Strong point: The Independent expert perspectives added to the story.
Weaker points: Harms not discussed. Benefits not adequately quantified. The true novelty of the study was not adequately explained. And why was there no mention of adjuvant chemotherapy or hormone therapy?
Individuals diagnosed with breast cancer are in shock. Psychologically challenged, they must then make major decisions about treatment. Two common choices include mastectomy, or lumpectomy with radiation. Both have major consequences, with little time to consider options. Any facts can help women and men make this decision, taking into account physical costs, psychological costs, and survival probabilities.
There was no discussion of the differences in cost between the two options.
The story only attempted to quantify a benefit for one subset of women, when it reported:
“The group that benefited the most — who had the biggest difference in breast cancer survival — were those women over 50 with estrogen-receptor positive disease,” Hwang said. This means their cancer depends on estrogen to grow.
Among those women, the lumpectomy group had a 13 percent lower risk of death from breast cancer and a 19 percent lower risk of death from any cause than those who had a mastectomy.”
But that was only a subset of women. And even in that subset, what was the risk of death? Was the difference of 13% and 19% really that much of a difference?
There was no mention of possible harms from either treatment. In particular, there was no mention of the possible long-term dangers of radiation.
The story did turn to two independent sources to evaluate the quality of the evidence, one of whom said, “I am not sure the study convinces us that lumpectomy and radiation is better for breast cancer survival, but it may be.”
The story also pointed out that the “study was observational… It found a link or association but could not provide cause-and-effect proof that the breast-conserving treatment is more effective than mastectomy in early stage breast cancer.”
There was no disease mongering noted.
The article did include the perspectives of two independent sources.
The story didn’t say anything about adjuvant chemotherapy or hormone therapy.
No discussion of availability of either approach, but we don’t think that was necessary in this case.
All the story said was that “Earlier research had also concluded that the two procedures are similarly effective, but Hwang’s is a more “real-world” study.” But the story never adequately explained what that means and why it makes this analysis different.
The story includes several independent sources.