TODAY   |  April 02, 2014

Study reveals complexity of mammogram issues

Dr. Roshini Raj and Dr. Adam Ofer join TODAY to chat about the latest health headlines, including  new blood pressure guidelines and the complex findings of a study about mammograms.

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This content comes from Closed Captioning that was broadcast along with this program.

>>> there's new guidelines to tell you about that could affect the way you're being treated.

>> plus a controversial new study on mammograms and a test that rules out heart attacks . here with more on all of these health headlines is a "today" contributor and assistant professor of medicine at nyu.

>> also the director of gynecology at norwalk hospital . good morning to both of you. all right, doctors, let's get started. and this is that controversial new study out about mammograms. and what does it tell us?

>> this is a review of the last 50 years on mammograms and basically what it's telling us is there's probably more harm than we previously thought due to mammograms and probably less benefit to them. so we know that guidelines have changed and now it's no longer recommended by some groups to start mammograms at age 40. and this study underscores that. the fact that over half women that will get annual mammograms for ten years will have false positives . that means they're going for more tests, maybe even biopsies and a lot of the anxiety that's associated with that.

>> that's the thing, i had a false positive . i had a biopsy, the whole scar experience. i'm 43, i've had three doctors tell me three different ages over the last few years.

>> there's a lot of confusion. the problem is this, do mammograms save lives? yes, absolutely for almost any age group . the question is, at what cost? for someone in their 50s, it can take 1,300 mammograms with false positive rates of 8% to 9% of those women getting a biopsy at one point to save a life. where is that risk balance? if we're talking about my daughter? what am i willing to spend, to do to save her life? millions. but how do you balance that for a society? to create guidelines that work. we all have different levels. some people have more level of stress about cancer, other people have more level of stress about the unnecessary biopsy. how do you balance that? there's no answer. we need to stratify the risk. show women what the risk is and let them make a personal, educated decision.

>> seems every new study creates more confusion. what do you tell women watching today?

>> the take away from this is you need to have a discussion with your doctor about your individual risk. and your personal beliefs about how much you want to know or are you more of a watchful waiting person? because we don't have clear data saying that absolutely mammograms should start at age 40.

>> you saw your mother die of breast cancer , you're probably more willing to accept the false positive .

>> i was talking to savannah earlier, and all three of us ladies have all had false positives . goes to show you. we're in that group. it's important to be watching it, and i go every six months and get checked as a result of it. important -- raises your awareness.

>> let's look at the next study how a bad night's sleep can affect more than your mood.

>> i love this study. it's talking about how it can age your brain. and what they did is looked at older men over the age of 70 and measured the quality of their sleep and then they tested them three to four years later on their cognitive function . memory and concentration. and those with the poorer quality sleep did have a decline in their brain function .

>> wow.

>> what was equivalent to aging five years. so we're always talking about how do we feel younger and act younger? well, something as simple as getting a good night's sleep can make a difference.

>> how to rule out a heart attack .

>> millions of americans are showing up in emergency rooms throughout the year complaining of chest pain . most of that is congestion, muscular pain . but most of it is not a heart attack . the e.r. doctors have a tough job figuring out who do we take seriously? many people are admitted unnecessarily. this test looks at a new, more sensitive, better test which is a byproduct of degradation of heart muscle during a heart attack and looks at a typical ekg and tells us who we can send home and who we need to keep in the emergency room .

>> a blood test , right?

>> a blood test and it's a typical ekg. they send home 9,000 people with negative test in this study, none of those people died from a heart attack . it's an accurate test. it can save a lot of time in the emergency room and a lot of money in the health care system .

>> we wanted to mention new guidelines for blood pressure .

>> that's right. new guidelines came out in february that actually relaxed the level at which we should treat blood pressure . so instead of 140 over 90, 150 over 90. a lot of cardiologists and doctors don't necessarily agree with these guidelines, but this study said if we do follow them, about 1/4 americans taking blood pressure medications would not need to be treated. you never stop your medication on your own, talk to your doctor. but for people taking a lot of medicines potentially with interactions, they may not need the blood pressure medication.