“Less is more” theme from breast cancer conference attracts little mainstream news coverage

Michael Joyce produces multimedia at HealthNewsReview.org and tweets as @mlmjoyce.

The last weekend in April the American Society of Breast Surgeons held their 18th Annual Meeting in Las Vegas, Nevada.

breast cancerThe first day of the conference I wrote a blog post simply looking ahead and wondering how reporters would cover the event. What might emerge as a hot topic? Or, perhaps, be neglected?

The post-conference upshot is that the meeting received almost no coverage from the mainstream media at all. Most of the coverage came from trade magazines, patient advocacy groups, and the public relations departments of medical institutions whose doctors were presenting.

I wondered why that was the case and turned to some expert sources for their perspective.

Larry Husten | @cardiobrief

“Most meetings have always been covered by PR departments and trade magazines,” says veteran health reporter, Larry Husten, who mostly covers the very large and very popular cardiovascular meetings. “That hasn’t changed, but maybe what has is that more reporters are now able to cover meetings from a distance.”

But this speaks to how meetings are covered and not what gets published.

deanna attai breast surgeon

Dr. Deanna Attai | @DrAttai

Going into the conference, Dr. Deanna Attai — a UCLA breast surgeon, frequent contributor of ours, and past president of the society — was pretty sure that DCIS (ductal carcinoma in situ), and advances in both screening mammography and genetic cancer markers would probably be popular because they usually are.

She also thought new research about post-surgical lymphedema (swelling of the arm on the side of the breast surgery), as well as other issues of “survivorship,” might not be attractive to reporters.

Dr. Attai has been going to the meeting for years and I asked her if she noticed a difference in media attention this year.

“I agree that there wasn’t much coverage this year,” she said, adding that there were probably several reasons. “We’re a relatively small organization compared to AACR and ASCO (American Association for Cancer Research, and American Society of Clinical Oncology, respectively).

“And while our program covers all aspects of breast disease from benign conditions to metastatic cancer, you’re not likely to find the ‘hot’ stories about new immunotherapy treatments or blockbuster drugs. Surgical research is slow and — to many in the media — boring. But I would disagree. This meeting covered the trend of decreasing surgical therapy in many settings … however, these topics don’t seem as appealing to the media.”

Key phrase here is “decreasing surgical therapy.” If there was an underlying theme to the conference it was not so much focused on new therapies or more surgeries; rather, it was about less surgery or — at the very least — more conservative and judicious approaches to breast cancer.

Less is more … vs … less is less?

This is what intrigues me most about the lack of mainstream media coverage at the conference: is a cautious and tempered approach to breast cancer treatment not sexy to the media? Even though less may be more for patients, is less simply less for the media? If so, then readers are being short-changed, because this represents a watershed moment in how we approach breast cancer.

Case in point. There was an abstract presented at the conference showing that, in women with DCIS, only 6 percent developed cancer in the other (contralateral) breast within ten years. It suggests that removal of that breast may be totally unnecessary. This is vital information which directly and significantly changes the shared decision-making between DCIS patients and their physician.

Likewise, a study presented by Mayo Clinic doctors demonstrated that breast cancer-related swelling (lymphedema) may not be simply related to surgery alone — as traditionally believed — but the result of the cumulative trauma of radiation, chemotherapy, and other factors. Not only is this a paradigm shift, but it’s a key piece of information that will likely change how doctors advise their patients. Whether this information will encourage a more cautious approach to using multiple therapies will be interesting to watch.

Miles Davis, the American jazz trumpeter and composer said: “It’s not the notes you play, it’s the notes you don’t play.”

Clearly, this latest conference of the American Society of Breast Surgeons falls into the latter category. Research from this meeting confirms overtreatment is a very real issue. That is an important story in and of itself. As is the possibility that reporters tend not to give as much coverage to research that does not lead to more drugs, more surgeries or more interventions.

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Bob Roehr

May 9, 2017 at 6:04 pm

First, conference coverage overall is down, even for trade publications but especially for more general readers; it’s a long-term trend because money is tight all around.

Second, Vegas is not exactly a hotbed of local freelancers covering medicine, compared with Boston, DC, Chicago, SF etc. and that means travel/hotel expenses add up.

Third, if one is going to take on travel expenses to attend a meeting, one is more likely to hit one of the larger ones that have more potential stories being generated there.

Fourth, maybe reporters are getting smarter, and particularly for softer delivery of care studies compared with those that have p values, are waiting for peer review and publication not simply presentation. That is particularly true if the insight is only an observation that is not quantified or explained.

Fifth, why is the amount of surgery declining? Some of it likely is a trend toward less aggressive intervention and more watchful waiting. But another part is the development of alternative interventions, particularly small molecule drugs and biologics that often work better with early intervention and preclude the need for surgery.

Caroline Helwick

May 15, 2017 at 8:22 am

I write for the ASCO Post, which goes to members of the American Society of Clinical Oncology. The ASBrS is a terrific conference and I attended last year but due to a personal conflict could not be onsite this year. I was able to capture the two important studies Larry mentioned–DCIS and lymphedema–in the ASBrS telebriefing, without attending the meeting. The ASBrS communications team does a fine job of promoting the conference and such topics. Any reporter could cover this topic without the associated costs of travel, as pointed out in another comment. No excuses! Mainstream media should have identified these topics as important to the general public.