NPR on breast cancer – what we learned in 2012

Read or listen to Richard Knox’s piece. Among several strong elements in his story, he profiles Shannon Brownlee’s decision to stop having mammograms:

Health writer Shannon Brownlee of the New America Foundation says the issue is a prime example of what she calls American medicine’s tendency to overdiagnose and overtreat disease. She’s the author of Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer.

Currently, Brownlee says, most doctors present annual mammograms as a “got-to-do-it” thing, not an individual choice.

Brownlee, who’s 56, has made up her mind. She doesn’t get regular mammograms. But she says it wasn’t easy.

“We have been told for, oh, almost a century now that catching cancer early is always a good thing,” she tells Shots. “So when people come along and say, ‘Well, maybe screening may not always be such a great thing,’ it’s very, very difficult to contemplate that.”

As she delved into the subject, Brownlee was impressed with the downside of routine mammograms.

When Brownlee decided she didn’t want an annual mammogram, that put her at loggerheads with her doctor.

“She would say, ‘You have to get a mammogram,’ and I would demur,” Brownlee explains. “And she would say, ‘Not a week goes by that a patient of mine didn’t have her life saved by getting a mammogram.’ And I wanted to say, ‘How do you know?’ Because you can’t know after the fact.”

That, in fact, is true. While studies show routine mammograms do save lives overall, even their staunchest advocates acknowledge you can’t know in a particular case.



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William M. London

January 8, 2013 at 2:08 am

You wrote at about how inappropriate it was for Dr.Jonathan LaPook to discuss the advice he gives patients while reporting about Flegal’s BMI & mortality meta-analysis. Why are you not being similarly critical of Brownlee for reporting about her own personal choice to not get regular mammograms? Did Brownlee do a better job of the kind of labeling of the shift from reporting to commentary you emphasized in discussing LaPook? Did you exempt Brownlee for criticism because she made a choice consistent with how you see the relevant science?

    Gary Schwitzer

    January 8, 2013 at 7:27 am


    You missed the key difference.

    LaPook was the reporter, yet gave his own advice to patients from his platform as national TV news reporter.

    Brownlee was not reporting anything. NPR approached her for an interview. She was the interviewee – not the reporter. So I didn’t exempt her from criticism for any reason. The comparison of her with LaPook in this instance is apples and oranges. Journalism ethics – codes for which I cited in my blog post – apply to the reporter in the former case. They don’t apply to the interviewee in the latter.