Rumors, misinformation, and half-truths: breast cancer seems to attract more of these than almost any other disease. By the time a new patient has come to see me for the first time, she’s usually learned all kinds of “facts” about breast cancer from friends, from family members, and from looking online—and is terrified about her prospects as a result. Although I’m not entirely sure why this should be the case, I think it has to do with how common the disease is. Everyone seems to know something about it and is willing to share their information, some of which is true, but most of which isn’t applicable to any individual case. Breast cancer is also predominantly a women’s disease, and I suspect that in general, women tend to share more, which can cut both ways. What I do know is that breast cancer myths generate a huge amount of anxiety for patients. When a new patient comes to my office, what she’s looking for is clarity and a trusted source of information, so that she can make informed decisions about her treatment and recovery without any more stress and anxiety than necessary.
Over my many years of treating breast cancer patients, I’ve heard every myth in the book (or on the web). Here are a few of the biggest and most commonly mentioned misconceptions out there. Most of them have been brought up in previous chapters, but all are worth repeating.
MYTH: “Needle biopsies spread cancer.”
TRUTH: Needle biopsies are a critical tool for diagnosing breast cancer and do not spread breast cancer.
MYTH: “Mammograms cause cancer.”
TRUTH: Mammograms are associated with one of the lowest doses of radiation exposure of all radiology tests. Even when multiple pictures are taken—which happens when we perform a biopsy—the overall exposure is low, and is not associated with increased risk of cancer.
MYTH: “If you don’t have a history of breast cancer in your family, you don’t need to start mammograms until you’re older.”
TRUTH: Having your first mammogram at age forty is the recommendation for breast cancer screening for the general population with no specific breast cancer risk factors.
MYTH: “Cancer grows and spreads quickly; time is of the essence.”
TRUTH: Breast cancer usually grows over the course of months and even, in some cases, years. While it’s never a good idea to delay diagnosing and treating breast cancer for any considerable length of time, days or even weeks will not make a difference in the potential for cure.
MYTH: “If you have no family history of breast cancer, you really aren’t at much risk.”
TRUTH: It’s important to know that 80 to 90 percent of women newly diagnosed with breast cancer have no family history of breast cancer. In other words, we are all at risk, whether there is a family history or not.
MYTH: “If you have a family history of breast cancer, you will definitely get breast cancer.”
TRUTH: While it’s true that having a family history of breast cancer raises your risk to above that of the general population, it does not necessarily mean you will get breast cancer in the future.
MYTH: “Mammograms don’t really do anything to reduce risk of death from breast cancer.”
TRUTH: The mammogram is the only test that has been shown to reduce the risk of dying from breast cancer by detecting cancer earlier, thereby increasing the chance for cure.
MYTH: “Mammograms are a fail-safe to prevent breast cancer.”
TRUTH: Wrong on two counts. First, approximately 10 to 15 percent of breast cancers won’t show up on mammograms at all and are therefore missed by routine mammography. Second, mammograms don’t prevent breast cancer; they detect it. But they can reduce the risk of dying from breast cancer by detecting it early.
MYTH: “If you have a lump and the mammogram is normal, you have nothing to worry about.”
TRUTH: Approximately 10 to 15 percent of breast cancers cannot be seen on mammogram. Therefore, a normal mammogram can’t guarantee that you don’t have breast cancer. A new or suspicious lump should always prompt further investigation, even when a mammogram is normal.
MYTH: “If you have a lump in your breast, it’s definitely breast cancer.”
TRUTH: There are normal causes of new breast lumps besides breast cancer. These include cysts, benign breast tissue, and even benign tumors. These can be differentiated from cancer by imaging, examination, and biopsy if necessary.
MYTH: “Breast cancer always comes in the form of a lump.”
TRUTH: The smallest breast cancers detected may not be big enough to form a lump that you or your doctor can feel. Approximately 20 to 25 percent of all new breast cancers detected are DCIS (stage 0 breast cancer), which commonly shows up as microcalcifications on a mammogram but which cannot be felt.
MYTH: “Breast implants increase your risk of breast cancer.”
TRUTH: Not true. Breast implants do not increase one’s risk of developing breast cancer.
MYTH: “Women with larger breasts have a greater chance of getting breast cancer.”
TRUTH: Not true. Breast size does not factor into one’s risk of getting breast cancer.
MYTH: “You can treat your cancer by altering the pH of your diet.”
TRUTH: The pH of the body cannot be altered at will or by dietary or lifestyle changes, although various states of severe illness can. Therefore, the course or treatment of breast cancer cannot be altered in any way by trying to change physiologic pH.
MYTH: “You can starve your cancer by eating less sugar.”
TRUTH: Dietary sugar consumption does not directly fuel breast cancer cell growth. Everything we eat gets converted, at the cellular level, to sugar, and this is necessary to feed cells, both good and bad. While it’s true you can improve your health by eating less sugary foods—they are usually associated with low nutritional value and obesity, which can increase one’s risk of breast cancer—you can’t “starve” your cancer by eating less sugar.
MYTH: “Underwire bras can cause cancer.”
TRUTH: Not true.
MYTH: “Using deodorant or antiperspirant can cause breast cancer.”
TRUTH: Not true (thankfully).
MYTH: “Caffeine can cause breast cancer.”
TRUTH: Not true (thankfully again, for those of us who are reliant on our daily cup of joe). However, caffeine can promote benign breast lumps, cysts, and pain. And I do tell my patients who complain of breast pain or discomfort to try discontinuing caffeine intake (coffee, tea, diet sodas, chocolate), as this may provide some relief from these symptoms.
MYTH: “Cellphone or microwave use can cause breast cancer.”
TRUTH: Not true.
MYTH: “Taking birth control pills can cause breast cancer.”
TRUTH: Taking birth control pills does not increase the risk of breast cancer. However, it can decrease the risk of ovarian cancer.
MYTH: “If you eat all the right things, stay thin, and exercise, there is no chance you can get breast cancer.”
TRUTH: The reality is all women are at risk for developing breast cancer regardless of their lifestyle choices.
MYTH: “There is nothing that you can do to decrease your risk of developing breast cancer or decreasing your risk of recurrence if you already have it.”
TRUTH: Not precisely true. In fact, being overweight and drinking alcohol regularly can increase the risk of breast cancer and its recurrence. Therefore, maintaining a healthy weight and drinking alcohol in moderation can reduce risk.
MYTH: “If you have a mastectomy, you have a better chance of survival than if you have a lumpectomy with radiation.”
TRUTH: For women who are eligible for both operations, lumpectomy and mastectomy are associated with equivalent survival rates.
MYTH: “You can’t get breast cancer again after a mastectomy.”
TRUTH: The risk of systemic breast cancer recurrence (when the cancer comes back in another part of the body) is the same for women who have mastectomy as have lumpectomy. In addition, breast cancer can recur in the remaining skin or residual breast tissue even after a mastectomy.
MYTH: “Men can’t get breast cancer.”
TRUTH: Approximately 2,500 men are diagnosed with breast cancer each year in the United States. They account for less than 1 percent of all new breast cancer diagnoses, and less than 1 percent of all new cancer cases in men.
MYTH: “If cancer has spread to the lymph nodes, then mastectomy is a better choice than lumpectomy.”
TRUTH: Positively not true, and many patients are surprised to hear this. Having positive lymph nodes may mean that more lymph nodes need to be removed, but it does not mean that more tissue needs to be taken from the breast. As long as lumpectomy with clear margins can be achieved in the same way that we would desire for a woman with negative nodes, lumpectomy is perfectly acceptable for women with positive nodes as well.
ABOUT THE AUTHOR
Elisa Port, MD, is chief of breast surgery at Mount Sinai Medical Center and director of the Dubin Breast Center, a state-of-the-art breast center in Manhattan that opened in April 2011. She sees and consults with approximately two thousand patients and performs between four hundred to five hundred surgeries a year. Regularly quoted in the print and electronic media—including NPR, The New York Times, New York Daily News, Martha Stewart radio, Vogue, Businessweek, and Redbook—Dr. Port has also appeared on Today, The Early Show, ABC World News Tonight, Fox News, and NBC news. She lives in Manhattan with her husband and their two children.
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