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MRIs urged in breast cancer detection

Rating

5 Star

MRIs urged in breast cancer detection

Our Review Summary

This 5-star story is an example of excellent health journalism.  The story provides a thorough review of the pros and cons of MRI breast cancer screening.  The reporter cites unbiased sources who provide evidence-based advice. What is particularly noteworthy in this story is the discussion of the value of early screening and treatment, and whether this screening is finding cancer that would cause harm. This is not a concept often found in stories such as this.

 The story notes annual incidence of breast cancer, as well as the estimated risk of a woman developing breast cancer during her lifetime, depending on whether she is at higher or lower risk of the disease.  The story notes who might benefit from the additional screening—i.e. only those women at higher risk–and provides the downside of overzealous screening for breast cancer in lower-risk women. The story does an excellent job detailing the pros and cons of MRI screenings for breast cancers for any woman who is considering this as an adjunct to, or in lieu of mammography. The story lists data that 5 percent to 25 percent of MRI tests (not just those for breast cancer) are wrong, causing psychological distress and unnecessary treatment.

The story reviews various methods of screening for breast cancer and notes the follow-up procedures (i.e. biopsies and other surgeries) and the medical decisions that must be made if there is a suspicion of cancer.
 
The story lists the additional cost of this screening and notes that it may not always be covered by insurance. The story also mentions the cost to public health for these expensive diagnostic tools.

All in all, an excellent job by a veteran reporter at a top newspaper.
 

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story lists the costs of this screening tool and notes the cost may not always be covered by insurance. The story also notes the cost to public health spending for additional, and sometimes unnecessary, diagnostic tools.

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

Satisfactory

The story provides a good review of the benefits of MRI screening for women at high risk of breast cancer and breast cancer recurrence.

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

Satisfactory

The story does an excellent job detailing the pros and cons of MRI screenings for breast cancers in high risk women, and for any woman who is considering this as an adjunct to, or in lieu of mammography.  What is particularly noteworthy here is the discussion of the value of early screening and treatment, and whether it is finding cancer that would cause harm. This is not a concept often found in stories like this. The story lists data that 5 percent to 25 percent of MRI tests (not just those for breast cancer) are wrong, causing psychological distress and unnecessary treatment.

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

Satisfactory

The story describes the trial design of the MRI screening study cited and provides quantitative evidence from this trial. The story also notes the false positive rates of MRI screenings, but does not list the false positive or false negative rates for the study cited.

Does the story commit disease-mongering?

Satisfactory

The story does not engage in disease mongering or test mongering. The story notes who might benefit from the additional screening – only those women at higher risk – and provides the downside to overzealous screening for breast cancer in lower-risk women. The story also notes annual incidence of breast cancer and the estimated risk of a woman developing breast cancer during her lifetime.

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

Satisfactory

The story again does an excellent job citing several clinicians and researchers not affiliated with the American Cancer Society or the recently published article in NEJM on the benefit of additional screening in women recently diagnosed with breast cancer. These sources provide balance and sound, evidence-based advice on MRI screening for breast cancer.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story reviews various methods of screening for breast cancer and notes the follow-up procedures (i.e. biopsies and other surgeries) and the medical decisions that must be made if there is a suspicion of cancer.

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

Satisfactory

The story mentions that MRI screening should be performed at centers that also do breast biopsies. These centers may not be available to all women. The story also notes the cost of MRI screenings, which may not be covered by insurance, making them unavailable for some women.

Does the story establish the true novelty of the approach?

Satisfactory

The story reports on evidence  published in the New England Journal of Medicine suggesting women diagnosed with breast cancer should consider having their other breast screened via MRI.  According to the source article, mammography and physical examination missed cancer in about 3% of newly diagnosed breast cancer patients.  The story also reports that the  American Cancer Society has recently revised screening guidelines and recommendations that women at higher risk of breast cancer and women whose breasts are difficult to read via mammograms undergo MRI screening.

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

Satisfactory

The story includes a great deal of independent reporting and does not appear to be driven by any news release.

Total Score: 10 of 10 Satisfactory

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