For many women, breast reduction means less pain and more activity June 02, 2009 ![]() The story conveys the impression that the surgery is effective without providing any credible information to verify this. No mention of risks or costs. Egregious disease-mongering example. Our Review Summary
This story on breast reduction surgery is triggered by news reports about Simona Halep, a Romanian tennis player whose breasts are so large they reportedly affect her performance on court. While this has launched predictably vulgar chatter around the Internet, it does create something of a "teachable moment" on the topic of macromastia, as the condition of excessive breast size is known. Alas, the Daily News isn't quite up for the challenge. On the positive side, the reporter did talk to four breast surgery specialists and provides a basic explanation of the condition. The reader essentially learns that macromastia can be serious--that it causes pain, limits activity and can be treated with surgery. On the negative side:
The story's rosy view of the surgery is likely to have been shaped by the enthusiasm of the four plastic surgeons used as sources, one of whom has "his" own technique, called the "lollipop lift." All have economic self-interest in seeing breast reduction surgery portrayed as medically important and highly effective. The story has conveyed this viewpoint without resistance. [Curiously, all of the sources are men.] A reader is likely to exit this story with plenty of questions: How successful is the surgery, and how long-lasting are the symptoms? At what point does breast size become a treatable condition? At what point do the benefits of surgery outweigh the risks? Is this problem best treated early to prevent chronic pain from settling in? Alas, the story doesn't explore any of these questions. And it can't go without a final mention: Comparing the symptoms of excessively large breasts to those of metastatic cancer is just shameful.
Click on Criteria for definitions. The story states that 140,000 women per year get breast reduction surgery. This clearly implies wide availability. ![]() Discuss costs? - NOT SATISFACTORY
The story fails to mention the cost of breast reduction, which ranges from $6,000 to $10,000. The story includes the fact that insurance sometimes pays. But readers would be curious to know what might qualify/disqualify women for coverage. ![]() Avoid "disease-mongering"? - NOT SATISFACTORY
The story quotes a doctor who compares the pain of macromastia to the pain suffered by someone with metastatic cancer of the spine. This is a shamefully sensational exaggeration. It is completely unnecessary to make the point that macromastia is a serious and debilitating condition.
![]() Evaluate the quality of evidence? - NOT SATISFACTORY
The story does not cite any evidence of rates of pain reduction and increased mobility. ![]() Quantify the potential harms? - NOT SATISFACTORY
The story fails to mention the risks of breast reduction surgery, which are considerable: infection, bleeding, blood clots, nerve and muscle damage, plus the risks associated with anesthesia. Further, the story fails to mention a risk of great importance to younger women: inability to breastfeed. The story makes plain that the surgery is commonly done and makes no claim for its novelty. ![]() Quantify the potential benefits? - NOT SATISFACTORY
The story describes the benefits of breast reduction surgery but does not use any data to quantify the frequency or magnitude of the benefit. ![]() Appear to rely solely or largely on a news release? - NOT APPLICABLE
There does not appear to be a press release linked to this story. ![]() Use independent sources and identify conflicts of interest? - SATISFACTORY
The story includes comments from four plastic surgeons linked to credible institutions. Having said that, all of the sources are biased in favor of the procedure for reasons of economic self-interest. It's also worth noting that all four are men.
![]() Compare the new approach with existing alternatives? - SATISFACTORY
The story quotes a specialist saying that women with macromastia who do not have surgery can wear special reinforced bras, sports bras or even two bras, and can treat pain with analgesics and rashes with ointments. Total Score: 4 of 9 Satisfactory The U.S. Preventive Services Task Force is considered the gold standard of preventive health recommendations - including on screening tests. It's a good source for journalists and consumers.
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The website NoFreeLunch.org posts "a database of health care professionals who have pledged to accept no gifts from industry and to rely on non-promotional sources of information."
To help journalists cover stories responsibly, we post a list of independent experts who state that they do not have financial ties to drug or medical device manufacturers.
We apply the same ten standardized criteria to the review of every story.
We have about 30 story reviewers. Each story is reviewed by 3 different people.
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