A new 3-D mammography is now available, but without strong scientific evidence to support using this device, it is not clear whether the harms associated with it are worth the benefits or extra cost.
Mammography is still one of the most common tools used by doctors to find breast tumors; however, some tumors may be difficult to see due to dense breast tissue or the angle at which current pictures are taken. The new 3-D device may help improve mammograms, but testing is still being done to determine the actual benefit, and whether it is worth the increase in the amount of radiation exposure during the procedure.
The story stated, “Insurance often doesn’t cover the 3-D portion so doctors say you often need to pay about $50 out of pocket.” However, would have preferred a quote from an insurance company instead of doctors to be sure that this cost is reflective of true out-of-pocket expenses.
The story mentioned a 47% increase in cancer detection, but 47% of what? Also, the story mentioned the recall rate for women needing a follow up mammogram was reduced with the new device from 11% to 6.6%, but recall rate is not the true gold standard of how the device could be beneficial to women.
The article did discuss the potential harm due to the increase in radiation exposure, but was then followed by a quote from the VP of breast health at the company making the device dismissing some of the concern related to the increase in radiation.
The article did not mention rates of false positives or false negatives with the new imaging. It could be that it finds lots of new things that lead to many more biopsies but not all cancer (i.e. they report the recall rate, but what about the biopsy rate for traditional vs. 3-D?)
So despite the headline that addresses false positives, the story doesn’t give any evidence on that question.
Mixed bag on this criterion. The article cautioned readers that results were preliminary, but it still didn’t pose enough tough questions about the new approach. A bothersome quote from a doctor who once consulted for the company stated that the new exam would likely save lives by finding cancers earlier; this is potentially an overstatement of benefits and also fails to consider lead-time bias.
The article did state doctor affiliations to the company making the device and also quoted some people not affiliated with the company.
The new device was compared with traditional 2-D mammography but, as already noted, the story did not compare the approaches on some meaningful measures such as rates of false positives or false negatives or biopsy rate for traditional vs. 3-D.
Although the article stated the device had been available in the U.S. since February, it was unclear if this was only for people in clinical trials, or if hospitals and cancer centers across the country were currently using it. Nonetheless, we’ll give the story the benefit of the doubt on this one.
The relative novelty of the approach and of the new study is clear in the story.
It does not appear that the story relied solely on a news release, although there was certainly a lot of space given to the manufacturer’s perspective.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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