammograms will continue as both the major cancer organizations announced plans to revisit the issue in the next two months.

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