February 12, 2014 – February 28th, 2014
Guideline On Lumpectomy Margins May Help To Reduce Re-Excision Rate.
Medscape (2/12, Chustecka, 164K) reports that “a new guideline on margins in breast cancer surgery is likely to reduce the re-excision rate for women with early-stage breast cancer who undergo lumpectomy. At present, this re-excision rate is around 20% to 25%, and is considered unacceptably high by experts.” This “guideline was developed by the Society of Surgical Oncology (SSO), in conjunction with the American Society of Radiation Oncology, and has been endorsed by the American Society of Clinical Oncology and the American Society of Breast Surgeons.” The guideline is available online in the Journal of Clinical Oncology.
Study Questions Value Of Mammography.
Research suggesting that mammography may not be beneficial was covered by some of the nation’s most widely-read newspapers, including two stories in the New York Times print edition, as well as on several medical websites. Much of the coverage focuses on the controversy that continues to surround mammography. Many articles also highlight criticisms of the new study, In a 1,100-word front-page story, the New York Times (2/12, Kolata, Subscription Publication, 9.61M) reports that research published in the British Medical Journal, “one of the largest and most meticulous studies of mammography ever done, involving 90,000 women and lasting a quarter-century, has added powerful new doubts about the value of the screening test for women of any age.” The findings may “lead to an even deeper polarization between those who believe that regular mammography saves lives, including many breast cancer patients and advocates for them, and a growing number of researchers who say the evidence is lacking or, at the very least, murky.”
In a 1,000-word story, the Los Angeles Times (2/12, Morin, 3.07M) reports that investigators “examined the medical records of 89,835 women in six Canadian provinces between the ages of 40 and 59. All of the trial participants received annual physical breast examinations, while half of them also had yearly mammogram screenings for five years, beginning in 1980.” During “the next 25 years, 3,250 of the 44,925 women in the mammography arm of the study were diagnosed with breast cancer, along with 3,133 of the 44,910 women in the control group.” Meanwhile, a nearly identical number of patients from each group died of breast cancer.
In a separate story, the New York Times (2/12, A3, Rabin, Subscription Publication, 9.61M) reports that the new findings will add to the controversy surrounding the value of mammograms. Further complicating the issue is the fact that different medical groups have different recommendations regarding mammography. About five years ago, “the United States Preventive Services Task Force…concluded that women over age 50 should have mammograms every two years instead of annually and that the evidence of benefit was only moderate.” The USPSTF “did not recommend the screening test for younger women.” However, “the American Cancer Society refrained from following the task force’s lead and continues to recommend annual mammograms beginning at age 40, as do the National Cancer Institute and the American College of Radiology.”
USA Today (2/11, Szabo, 5.82M) reports that “Barbara Monsees, a radiologist with the American College of Radiology, says the…study is fundamentally flawed and useless for drawing conclusions.” Participants “received very poor-quality mammograms, she says.”
The Boston Globe (2/12, Kotz, 1.75M) reports that some “have questioned whether the women in the Canadian study were properly randomized since a significantly higher number of women in the mammography group were diagnosed with advanced cancers during the first year or two of the study than those in the control group.”
HealthDay (2/12, Doheny, 5K) reports, “In a statement issued Feb. 11, the” ACR “called the report ‘an incredibly misleading analysis based on the deeply flawed and widely discredited Canadian National Breast Screening Study.’” HealthDay added that the “findings are at odds with many other reports that show a benefit for routine screening,” Dr. Carol Lee, chairwoman of the college’s breast imaging communications committee “added.”
Double Mastectomies May Be Beneficial For Breast Cancer Patients With BRCA Mutations.
USA Today (2/12, Szabo, 5.82M) reports that research published in the British Medical Journal suggests that “breast cancer patients with” BRCA1 or BRCA2 “mutations can cut their long-term risk of dying from the disease in half if they undergo double mastectomies.” Researchers found that “in the new study, 88% of women who had both breasts removed were alive 20 years later, compared with 66% of those who had a single mastectomy.”
The Newark (NJ) Star-Ledger (2/12, O’Brien, 694K) reports, however, that “was small, examining the survival experience of just 390 women.”
Bloomberg News (2/12, Kresge, 1.91M) reports that although “it’s reasonable for doctors to suggest the procedure as an initial treatment for an early-stage breast cancer patient with the BRCA mutation, the findings need to be confirmed in larger trials, researchers said.”
Panel Of 55 Genes May Help Predict Whether Early Breast Cancer Will Become Invasive.
HealthDay (2/12, Doheny, 5K) reports that research published in PLOS ONE suggests that “a panel of 55 genes” may help predict “whether early stage breast cancer will become invasive and lethal.” Investigators “studying this panel focused on the loss of a powerful tumor suppressor gene known as SYK.” HealthDay points out that the researchers studied data from the US National Institutes of Health’s Cancer Genome Atlas.