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Early breast cancers may need less lymph node surgery


4 Star


Early breast cancers may need less lymph node surgery

Our Review Summary

Improved quality of life, with no reduction in survival. This story hits the high points of an important study looking at overall survival in some breast cancer patients who face lymph node dissection of multiple nodes with its not infrequent life-long complications.

Strong points:

  • emphasized this finding applied only to “some” women even in first sentence
  • then later emphasized “the findings apply to only a small number of breast cancer patients”
  • mentioned that results had been presented at a medical conference last summer and that “some surgeons are already changing their practices”

Areas for improvement:

  • could have discussed impacts on cost and on insurance decisions
  • discuss the possible limitations to the research that the authors mentioned
  • tell readers how often complications occur from axillary lymph node dissection and from sentinel node approach


Why This Matters

Until now, if a patient has a positive node on a sentinel node biospy they then have additional lymph node surgery. Based on this study, which suggests there is no overall  or disease-free survival benefit to  ALND for the patients named above, there would be no reason for them to go through the additional suffering that often accompanies the procedure.


Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The article didn’t discuss any differences in the financial cost of the two approaches.  Nor did it discuss whether insurers are likely to curtail coverage based on the new findings.

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


The story presented a brief quantification of the overall survival rate but would have been improved by using numbers of breast cancer patients who might be affected.

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

Not Satisfactory

The story presented a clear statement regarding the lack of long-term evidence. However, it did not clearly quantify the potential harms of sentinel node biopsy and axillary lymph node dissection and compare them. How often do complications occur?

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

Not Satisfactory

The story was specific about study population and the current and possible future effects on clinical practice. However, it didn’t address the fact that recruitment was stopped early because it would have taken 20 years to get the 500 deaths required to fully power the analyses, given that overall survival was so much higher than expected.   The researchers were quite clear in their published manuscript about the possible limitations in their study.

Does the story commit disease-mongering?


There was no evidence of disease-mongering in this story.

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


The story identifies its journal source, and includes interviews with several independent clinical sources, as well as a statement from the Chief Medical Officer of the American Cancer Society.  It did explain the NCI funding for the trial.

Does the story compare the new approach with existing alternatives?


The article briefly mentions standard-of-care treatment and how that might be affected by this study.

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


The article appropriately defines to whom these findings would apply and briefly indicates not all physicians would be likely to adopt the findings immediately.

Does the story establish the true novelty of the approach?


The article uses helpful quotes from breast cancer experts to establish the significant effect of this new information on clinical practice.

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


The story does not rely solely on a news release.

Total Score: 7 of 10 Satisfactory


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