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A more sensitive exam?

Rating

5 Star

A more sensitive exam?

Our Review Summary

The story discusses self-breast exams with and without a self-breast exam kit. The story presents the pros and cons of this relatively new addition to the arsenal of screening tools.  There is little published evidence that this device is any better at detecting lumps than a traditional self-breast exam using your fingers. One physician interviewed suggests that using soap and water when conducting an exam should provide the same friction as using a self-breast exam kit with a Touch Enhancing Pad.

This 5-star story is quite balanced and provides the reader with useful information about self-breast exams.  The story notes sources’ affiliations and balances comments from self-breast exam advocates (mainly Olivia Newton John as a breast cancer survivor and those who stand to gain from the sale of self-breast exam kits), with comments from breast cancer researchers. The latter provide excellent perspective on self-breast exam kits and discuss current evidence on the practice of self-breast exams. 

The story lists the downsides of screening via a self-breast exam, namely, increased anxiety about benign lumps and overtreatment via biopsies for false positives. The story appropriately notes a woman’s individual risk is a factor when choosing how and when to be screened and notes that results from population-based studies may not apply to an individual woman. For example, a woman at higher-risk may feel that  monitoring tissue changes via self-breast exams is useful.

Overall, the story discusses the self-breast exam kit as an option for conducting self-breast exams. The story also mentions "other tests" as options for breast cancer screening. It would helpful to note that these other tests (such as mammography with ultrasound or an MRI) are more accurate than the SBE and might be more useful for younger women or women at higher-risk of breast cancer.  Additionally, screening via these other tests might avoid the need for a biopsy or other invasive treatment.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story lists the cost of the kits: $25.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story provides unpublished data on a self-breast exam kit study and puts the results in context by also discussing a 10-year randomized controlled study looking at the efficacy of self-breast exam in detecting early-stage breast cancer.  The latter study called into question the practice and noted that more benign lumps (false positives) were found and there is no real survival benefit for regular self breast exam. The story also discusses that self breast exams by themselves are not recommended for detecting breast cancer, especially in higher-risk women. The story notes that self breast exams may help women become more familiar with their breast tissue, and thus be more aware of any changes. This echoes current United States Preventative Services Task Force Guidelines which state:  breast self-examinatino has not been shown to lower deaths from breast cancer.  Based on current evidence, USPSTF does not recommend for or against BSE (USPSTF 2002).  

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story lists the downsides of screening via a self breast exam, that is, increased anxiety about benign lumps and overtreatment via biopsies for false positives. The story appropriately notes a woman’s individual risk is a factor when choosing how and when to be screened, that is, results from population-based studies may not apply to an individual woman. A woman at higher-risk may feel that  monitoring tissue changes via self-breast exam is useful.

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story does an excellent job presenting the lack of adequate quantitative evidence for the device, as well as the results of a large, randomized trial examining the efficacy of self breast exam for improving survival.

Does the story commit disease-mongering?

Satisfactory

The story does not engage in disease mongering. The story notes the pros and cons of a self-breast exam and explains that there is little evidence that the Liv Aid exam kit is more accurate (or more useful) than a traditional self-breast exam done by palpating breast tissue with your fingers.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story has a great deal of independent reporting and is quite balanced.  The story notes sources’ affiliations and has a good mix of self-breast exam advocates (mainly Olivia Newton John as a breast cancer survivor and those who stand to gain from the sale of self-breast exam kits), as well as breast cancer researchers. The latter provide perspective on self-breast exam kits and discuss current evidence on the practice of self-breast exams.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story provides the self-breast exam kit as an option for conducting self-breast exams. The story also mentions "other tests" and biopsies as options for breast cancer screening. It would helpful to note that these other tests (such as mammography with ultrasound or an MRI) are more accurate than the SBE and might be more useful for younger women or women at higher-risk of breast cancer.  Additionally, screening via these other tests might avoid the need for a biopsy.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story mentions self-breast exam kits may be difficult to find in some stores, and notes the lengthy process of approval.  The kits with a Touch Enhancing Pad didn’t win FDA approval until 1997, though they were patented in 1987.

Does the story establish the true novelty of the approach?

Satisfactory

The story presents the pros and cons of this relatively new addition to the arsenal of screening tools.  The story discusses self-breast exams with and without a self breast exam kit. There is little published evidence that this device is any better at detecting lumps than a traditional self breast exam using your fingers. One physician interviewed suggests that using soap and water when conducting an exam should provide the same friction as using a self-breast exam kit.

Does the story appear to rely solely or largely on a news release?

Satisfactory

There is independent reporting from multiple sources and information in this story does not appear to be taken directly from a press release.

Total Score: 10 of 10 Satisfactory

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