This “founding mother” of the breast cancer advocacy movement has strong opinions, the support of the government, and most importantly for women facing the threat of getting breast cancer, she isn’t afraid of controversy.

When looking for someone in the forefront of the fight against breast cancer, you need look no further than Dr. Susan Love. Dr. Love is a researcher, author, activist and surgeon, who is one of the earliest founders of the breast cancer advocacy movement.

Her work in the field of breast cancer reform and research is endless. She is the Director of the National Breast Cancer Coalition, and the Medical Director of the Susan Love MD Breast Cancer Foundation (www.susanlovemdfoundation.org), a non profit organization dedicated to the eradication of breast cancer. In recognition of this work, she was appointed by President Clinton to the National Cancer Advisory Board in 1998.

Dr. Love is the author (with Karen Lindsey) of Dr. Susan Love's Breast Book (Third Edition, Perseus, 2000), which has been called the bible of breast health, as well as Dr. Susan Love's Hormone Book: Making Informed Choices About Menopause (Random House, 1998). The American Breast Cancer Guide recently spoke with her about some of the newest developments in research in breast cancer, her thoughts on mammograms and breast self-exams, her Foundation and the exciting new breast cancer detection method she has created, the breast pap smear.

ABCG: "Let's start by talking about some of the newest developments in the field of breast cancer research. A recent study came out in the New England Journal of Medicine saying that breast cancer support groups don't extend the lives of cancer patients. Can you comment on that?"

DR. LOVE: "A previous study by Dr. David Spiegel at Stanford showed that women with metastatic disease who participated in support groups lived 18 months longer than women who did not participate in support groups. Since Dr. Spiegel's study was a great surprise in the field, this second study that you are referring to, was done to confirm the first study. In the current study, support groups do not change the mortality rate of breast cancer once the cancer has spread. It's important to clarify that the study didn't say that support groups don't do any good, it just says it may not make a difference as to whether a woman lived or died if she had metastatic disease (which means she is very far along in her cancer). Also, a lot of variables come into play. Perhaps treatment is better now than when he did his study. Or support groups may have an effect earlier in the process."

ABCG: "Another study came out saying mammograms don't make a difference in early detection of breast cancer. What are your thoughts on that subject?"

DR. LOVE: "This is not a new study, but a recalculation of previous studies. The important message is that mammography is not perfect. The reality is some small cancers spread very aggressively, while others are so big you don't need a mammogram to catch them, and others fall somewhere in the middle. Bottom line: Mammography is the best screening test we have, but it's not perfect."

ABCG: "Can you explain why you don't support breast self-exam?"

DR. LOVE: "There has been no scientific data showing that there is a benefit from breast self exam; instead, there is good data showing that there is no mortality benefit at all. Mammograms and breast self exams have been oversold to women, as if they always work. One quarter of women who get breast cancer will die from it. Rather than focusing on breast self-exam, we need to find something that will work all the time."

ABCG: "Speaking about finding something that might work, tell us about your newest procedure ­ the breast pap smear. Do you want it to replace mammograms?"

DR. LOVE: "All breast cancer starts in the lining of the milk duct, and by the time you can see or feel it, it's been there a long time. The problem is we don't have a way to get there. If we can find a way to get into the lining of the milk ducts, we can sample the cells, similar to the way a pap smear can find precancerous cells, or cells on the verge of being cancerous. That's why I've created a tiny catheter, to be used in an FDA-approved procedure called ductal lavage, which washes out the ductal cells.

What we do is painlessly insert the catheter into the milk duct, squirt in salt water and wash out the cells. The resulting fluid can then be analyzed to give a picture of the types of cells lining the duct, so we can see who is at risk. It isn't being used to detect cancer (cause we don't know if it can). Where it is valuable is in helping high risk women get more information. The procedure using my catheter is available in many centers in the United States, and you can find these centers on my website www.susanlovemd.com."

ABCG: "Tell us about the work The Susan Love MD Breast Cancer Foundation
is doing?"

DR. LOVE: "The Foundation runs the web site and answers people's questions about breast cancer and menopause. We also raise money and fund research into the intraductal approach to breast cancer. I firmly believe that the intraductal approach to the breast is the beginning of the end of breast cancer. This is the basis of our mission."

ABCG: "Can you tell us about some of the most promising clinical trials you are aware of?"

DR. LOVE: "There are new studies going on that are looking at hormonal approaches to breast cancer. For example, in younger women, there is research on a drug called Zoladex which puts them into temporary menopause. There is also a lot going on in targeted therapies right now. For example, the same chemotherapy is given to most to patients ­ a one size fits all mentality. New studies try to characterize the molecular abnormalities so that therapies can be directed specifically to that type of cancer."

ABCG: "As an advocate for reform in the area of breast cancer, what would you recommend a woman diagnosed with breast cancer to do?"

DR. LOVE: "I'd like her to realize that a diagnosis of breast cancer is not an emergency. She has time to get a second opinion, read, do research, search out her options. The first reaction most women have is 'Get it out of me,' and the surgeon says, 'Fine, I have time tomorrow morning,' and the next thing she knows she's had a mastectomy and she may or may not have needed it.

I would tell any woman who has gotten a diagnosis of breast cancer to calm down and take a deep breath, before rushing to do something drastic she may regret."