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This article examines the way numbers, often concerning risk, were communicated by politicians, covered by the news media and interpreted by the public during the early stages of the COVID-19 crisis in the United Kingdom. To explore this topic, we adopted a mixed-methods approach that included content analysis, comparative thematic analysis and a series of focus groups. Whilst coherency and consistency are touted as essentials in public health messaging, our textual analysis highlighted the disconnect between political communication and news media coverage. Whereas the UK government relied on vague references to curves and peaks to underpin a narrative of consistency and certainty in public health policy, the UK news media referred to specific numbers from within and outside the UK to criticise the government's approach as haphazard and lacking. This disconnect gained even more significance during our focus groups. When discussing numbers, participants referred to news media coverage rather than political messaging, using these figures to challenge the timing and nature of the UK lockdown. These findings present a significant critique of the UK government's communication during this health crisis. Instead of putting forward a coherent, homogenous and clear message to the public, the discourse around numbers and risk was diffracted, disconnected and opaque. This was largely due to the competing narratives presented by the news media.
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AIM: To assess whether ultrasound features of breast cancer are associated with breast cancer specific survival (BCSS). MATERIALS AND METHODS: Within a single breast service, data was collected prospectively (April 2010-April 2012) from 319 consecutive women (mean age 63 years) with 335 ultrasound-visible invasive breast cancers. Ultrasound features were evaluated retrospectively from the recorded images according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon by a radiologist blinded to outcomes. Survival and cause of death were ascertained from local and national sources. Kaplan-Meier survival curves were generated, and statistical significance tested using the log-rank test. RESULTS: Mean follow-up in those alive was 80.9 months. Thirty breast cancer deaths and 45 non-breast cancer deaths occurred. Five-year BCSS in the presence of distal acoustic enhancement was 76% compared to 88%, 96%, and 100% for those with distal shadowing, no distal effect or combined effect respectively (p<0.0002). Patients with sonographic skin involvement had 73% 5-year BCSS compared to 92% for no skin involvement (p<0.0001). Focal oedema was associated with 56% 5-year BCSS compared to 89% for those without (p=0.0002). A significant association was demonstrated between ultrasound tumour size and BCSS (p<0.0001). At multivariate analysis, skin changes, distal enhancement, and focal oedema maintained prognostic significance. CONCLUSION: Distal enhancement, focal oedema, and skin involvement have strong associations with breast cancer death. These factors could be taken into account, along with lesion size and other commonly used preoperative prognostic features, when considering management of women with breast cancer.
