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SCIENCE IN THE NEWS - February 26, 2002: Mammograms
By Jerilyn Watson
VOICE ONE:
This is Bob Doughty.
VOICE TWO:
And this is Sarah Long with Science in the News,
a VOA Special English program about recent developments in science.
Today, we tell about the debate over a test used in the fight against
breast cancer.
((THEME))
VOICE ONE:
For many years, experts have suggested that
women have breast X-ray examinations called mammograms. Many doctors
say these X-ray examinations reduce a woman's chances of dying of breast
cancer. In the United States, an estimated one of eight women will develop
breast cancer during her lifetime. The risk increases as a woman gets
older. The government has spent hundreds of millions of dollars to help
pay for these mammograms.
VOICE TWO:
A mammogram takes a detailed X-ray picture of
the inside of the breast. The picture can show if a woman has abnormal
tissue that could be cancer. Health experts have told women that early
discovery could reduce their chances of dying of the disease. They say
the chances could be reduced by thirty percent. These experts have said
early discovery of cancer might prevent removal of the whole breast
and other severe treatments.
However, some experts no longer give this advice.
They now say there is not enough evidence to say that mammograms reduce
deaths from breast cancer. They say early discovery of breast cancer
does not always guarantee that the disease will not spread to other
parts of the body. Many women and their doctors are left questioning
what to do.
VOICE ONE:
Mammograms can show an extremely small tumor.
They can show cancer long before a patient suspects it. But now, some
doctors say cells from even a very small tumor may threaten a woman's
survival. They say a small tumor may not be an early tumor. They say
cells from these cancers may already have spread to other parts of the
body.
Some experts say long-term survival does not
depend on the size of the breast tumor. They say survival depends on
the aggressiveness of the tumor. If a tumor has already invaded other
parts of the body, even the best treatment may not save the patient's
life.
VOICE TWO:
An independent committee advises the National
Cancer Institute about cancer testing and prevention. For years, this
committee has advised women to start having mammograms at about age
forty.
Last month, the committee said it would no longer
advise mammograms. Ten experts found problems in the studies that helped
make mammograms an important cancer-fighting tool. The experts said
these studies were not performed correctly. Some of the studies were
started as early as Nineteen-Sixty-Three. At that time, some requirements
for such studies were not as demanding as they are today.
However, the National Cancer Institute disagrees
with the independent committee. The institute will continue to advise
women in their forties and older to have mammograms every one to two
years.
((MUSIC BRIDGE ))
VOICE ONE:
Criticism of mammograms began to increase last
October. At that time, the British scientific publication The Lancet
reported on early breast cancer studies. The report said they show mammograms
provide only a little protection against dying of breast cancer. It
said there is not enough clear evidence to decide the value of mammograms.
Two scientists from the Nordic Cochrane Center
in Copenhagen, Denmark wrote the report. They said five of seven earlier
studies of mammograms have problems. They said possible mistakes in
the records may have weakened the research. They also said health histories
of women in one study may have contained mistakes.
The Lancet, however, now has published a more
recent report on the subject. This report says a Swedish study confirms
the value of mammograms. Their report says evidence developed in Sweden
shows mammograms can provide long-term protection against death from
breast cancer.
((MUSIC BRIDGE))
VOICE TWO:
Health scientists are debating the conflicting
evidence. For example, ten health advisory organizations placed an advertising
message in The New York Times newspaper in late January. This ad advised
women to continue having mammograms. The American Academy of Family
Physicians and the American Cancer Society were among the groups that
placed the ad.
Doctors who treat cancer belong to the American
Society of Clinical Oncology. The society has organized a committee
to study mammograms. The United States Preventive Services collects
and prepares health information. The group is organizing a report. Two
United States senators plan hearings on the issue.
VOICE ONE:
Barron Lerner is a doctor at the College of
Physicians and Surgeons of Columbia University in New York City. Doctor
Lerner has written a book called "The Breast Cancer Wars."
He says both supporters and critics of mammograms have provided valuable
information.
Doctor Lerner says a woman's age can help her
decide about mammograms. He says he will not advise women under fifty
whether or not to have the test. He will continue to suggest a yearly
mammogram for women ages fifty to seventy.
Many breast cancer experts still believe that
mammograms can save lives. They say mammograms find more early cancer
tumors than any other test. In the past twenty years, death rates from
breast cancer have dropped. However it is not clear if this is the result
of early treatment due to mammography, better treatment, better education
or some other reason.
((MUSIC BRIDGE))
VOICE TWO:
Millions of Americans have become activists
against breast cancer. This activism began almost thirty years ago.
In Nineteen-Seventy-Four, the wife of President Gerald Ford had an operation
for breast cancer. At the time, there was far less public discussion
of this kind of cancer than today. Then Betty Ford openly discussed
her disease. She helped Americans learn and talk about breast cancer.
Many women went to their doctors for examinations.
Today, activists work to increase money for
breast cancer research. They demand better education and treatment for
the disease. Activists include men and women, individuals and businesses.
They may disagree about mammography or other issues. But they all share
the goal of trying to save lives.
VOICE ONE:
For example, a woman named Nancy Brinker started
the Susan G. Komen Breast Cancer Foundation in Nineteen-Eighty-Two.
It honors the memory of her sister who died of breast cancer.
The sisters had a close relationship while growing
up in Peoria, Illinois. Later they lived far apart. However, they talked
by telephone every day. Miz Brinker says she still remembers the day
her sister said she had a lump in her breast. This growth proved to
be cancer.
Some of America's best doctors treated Susan
Komen. But she died of the disease. After that, Nancy Brinker started
her foundation. She decided to see if one person could make a difference
in the struggle against breast cancer. During the past twenty years,
this organization has worked hard to fight the disease.
The Komen foundation operates a telephone information
line for patients and others. The foundation and allied organizations
have raised more than two-hundred-forty-million dollars. The money helps
provide research, education, examinations and treatment.
VOICE TWO:
One of the events that the Komen foundation
organizes is called "Race for the Cure." This year, more than
one-million people will walk or run in the five-kilometer race. These
events take place in more than one-hundred American cities and three
other nations. They are held to raise money. Many other organizations
and businesses also organize walks, races and other events to raise
money for breast cancer research.
The wife of a seventy-five-year-old retired
Army officer died of breast cancer several years ago. Since then her
husband has taken part in two fund-raising events. Last year, he walked
more than eighty kilometers to aid breast-cancer research and treatment.The
retired officer said he did this to honor the memory of his wife. He
said he also did it to protect the future of their daughter.
((THEME))
VOICE ONE:
This SCIENCE IN THE NEWS program was written
by Jerilyn Watson. It was produced by Cynthia Kirk. This is Bob Doughty.
VOICE TWO:
And this is Sarah Long. Join us again next week
for more news about science in Special English on the VOICE OF AMERICA.
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