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Study: Bone drug lowers breast cancer risk 38% in high-risk women

Rating

3 Star

Study: Bone drug lowers breast cancer risk 38% in high-risk women

Our Review Summary

Two quotes in the story also demanded a challenge from another perspective.  One saying the study "suggests more high-risk women should consider taking raloxifene."  And one saying "If women were not so risk-averse, we might actually be able to reduce the risk of breast cancer in high-risk women."  In point of fact, some women who are fully informed will still be risk averse and may choose not to take either drug.  That’s a point that didn’t come through in the story.

 

Why This Matters

This is just an option for women who are concerned about their risk, but it is not something they must do.  This is a genuine shared decision-making issue – an issue of tradeoffs and choices that the AP story emphasized but this one didn’t.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There is no discussion of the cost of these drugs. 

 

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

Not Satisfactory

The story states that tamoxifen reduces the risk of breast cancer by 50% and Evista reduces it by 38%; however, we’re not given absolute data to determine what that really means – and the absolute numbers are really small.  According to the trial, 247 women in the tamoxifen group developed invasive breast cancer versus 310 in the Evista group. 

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

Not Satisfactory

The story provides data indicating that tamoxifen “doubles the risk of endometrial cancer” from 1 in 1,000 to 2 in 1,000 and Evista “doesn’t substantially increase the risk of endometrial cancer.” It would have been useful to provide the data for Evista as well, 1.23 in 1,000. Furthermore, there was no mention of the rate of blood clots or cataracts for these drugs.   

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

Satisfactory

Satisfactory in that the story indicates that this was a large trial (20,000 postmenopausal women) with a follow-up time of 7 years.  However, it could have noted that for a prevention study, 7 years is not that long (there were very few cases of breast cancer in either group).

Does the story commit disease-mongering?

Satisfactory

This story does not engage in disease-mongering.  

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

Not Satisfactory

The story interviewed one expert not directly involved in the research. However there was no mention that one of the main authors of the study received funding from Eli Lilly, the maker of Evista.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story discussed the benefits and harms of tamoxifen and Evista; however, it could have mentioned how they compare to the other drugs used for prevention (i.e. toremifene and tibolone).

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

Satisfactory

This story makes it clear that tamoxifen and raloxifene (Evista) are widely available, but are not widely used as breast cancer preventives.

 

Does the story establish the true novelty of the approach?

Satisfactory

The story makes it clear that tamoxifen and Evista have been approved for preventing breast cancer in high risk women, but concerns about side effects prevent many of these women from taking them.

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

Satisfactory

The story does not appear to be based largely on a news release.

Total Score: 6 of 10 Satisfactory

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