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Conflicting Studies Fuel Debate Of Ways To Prevent Breast Cancer

Posted November 20, 2002

— Do mammograms really save lives? Are self breast exams a waste of time? These days, women are not sure what to believe when it comes to protecting themselves against breast cancer. WRAL's Health Team sorts through all of the confusion to provide the real facts.

While many people settle in for their first morning cup of coffee, Carol Lebing gets a toxic dose of radiation. At 60 years old, she found out she has breast cancer.

"It hit me like a thunderbolt. It devastated me," Lebing said.

Doctors diagnosed Lebing in July, seven months after a mammogram found nothing.

"I thought I was immune to it," she said.

Cases like Lebing's add fuel to the debate over mammography. In 1999, Danish researchers published a study, claiming mammograms did not decrease death rates.

"We were getting calls every day," said Dr. Julie Taber, director of the Rex Breast Care Center.

Taber said the study grabbed headlines, but according to her, "there are always two sides to the story."

Dr. Carol Hahn, a Duke radiation oncologist, said a study can be skewed depending on how it is conducted and interpreted.

"In terms of how who you pick and how you select your patients, you can affect the relative benefit," she said.

Both doctors point out that recent studies refuted those claims, but never received the same attention.

"It wasn't front page news," Taber said.

So what is a woman to do? The American Cancer Society and American College of Radiology recommend annual office exams for all women. Their guidelines also call for one mammogram somewhere between ages 35 and 40. Once a woman turns 40, experts suggest getting one every one to two years depending on their risk and every year after 50.

Karan Tremoulis said she does just that. Her grandmother had breast cancer, so she never misses a checkup.

"Cancer is a very scary thing, especially if you've had it in your family," she said.

Experts say mammograms work best when women get them regularly. They say you may not detect anything the first, second or fifth year, but if something is discovered, this is time you cannot get back.

"Stability is our friend in a mammogram. If something has been there for three years and hasn't changed, it's very, very unlikely to be cancer," Taver said

Along with mammograms, self breast exams have come under attack. Last month, one study found they did not decrease breast cancer deaths. Some experts suggested that self breast exams are a waste of time, but Lebing found her cancer through self exam.

"I'm proof that they do save lives. If I had relied solely on the mammogram, I don't know where I'd be today," she said.

Taber said she thinks it is hard for studies to prove that self breast exams save lives.

"Everything is based on statistics, but if you are the one who found your breast cancer, that's 100 percent," she said.

Taber recommends monthly self exams starting at age 20.

"It's easy. It's free," she said.

Experts say women should not rely just on mammograms, self exams or clinical breast exams. They say all of them combined is a woman's best weapon.

Lebing has three more radiation treatments left, and she said she has not slowed down a bit. She said the diagnosis that devastated her has given her new strength.

"It wasn't the death sentence that you expect," she said.

Health officials claim many women are also going off hormone replacement therapy after a study linked it to increased risk of breast cancer.


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