Just a few years after debunking the myths about links between breast implants and connective tissue disease, last week the FDA announced more potential problems with implants: Women with saline and silicone gel-filled implants may have an increased risk of anaplastic large cell lymphoma (ALCL). ALCL, a rare malignant tumor, can occur in different areas of the body, including the breast, lymph nodes, and skin. You’ve never heard of it because it’s so rare: In the United States, it’s diagnosed in only one in 500,000 women annually. It affects the breasts even less often: in women without implants, it’s diagnosed in just 3 out of 100 million women annually. The reason for the FDA’s report? About 60 cases have been identified among the 5 million-10 million women worldwide who have breast implants.

So what’s the big fuss? Why did Well, the New York Times' health blog, give its story the scary and overblown title “Breast Implants Linked to Rare Cancer”? Why are these truly tiny numbers making headlines that are probably freaking out women all over the world?  Part of the problem is poorly translated scientific jargon. In one of the FDA reports, the risk of ALCL is described as “very small but significant.” In science, “statistical significance” refers to something that is unlikely to have occurred by chance. According to the report, the appearance of ALCL in women with implants “may not be coincidence.”  In other words, ALCL may occur more frequently among women with implants than among those without implants. But here’s the problem: While the numbers may be different—say, one in 500,000 vs. six in 500,000, to take a crude example—in either case the risk is vanishingly small. (Compare that with the one in 400,000 annual risk of dying in an airplane crash.)

The dictionary definition of “significant” implies something quite different—something important, something big, something that can make a noticeable difference. I understand that the FDA is publicizing this possible association so as to encourage women and their doctors to report ALCL cases to a new registry. That is a good thing. But it’s not good that the word “significant” is unnecessarily stressing out many of the millions of women with breast implants. FDA scientist Dr. Binita Ashar commented, in one news report, on a “very small but increased risk.” That sounds better than “a small but significant risk.” Health and science reporters, and especially the people who write the FDA press releases, should think twice before using the s-word.

Tags: breast implants; cancer; ALCL; anaplastic large cell lymphoma; FDA

Florida District Judge Roger Vinson, just became the second federal district court judge to find President Obama’s sweeping health care law unconstitutional. Here’s the opinion. Vinson, ruling on behalf of the 26 state attorneys general or governors, found that the Congress had “exceeded the bounds of its authority in passing the Act with the individual mandate.”  And then Vinson went one better than Virginia Judge Henry Hudson by determining that the unconstitutional provision was not severable from the bill in its entirety, and that the entire law is thus unconstitutional.

With references to James Madison and the need to curb federal powers, Vinson quotes Supreme Court precedent for the argument that “the principle behind a central government with limited power has “never been more relevant than in this day, when accretion, if not actual accession, of power to the federal government seems not only unavoidable, but even expedient.” Vinson determines that the plaintiffs could not prevail on their spending clause and coercion theories, then turns to the individual mandate. He finds that the plaintiffs had standing to challenge the individual mandate, then turns to the question of whether the mandate is a constitutional exercise of power under the commerce clause. With a long, long walk down commerce clause history lane, Vinson pauses ominously to note that “everything changed in 1937, beginning with the first of three significant New Deal cases and a time of expansive reading of the Commerce clause.

Toggling back and forth between the various federalism revolution cases of the 1990s, Vinson then concludes that what Congress requires here is unprecedented; that “never before has Congress required that everyone buy a product from a private company (essentially for life) just for being alive and residing in the United States.” He finds that “it would be a radical departure from existing case law to hold that Congress can regulate inactivity under the Commerce Clause” and that “if Congress can penalize a passive individual for failing to engage in commerce, the enumeration of powers in the Constitution would have been in vain for it would be “difficult to perceive any limitation on federal power and we would have a Constitution in name only.” Citing Erwin Chemerinsky appearing on Reason TV to reject the argument that there is a unique health care market, Vinson concludes that the economic decision to forgo participation in the health care market is not “activity” for commerce clause purposes, warning, with proper citations, that “everything could be said to affect interstate commerce in the same sense in which a butterfly flapping its wings in China might bring about a change of weather in New York.”

Vinson concludes with a warning that the Necessary and Proper clause not be transformed into a “hideous monster [with] devouring jaws” (Hamilton), and determines that the unconstitutional section of the Act cannot be severed from the rest of it. Vinson points out that “ going through the 2,700-page Act line-by-line, invalidating dozens (or hundreds) of some sections while retaining dozens (or hundreds) of others, would not only take considerable time and extensive briefing, but it would, in the end, be tantamount to rewriting a statute in an attempt to salvage it”

Vinson makes the decision not to grant the plaintiffs' request for injunctive relief and sends them on their way.  Let the wild rumpusing begin.

Judge’s gavel by Stockbyte/Thinkstock Images.

Tags: health care reform

This Wednesday, Feb. 2, I'm going to be discussing the Home Economics series running in Slate at Housing Works in New York City as part of a panel called "Money, Marriage, and the Madness of Dividing It Up." I'll be gabbing with the lovely Paula Szuchman and Jenny Anderson, the co-authors of the new book Spousonomics: Using Economics to Master Love, Marriage, and Dirty Dishes, which is out on Feb. 8.

Our own Emily Bazelon will moderate the discussion, and we'll be talking about how modern couples are managing their money and how to solve the common pitfalls they encounter. You can check out Paula and Jenny's blog here. If you're in the New York metro area and can make it down to 126 Crosby Street at 7 p.m. on Wednesday, we would love to see you!

Tags: couples and finance, home economics, housing works, spousonomics

Apparently, we’re all crying over Facebook. My recent DoubleX piece about how Facebook makes us feel alone in our troubles by allowing us to broadcast only the cheeriest versions of our lives hit quite a nerve. (22,000 "Likes" so far, though, as I noted in the article, Facebook doesn’t offer a “Hate” button.) I’ve heard from a lot of people via e-mail, Twitter, story comments, and yes, Facebook, with many saying they’ve fallen prey to the social networking site’s mirage, and some women adding they agree with the piece’s contention that our gender may be especially vulnerable to it. Some have even said they quit Facebook because of this. The story has prompted a lot of discussions, including at an aptly named site called The Web of Loneliness (“A place for those who feel lonely, isolated, and alone to share with others”).  And others have written that I’m a wrongheaded idiot, that I’m jumping to conclusions, and/or that it is ourselves—not Facebook—that is to blame. Also fair.

On Twitter, folks have started using the Slate-created hashtag #sadbook to tweet about how Facebook makes them sad. A few actually made me laugh out loud, all but drying the tears from my latest Facebook session. (Just kidding. Mostly.) It should be said that many of the #sadbooks have nothing to do with social networking comparisonitis; they’re commentaries on bad spelling, on the boneheaded ways people treat each other online, and on the pathos you can often glimpse in the cracks of our networked lives. The best of the best:

When your 70-year-old dad shows up as "someone you might know."

Not sending friend requests to people from high school who were popular just in case they still think they're too good for me.

Photo albums consisting of nothing but selfshots taken in the bathroom. 

When the whole of the "friendship" is a repeated "Let's meet for coffee sometime." 

Noticing that one person in a group photo isn't tagged makes me sad. Who are they? Why won't anyone tag them?

An entire generation is going to grow up totally unaware that an ellipsis is only 3 periods ... not 16.

People who announce their divorce by changing their relationship status to "single."

The song that my close friend has referenced in his status update is by Nickelback.

Following the #sadbook feed.

Tags: #sadbook, alex jordan, Facebook, facebook making us sad, sadbook, Stanford, twitter