A earlier than & after examine this weekend's breast cancer conference: How will reporters cowl it? (half One) - HealthNewsReview.org

April 27, 2017

Michael Joyce produces multimedia for HealthNewsReview.org and tweets as @mlmjoyce

This weekend over 1,600 surgeons should be in Las Vegas for the 18th Annual meeting of the American Society of Breast Surgeons.

Media insurance of this conference is always large for several causes; now not the least of which is that breast melanoma is 2nd simplest to dermis cancer as the most often clinically determined cancer in American girls.

Roughly 1 in 3 of newly diagnosed cancers in women should be breast cancers. despite the fact the incidence of breast melanoma has been dropping for essentially two a long time, this 12 months by myself it's expected that over 250,000 ladies may be clinically determined with invasive breast cancer. 

another reason for the consideration may be that breast cancer — no longer unlike prostate melanoma in guys — generates a fair volume of controversy when it involves screening and remedy decisions.

eventually, as with most cancers, the emotional toll of breast cancer is considerable and provides gravitas to each the information and controversy.

Given this I'm curious to see how the breast surgery convention will be covered by means of newshounds. I'm also drawn to what a veteran surgeon thinks should still be covered.

So we'll do this in two components:

half one (pre-conference): What are the scorching topics? How have they historically been lined? Or, what hasn't been covered satisfactory?

part two (post-conference): What type of insurance in fact got here out of the convention? What may also be realized from it?

"are you able to give me three prices or three sound bites?"

"The sizzling topics at the conference can be the genetics of breast melanoma, DCIS (ductal carcinoma in situ), and screening mammography," says Dr. Deanna Attai, a UCLA breast surgeon and instant past president of the American Society of Breast Surgeons. (Dr. Attai is also a a lot valued member of our editorial group.)

"These issues are controversial and sophisticated so it takes time to understand the history and nuance. The last few interviews I've performed I've been impressed with the level of questioning through reporters. but I nonetheless get people who say: 'are you able to supply me three prices or three sound bites?' It's simply no longer that standard. Too many news stories don't have the be aware count vital to trap the complexity and nuance."

Nowhere is that this more apparent than with ductal carcinoma in situ, or DCIS: the presence of abnormal cells inner a milk duct of the breast (in situ potential "in its common place"). sometime these cells spread backyard the duct to become invasive cancer. That's why some americans label DCIS a "cancer." however DCIS can additionally live within the duct, by no means unfold, and that's why you'll hear others argue it can now not be labeled "cancer" in any respect.

Mammogram displaying 'microcalcifications'

medical doctors can't predict which classification a lady has so the query of whether to without difficulty do surgical procedure and err on the protected side is an ongoing debate. and because DCIS is predominantly clinically determined by means of mammogram (characterized by using clusters of white calcium specks), and mammography is fitting more and more sophisticated, greater DCIS is being clinically determined. This leaves docs, patients — and journalists — hungry for the newest information on what can mammography, genetics or different cellular characteristics inform us about who will strengthen invasive cancer and who received't.

A bias in coverage?

because conferences like this weekend's in Las Vegas are a massive pipeline of such new assistance, the high-quality of the reporting on the conference can in a roundabout way affect the exceptional of breast melanoma medication. How? The treatment of each DCIS and invasive breast melanoma depend closely upon shared determination-making between women and their physicians. well-advised sufferers are stronger fitted to make suggested choices together with their medical professional.

"There continues to be a big camp that thinks DCIS is 'melanoma' and wishes to be handled as such," says Attai. "And for certain cases that is certainly a 'yes.' however for a turning out to be variety of cases we've doubtless been overdiagnosing and overtreating."

How massive a problem is overdiagnosis? A Danish analyze posted ultimate month within the Annals of inside drugs found the following:

in case you don't consist of DCIS cases within the tallies, anyplace from 14.7% to 38.6% of breast cancers found via screening characterize overdiagnosis

if you do encompass DCIS cases within the tallies, anyplace  from 24.four% to as excessive as forty eight.3% of breast cancers found by means of screening symbolize overdiagnosis

these are big numbers. but they don't get massive coverage. in its place, Dr. Attai has observed a bent of journalists to preferentially focus on early detection and treatment.

"We need to get faraway from the messaging that 'early detection ends up in cure.' as a result of whereas that may well be actual in some instances and, while 'remedy' may additionally no longer be the only endpoint, definitely early detection may also also cause less aggressive and less invasive medicine. and that i suppose that's a very valid endpoint as smartly."

You don't ought to dig some distance to discover reporting which promotes early detection equals remedy; often devoid of a great deal context. closing year, simply every week after the American Society of Breast Surgeons held their annual conference in Texas, Fox information in Milwaukee ran a narrative entitled, in spite of no matter if there's a family unit historical past of breast melanoma, early detection saves lives . The story featured  a woman named "Beth" who got a diagnosis of breast cancer of unknown classification after a movements mammogram. contrary to the title of the video, it's mentioned her sister and mother had breast cancer, and concludes with the affected person advising "start (screening) as early as which you can and just go." The video is devoid of critical context.

overlooked coverage?

This weekend's conference will also handle the subject of "survivorship"; it really is, what are the challenges women face after being treated. Attai says it's whatever thing that matters essentially the most to her sufferers but "doesn't get tons media attention." It points prominently within the convention and it'll be exciting to peer if, and how, it is covered.

"As a breast surgeon I comply with my patients long run and spot the damage that medication does to patients, " says Attai. "With our modern treatment we will cure more individuals but that comes at a value … it's what Dr. Susan Love calls the 'collateral harm' of cancer medication. I need to do improved with this. we all should do more desirable. It's not sufficient to assert we cured your cancer."

And for health care journalists it's now not adequate to cover medical conferences like this one and and easily parrot consequences. I ask Attai what information she would have for journalists masking this weekend's conference:

"There should an understanding that 'one size suits all' is not applicable. not all DCIS and invasive melanoma are the equal. I are aware of it takes time however i'm hoping journalists will take some time and do the research vital to remember the complexities and nuances. It's getting there, many are doing a pretty good job, but extra needs to happen."

The 18th Annual assembly of the American Society of Breast Surgeons runs via this Sunday, April thirtieth.

subsequent week, partly Two of this sequence, we'll take a look at one of the vital information coverage from the convention and notice how it measures as much as Dr. Attai's view of what she idea worthy of coverage, and turned into the insurance itself beneficial.

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