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A breast cancer study in mice gets big headlines, setting up potential for patient ‘disaster,’ experts say

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Joy Victory is Deputy Managing Editor of HealthNewsReview.org. She tweets at @thejoyvictory.

“I spoke to several cancer specialists in New York City last night who said ‘caution, this is not ready for primetime.'” — ABC News chief medical correspondent Dr. Jennifer Ashton.

That’s the key quote from a recent Good Morning America “Cover Story” segment about a mouse study exploring why breast cancer sometimes spreads in the immediate months after tumor-removing surgery.

But that caution comes more than halfway through the segment, after GMA already floated an idea that will certainly alarm many cancer patients–and could even be harmful, several cancer experts said.

Researchers theorize that, based on what they studied in mice, post-surgery wound inflammation may trigger cancer growth in cancer patients whose tumors are surgically removed. They also theorized that anti-inflammatory drugs like aspirin might be useful in lowering the tumor growth, based on how the mice responded.

Despite her sources making it clear that this mouse study isn’t applicable to people, Ashton proceeded to put together a segment for a national morning audience about the research. Several other news outlets also reported on the study, including STAT, USA Today, and UPI.

We can only guess why Ashton chose to ignore her sources’ advice and run with the story, but it may be because breast cancer studies make for good viewer- and click-bait, especially among predominantly female audiences like GMA’s.

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Yet, when experts warn you that a study isn’t ready for primetime, isn’t that a really good sign to pass it over and wait for something more conclusive?

Fortunately, the news coverage we looked at had both strong points and weak points. For example, ABC News’s print version of GMA’s segment opens with a useful “if” phrase: “If a new study in mice ends up holding true for humans, there may be a new explanation for why breast cancer can spread after surgery.”

And STAT’s story deserves praise. The phrase “in mice” was included in their headline, and the article explored the many limitations–especially how the researchers implanted and then removed sponges out of the mice to replicate an inflammatory response similar to what people might experience after a lumpectomy. This detail alone will give many people pause.

Misleading news reports

That nuanced reporting differs from the story that ran in USA Today. Not until the sixth paragraph do we learn that the study subject were rodents, for example. And while the story said twice that the study wasn’t “definitive,” readers will be left with a different impression when they read quotes like this:

Although the data are not definitive in people, Dillekås said that if she got cancer surgery, she’d ask for an anti-inflammatory drug.

“I would definitely go for it,” she said.

Yikes.

UPI’s story also buried the whole “mouse” aspect of the study, and misinterpreted a different study:

A small, separate study showed breast cancer patients who were treated with the anti-inflammatory drug ketorolac in the days following surgery were five times less likely to have the cancer spread than those who didn’t receive the medication.

Based on the description, readers might be forgiven for thinking that this was a randomized, controlled trial in which a treatment was tested against a placebo–but it wasn’t. Instead this finding was determined by reviewing old medical records from one surgeon’s practice to find notable patterns that may or may not explain why someone had a cancer recurrence. While the study is useful for helping trigger further research, it’s far from conclusive.

News release makes it sound like human study

Breast cancer caused by surgery healing--Reckless reporting on a'not ready for primetime' studyWhat alarmed breast cancer survivor and epidemiologist Mandy Stahre, PhD was how the results of the mouse study were presented as proven facts.

“There are other factors about a person’s health that influence inflammation and a person’s health going into surgery should be considered,” said Stahre, who is a HealthNewsReview.org contributor. “The media coverage is confusing and gives women a false sense of control related to preventing metastases. More research is needed and human studies need to be conducted before jumping to any conclusions.”

If this isn’t primetime research, why did so many news outlets cover it? They were likely compelled by this MIT news release with a headline that sounds like a human study:

“Perioperative NSAIDs may prevent early metastatic relapse in post-surgical breast cancer patients.” [emphasis added]

The news release, to its credit, does disclose it was a mouse study in the sub-title and opening sentence. However, the release uses language that makes the reader conjure images of people, not mice. For example, by referring to genetically modified mice as “breast cancer patients” and then leaping to unknown and speculative human benefits based on the experiment:

According to new research conducted in mice by Whitehead Institute scientists, surgery in breast cancer patients, which while often curative, may trigger a systemic immunosuppressive response, allowing the outgrowth of dormant cancer cells at distant sites whose ability to generate tumors had previously been kept in check by the immune system. Taking a non-steroidal anti-inflammatory drug (NSAID) around the time of surgery may thwart such early metastatic relapse without impeding post-surgical wound healing.

This does impact patients

“There is nothing in this study that should lead to any changes in the way we treat breast cancer. I don’t want anyone to read the media coverage of this study and think that they shouldn’t have surgery. That would be a disaster,” said oncologist Larry Norton, MD in a blog post on the Memorial Sloan Kettering Cancer Center web site.

But it appears that people may be thinking that, at least on social media. Check out these comments left on a Facebook post from KSDK-TV in St. Louis, which republished the GMA story:

  • “Wish now I just would have gone with my first choice~mastectomy.”
  • “I feel like it’s a little unclear… are they referring to the mastectomy, reconstruction or any surgery in/around the breasts? I’ve had 5 surgeries in the last year and one more to come. And I had chemo in the middle… how does that play into it?”
  • “Lord, I wish I had known this, now I’m stage 4. 😢”

That’s a lot of anxiety–for a study that wasn’t even ready for primetime.

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Comments (3)

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Dr Jennifer Ashton

April 16, 2018 at 2:11 pm

It’s nice that you think (erroneously) that i have the sole power to decide what topics are aired but that is not remotely true. In fact, the ONLY responsibility i have is to explain the medical stories that people will be reading and hearing about in exactly the same way as i do in my medical office: by citing pros/ cons/ raising interesting scientific questions and, when appropriate, citing relevant methodology. All of which we did in our GMA segment.

    Joy Victory

    April 16, 2018 at 3:56 pm

    Dr. Ashton, thank you for reading our post and commenting. There’s a lot to unpack in what you said, and our diverging viewpoints may stem from differing ideas about what the responsibilities are of a chief medical correspondent for a major network: Is it to boost viewer numbers with exciting-but-overblown headlines, or is it to scrutinize the research and appropriately push back when a study is “not ready for primetime?” We feel it’s the latter, especially when the stakes are so high–when the subject is breast cancer metastases and the news audience is nearly a million people. If you, as you say, have little control over what airs–and had no option to pass on the study–then we at least think the segment could have been handled differently, for the reasons we explained in the post.

    That said, we were heartened that you did make it clear that it was a rodent study, and that your sources said it wasn’t ready for primetime. Had either of those detailes appeared in the lower-third, it would have gone a long way.

Bob Roehr

April 16, 2018 at 4:47 pm

Dr. Ashton’s comment is a cop out; it’s “the editors made me do it” excuse for not sticking with her own journalistic judgment. Would she use the excuse of “the insurance company made me do it” if it was a medical procedure she did or did not do, rather than her best medical judgment?