Information is powerful, and an informed patient is an empowered patient. Due to the growth of the Internet, there is now a greater amount of readily available information compared to any other time in history. Among this sea of data are a number of excellent websites providing reliable information to patients with breast cancer.
Unfortunately, some of the information patients come across and believe to be true may actually be incorrect. This misinformation can lead patients to make poor choices about their breast health.
The following are some of the more frequent misconceptions about breast cancer. In each case, we provide the latest evidence to shed light on the topic.
Myth: I don’t have to worry about breast cancer because…
- I’m too young
- I’m too old
- I don’t have a family history of breast cancer
- I don’t feel a lump or any pain in my breast
- I had a normal mammogram
Age: Unfortunately breast cancer can present at almost any age throughout a woman’s lifetime. Most breast cancer will not appear until about 40 years of age; however, there are a fair share of women in their 20s with breast cancer.
Older women are more likely to develop breast cancer since the risk of this disease increases with age. An 80-year-old with a new breast lump should not feel assured because she has never had breast cancer in the past. Her likelihood of the lump being cancer is actually quite high given her age. Essentially, you’re never too young or too old to get breast cancer. While a breast lump in a younger woman is much less likely to be cancer than a lump in an older woman, it can be cancer and needs to be evaluated. Statistics show that 25 percent of women with breast cancer are younger than 50 years old.
Family History: Having a family history of breast or ovarian cancer is certainly a known risk factor, but just because no one else in your family has had these cancers does not mean that you are safe from developing breast cancer. An estimated 80-90 percent of women who develop breast cancer do not have an affected family member like a mother, sister or daughter.
Lumps and pain: A lump may indicate a number of breast conditions, including breast cancer, but it is not the only way that breast cancer can present. Other subtle changes from breast cancer may occur long before anyone can feel a lump in your breast. Pain is actually an uncommon finding in most cases of breast cancer, so you cannot rely on pain as an early warning system. In fact, most cases of early-stage breast cancer are not associated with any symptoms or physical change that you or your doctor will be able to identify in your breast. Most early signs of breast cancer can only be identified on mammogram. This is why we promote appropriate breast cancer screening. It’s much easier to get good treatment results when the cancer is identified in these early, symptom-free stages.
Mammogram: The opposite argument is that although mammograms are very helpful in detecting some early-stage breast cancers, they do still fail to detect as many as 10-20 percent of breast cancer in women. The failure rate of mammography is highest in young women with dense breast tissue. This is why it is important to see your doctor if you have a concern about your breast, and also to be familiar with what is a normal vs. abnormal finding in your breast.
- Breast Cancer Early Detection: American Cancer Society
- Breast Cancer Risk Assessment Tool
- Mammogram Fact Sheet: National Cancer Institute
Myth: Breast cancer is caused by…
- Wearing underwire bras
- Using antiperspirants
We are learning more and more about breast cancer almost every day. There are certainly things that we believe we understand now that further research will provide greater comprehension in the future. With that said, to date the research has not supported underwire bras and antiperspirants as a known cause of breast cancer. Apprehension about underwire bras and antiperspirants usually involves concerns about blocking the lymphatic system and allowing toxins to accumulate in the breast leading to cancer. The reality is that although breast cancer may invade into the surrounding breast tissue and enter the lymphatic vessels, breast cancer typically arises from within the milk ducts in the breast and not from the lymphatic system. Now, there is research exploring the consequence of parabens used in some antiperspirants on breast cancer risk; however, there are no conclusive findings. Some women have opted to avoid parabens in body products, but more research is needed to see if this is really necessary.
There is also concern that the radiation exposure from a mammogram could increase the risk of breast cancer. This has to be weighed against the benefits of early detection mentioned above. Studies help place all of this in proper context. These studies suggest that only one breast cancer is caused from every 10,000 mammography procedures. The breast tissue of younger women is more sensitive to the effects of radiation. When to start receiving mammograms and how often to undergo screening remain controversial subjects. We are learning that one size recommendations may not fit all women and the concept of individual risk-based screening is emerging. Ultimately it comes down to personal choice; however, it seems that the benefits of screening mammography far outweigh the risks.
It is important to be aware of the research that has clearly identified risk factors for breast cancer. One important finding is the one linking lack of exercise and unhealthy diets to breast cancer. Specifically, post-menopausal obesity has been associated with a higher risk of developing breast cancer. Fortunately, studies have shown that engaging in regular exercise (even walking a mile a day) can help reduce this risk. Avoiding excessive alcohol is another strategy associated with decreased breast cancer risk. Some reports claim that as much as one-third to one-half of all cancers can be avoided by making healthy lifestyle choices. Of course regular exercise, healthy diet choices, and avoiding toxic substances have many other benefits beyond just breast health.
Myth: Removing the entire breast (mastectomy) gives you a better chance of surviving breast cancer compared to having a lumpectomy with radiation therapy.
For most cases of breast cancer, survival is the same for women undergoing mastectomy as it is for women undergoing lumpectomy.
There are certain circumstances where a mastectomy may be a better option. These may include cases where there is a genetic predisposition to breast cancer (e.g., BRCA), advanced breast cancer (e.g., inflammatory breast cancer), or when the cancer is very large or diffuse throughout the breast. However, most women with early-stage breast cancer will have the option of both lumpectomy and mastectomy.
Studies demonstrate that their survival is essentially the same with either of these two choices. The risk of the cancer returning is higher with the lumpectomy procedure, and this is why we often recommend adding radiation following a lumpectomy for breast cancer. Women who prefer a mastectomy should be offered breast reconstruction. Ultimately, it is a personal choice and the decision should be an informed one that encompasses the priorities and concerns of the individual patient.
- Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy Plus Irradiation For the Treatment of Invasive Breast Cancer
- Komen: Lumpectomy versus mastectomy for early invasive breast cancer (February 2011)
In summary, always be careful to assess the validity of your information. Misconceptions can do even more harm that ignorance. Avoid both by speaking with your doctor, asking questions and conducting your own due diligence.