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Less Radiation OK for Breast Cancer

Rating

4 Star

Less Radiation OK for Breast Cancer

Our Review Summary

 The story reports on a study of shorter course of radiation therapy for women with early stage breast cancer .  Results of this study were presented at the recent American Society of Clinical Oncology meeting and have not been published in a peer-reviewed journal. (The limitations of interpreting such findings could have been emphasized.) The story notes that more long-term data may be needed to determine the safety and effectiveness of the shorter course of radiation treatment.

The story notes that this shorter course treatment is for women who have cancer confined to the breast. The story lists some options for radiation treatment following breast cancer surgery; however, it does not mention partial breast radiation and other alternatives to traditional radiation currently being tested. 

 The story describes the study and provides recurrence rates at 5 years – from 2-5% in all groups.  We are told that doctors "believe the treatments are equivalent", but "cannot say so with certainty", meaning in lay terms the difference was not statistically significant.  It is important to note that this is a large study, which is good, but we do not know well it translates (e.g. what size tumors did these women have, what was the margin status, what type of systemic therapy). It would be good to note that results controlled for all these other factors. More data on side effects in the groups would also be useful.

The story does list some of the side effects of radiation, namely skin and breast tissue changes, and notes these were less common in women who had a shorter course of radiation.  Fatigue is also a common side effect of radiation, but this is not mentioned.  Time, energy and the expense of travelling to more radiation treatments may influence a women’s decision for breast cancer surgery. The story does not list the cost of radiation treatments; however, what is really at stake here is time lost from work or other activities. All of these may play into a woman’s decision to forego radiation or to have a mastectomy vs. lumpectomy with radiation.  

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not list the cost of radiation treatments; however, what is really at stake here is time lost from work or other activities which may play into a woman’s decision to forego radiation or to have a mastectomy vs. lumpectomy with radiation. 

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

Satisfactory

The story lists the current options for radiation treatment following breast cancer surgery and provides the recurrence rates at 5 years – from 2-5% in all groups.  We are told that doctors "believe the treatments are equivalent", but "cannot say so with certainty", meaning in lay terms the difference was not statistically significant.  More data on side effects in the groups would be useful.

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

Satisfactory

The story does note some of the side effects of radiation, namely skin and breast tissue changes, and notes these were less common in women in this study who had a shorter course of radiation.  Fatigue is a common side effect of radiation, but this is not mentioned. The story notes that longer follow up is still needed to assess the long-term safety and efficacy of the shorter course of radiation.

 

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

Satisfactory

The story describes the study and provides the 5-year recurrence data.  The story notes that results of this study were presented at a conference.  This means the results  have not been published in a peer-reviewed journal – a point not emphasized in the story. The story notes that more long-term data may be needed to determine the safety and effectiveness of the shorter course of radiation treatment and cites a researcher not affiliated with the study who notes that treatments seem to be roughly the same, "but we cannot say so with certainty".  It is important to note that this is a large study, which is good but we do not know well it translates (e.g. what size tumors did these women have, what was the margin status, what type of systemic therapy). It would be good to note that results controlled for all these other factors.

Does the story commit disease-mongering?

Satisfactory

The story does not engage in disease mongering, but lists the annual rates of diagnosis of early stage breast cancer in the U.S.

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

Satisfactory

The story provides balance by citing the study author, other clinician researchers not affiliated with the study and a patient who took part in the study and had the shorter course of radiation.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story notes that this shorter course treatment is for women who have cancer confined to the breast. The story lists some options for radiation treatment following breast cancer surgery, it does not mention partial breast radiation and other alternatives to traditional radiation currently being tested.  The story also does not mention that shorter radiation may provide some women with the option of lumpectomy and radiation. Time, energy and possibly expense of more radiation treatments and travel is reduced with a shorter course and more women may consider lumpectomy vs. mastectomy.

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

Satisfactory

The story mentions that the shorter course of radiation is being used in clinical trials (such as the one described). The same machines used for traditional radiation are used for a shorter course of radiation, just different doses.

 

 

Does the story establish the true novelty of the approach?

Satisfactory

The story reports on  a study looking at a shorter course of radiation therapy for women who have had breast cancer surgery.  This option for treatment is newer and still being studied.

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

Satisfactory

The information presented in this story does not appear to be taken from a press release. There is independent reporting and several sources cited.

Total Score: 8 of 10 Satisfactory

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