The story focuses on a preliminary report of an upward trend of mastectomy at one institution, possibly related to greater use of pre-operative MRI screening. However, it is not clear other than mastectomy rates falling then rising that there has really been much of a finding here. The story mentions that pre-operative screening with MRI is relatively new; however, the story does not mention if pre-operative MRI is standard practice at most breast cancer treatment centers.
The story suggests several hypotheses for the upward trend in mastectomy, even among women not screened with MRI. On this point, the story does not mention the cost of pre-operative screening via MRI, or if changes to healthcare reimbursement policies have affected the decision to have a mastectomy v. lumpectomy w. radiation. Federal law requires that health insurance cover the cost of breast reconstruction following mastectomy.
The story mentions lumpectomy as another treatment option for breast cancer, but radiation is not discussed. (Without radiation, recurrence is higher with lumpectomy than mastectomy; with radiation, the treatments are considered equal.) The focus of the report is that MRI may detect more diffuse cancer, or early-stage cancer in the contralateral breast (the breast not being treated), which may limit options for surgical treatment. More than one site of low-grade Stage 0 cancer would not necessarily preclude lumpectomy and radiation. For Stage 0 cancer, or Ductal Carminoma in Situ, lumpectomy in several parts of the breast may not be cosmetically acceptable, but this is a subjective assessment that requires input from a patient and not only provider opinion (in a sense the cosmetic result only is "better" after mastectomy if a woman has reconstruction); Someone may prefer a smaller or moderately misshapen breast compared to flat chest wall.
Lastly, there is little independent reporting and the story seems to rely heavily on an ASCO press release, although information is not taken verbatim. But there are lots of caveats to this data (or lack thereof) to figure out what it means, if anything. and there is some effort at putting the results of this early clinical data in context.
The story does not mention the cost of pre-operative screening via MRI, or if changes to healthcare reimbursement policy have affected the decision to have a mastectomy v. lumpectomy w. radiation. On this point, federal law requires that health insurance cover the cost of breast reconstruction following mastectomy. Time and energy away from work and family may also influence the decision to have a mastectomy v. lumpectomy w. radiation. Radiation can take several weeks following surgery.
The story reports on an upward trend for mastectomy with greater use of MRI screening. This is a claim that has not been well substantiated — namely whether MRI lowers recurrence by better targeting those who need mastectomy. The story does not mention this.
The story does not mention any potential harms.
The story describes the basic study design and suggests several hypotheses for the upward trend in mastectomy, even among women not screened with MRI. However, it is not clear other than mastectomy rates falling then rising that there has really been much of a finding here. The story does mention that this study is a preliminary report from a single institution, but does not mention that that results have not been published in a peer-reviewed journal.
The story does not engage in disease mongering. However, the story does not mention that not all DCIS (or stage 0 cancer) needs to be treated and that even if there were several sites of low-grade cancer, a woman might still be a candidate for lumpectomy and radiation.
The story seems to rely heavily on information taken from an ASCO news release. One of the study invesitgators is cited, but there is no other independent reporting.
The story mentions lumpectomy as another treatment option for breast cancer, but radiation is not mentioned. The focus of the report is that MRI may detect more diffuse cancer, or early-stage cancer in a contralateral breast (the other breast not being treated), which may limit options for surgical treatment; however, several sites of low-grade Stage 0 cancer would not necessarily preclude lumpectomy and radiation. For Stage 0 cancer, or Ductal Carminoma in Situ, lumpectomy in several parts of the breast may not be cosmetically acceptable, but this is a subjective assessment that requires input from patient not only provider opinion (in a sense the cosmetic result only is "better" after mastectomy if a woman has reconstruction) someone may prefer a smaller or moderately misshapen breast compared to flat chest wall.
The story does not mention if pre-operative MRI is standard practice at most breast cancer treatment centers. The story focuses on a preliminary report that MRI screening prior to breast cancer surgery may increase detection and influence a woman’s surgical choice, with more women choosing mastectomy.
The story mentioned that pre-operative screening with MRI is relatively new.
The story seems to rely heavily on an ASCO press release, but information is not taken verbatim, and there is some effort at putting the results of this early clinical data in context, but there are lots of caveats to this data (or lack thereof) to figure out what it means, if anything. E.g. "It is not clear that the experience at the [Mayo] clinic reflects that of the entire nation."
Systematic, Criteria-Driven
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like