fter skin cancer, breast cancer is the most common canceramong U.S. women. Despite its prevalence, however, many people don’t have a clear understanding of what it is, how you get it, and how you treat it. For Breast Cancer Awareness Month, HelloGiggles asked seven experts to reveal common breast cancer myths that they wish patients would stop believing. Their answers will help you to gain a better understanding of this disease.
The Centers for Disease Control (CDC) notes that breast cancer is one of the leading causes of death among American women. Breast cancer screenings can help detect cancer in the early stages, which increases your chances of successfully treating it. Starting at age 40, women can get screened for breast cancer annually through mammograms (an X-ray of the breast). But regardless of your age, you should always be doing breast self-exams so that you are familiar with your breasts. And if you note any irregularities, see your doctor. Your gynecologist will also perform a breast exam on you during your annual visit.
— NCI Cancer Stats (@NCICancerStats) August 7, 2018
1Myth: No one in my family has had breast cancer. I’m not at risk.
“Approximately 85% of women who receive a diagnosis of breast cancer do not have a family history of the disease. Women without a family history of breast cancer are not in the clear. Mammograms, monthly breast self-exams, and annual breast exams by a health care provider are important for the early detection of breast cancer.”
—Nicole Sroka, M.D., breast surgeon at Piedmont Fayette Hospital
“The two biggest risk factors are being female and getting older and you can’t change either one. Family history is actually not as high up on the list of risk factors because the majority of patients who come in with breast cancer do not have a family history.”
—Sangeetha Kolluri, D.O., breast surgeon at Texas Oncology
“Some of the statistics can be one in two men and one in three women can develop cancer in their lifetime. So it has to do with, of course, genetic factors, but also environmental factors, dietary factors, and whether you use tobacco and alcohol. A lot of people will say, ‘I didn’t think I’d ever get cancer because no one in my family has it.’ And actually, we see that quite a bit. Most breast cancers are not genetic.”
—Pamela J. Schlembach, M.D., radiation oncologist, professor in the Radiation Oncology department at MD Anderson Cancer Center, and medical director of MD Anderson in the Woodlands
2Myth: My father’s family history of cancer doesn’t matter.
“The most recognized breast/ovarian cancer gene, BRCA, is a non-sex-linked genetic mutation. Therefore, it can be inherited from the father’s or mother’s side of the family.”
—Richard W. Reitherman, M.D. Ph.D., medical director of breast imaging at MemorialCare Breast Center at Orange Coast Medical Center
3Myth: If I have a high risk of breast cancer in my family, there’s nothing that can be done.
“If you think you’re high-risk, please see a breast surgeon. Get a formal risk assessment and a calculation of your lifetime risk of breast cancer, because there are things you can do. Find out if you’re a candidate for a high-risk protocol, which may include a pill that can drop your risk by 50%. You don’t have to be in the dark.”
4Myth: Deodorant causes breast cancer.
“Deodorant does not cause breast cancer. I think some women find it confusing because when you get mammograms, they ask you not to wear deodorant. And people don’t realize that deodorant, most of them, actually have aluminum in them. And aluminum is a metal and it can look like little, white specks on the mammogram and that’s what calcium would look like which, when it clusters, could be cancer. So there’s no link between deodorant and cancer.”
—Julie Rani Nangia, M.D., assistant professor of medicine at the Lester and Sue Smith Breast Center at Baylor College of Medicine, board-certified internist and oncologist
5Myth: Bras, especially ones with underwire, cause breast cancer.
“A lot of patients come in with breast pain and then they’re baffled when I tell them they’ve been wearing the wrong bra size their whole life. Most patients are actually bigger in the cup than they think and most patients are skinnier than they think. If you have more breast tissue, you do need to be wearing a bra with an underwire. I get a lot of patients who give me one to two reasons not to wear an underwire. The first one being they pinch and they hurt—that means you’re wearing the wrong size. The other one being, ‘But I thought you’re not supposed to wear underwire because it causes breast cancer.’ And it absolutely does not. There’s no data whatsoever that supports that and frankly, if that was true everybody who is large-breasted would have a much higher risk of breast cancer than other people and they do not.”
6Myth: I can’t get breast cancer if I’m under 40.
“Typically breast cancer is seen in postmenopausal women, but we do see it in younger women, although it’s not as common. When we see it in women under the age of 40, we typically recommend genetic testing.”
7Myth: Men can’t get breast cancer.
“Men can get breast cancer. It is rare. It’s usually men who are between the ages of 60 and 70 and risk factors include if they have had a close female relative [with breast cancer], taken estrogen, a history of gynecomastia, a disease of the testicles, and a history of radiation exposure to their chest. There’s also a rare genetic disease called Klinefelter syndrome. And, of course, obesity. The men that I’ve treated with breast cancer tended to be very overweight and had some fatty liver.”
8Myth: Caffeine causes breast cancer.
“It doesn’t, but it can aggravate breast pain. So if someone’s having a lot of breast pain, we usually take a caffeine history and ask them to cut back or eliminate caffeine because it can help a lot.”
9Myth: Eating sugar will make my cancer worse or cause breast cancer.
“No. However, a high-sugar diet can contribute to excess weight and we know that obesity is associated with developing several types of cancers. We know for certain that sugar doesn’t cause cancer, but we know that obesity does. So it’s important to maintain a healthy weight. Also, all artificial sweeteners except for cyclamate have been approved by the FDA for sale in the U.S.”
“[Along with cancer cells,] sugar also feeds all normal cells and there’s no data saying that restricting sugar intake has better outcomes in terms of treating cancer. I’ve had patients who have literally tried to give up all sugar thinking it would beat the cancer. We do recommend healthy diets, but having sugar is not going to make your cancer worse. Normal dietary amounts of sugars also don’t cause cancers.”
10Myth: Hair dye increases my risk of cancer.
“There’s no convincing evidence to suggest that hair dye causes an increased risk of breast cancer.”
11Myth: Cell phones cause cancer.
“As far are we know from the best studies that have come out, we’re not aware at this time that cell phones cause cancer. Genetic mutations are what cause cancer at this point.”
12Myth: My stress caused my cancer.
“At this point, there’s no direct, scientific evidence that links a person’s attitude to her risk of developing or dying from cancer. But we certainly encourage people to maintain as much of an active, normal lifestyle and as much physical activity as they can during treatment and to obtain as much emotional support during treatment because, of course, cancer is extremely stressful and it can really take its toll.
Intense, psychological stress can affect your digestive tract and there have been studies that show intense and long-term chronic stress can weaken a person’s immune system. They can have trouble sleeping, which can lead to depression and that sort of thing. The other thing is that people who suffer from stress develop some behaviors that can actually indirectly cause cancer. They begin to smoke or drink excessive amounts of alcohol or overeat. And those things we know—obesity, alcohol, and smoking—those can all cause cancer. But we haven’t found a direct correlation yet [between stress and cancer].”
13Myth: Alcohol isn’t a risk factor.
“A lot of people don’t know that alcohol is associated with breast cancer. Research has been showing that alcohol increases your estrogen levels, which increases your risk of breast cancer. It also increases your risk of breast cancer by damaging DNA in the cells. There are some studies that came out a few years ago that were stating that women should really decrease their alcohol consumption due to these newer findings. We got mixed messages when the American Heart Association told us we should be drinking wine every day. But compared to women who don’t drink at all, women who have three alcoholic drinks per week have a 15% higher risk of breast cancer. I just tell women to limit their alcohol consumption and I tell them do not drink every day.”
“Alcohol can actually increase your risk of breast cancer, so we recommend less than three drinks a week. And people who drink alcohol, a dose of 800 micrograms of folic acid a day can be protective. There was a study for the Women’s Health Initiative where they looked at breast cancer and showed there was a slightly higher rate with alcohol, but in women who took folic acid, the risk was less. So that’s where that came from. Folic acid is naturally found in green, leafy vegetables.”
14Myth: I can’t do breast self-exams because my breasts are too lumpy.
“Breasts can often feel ‘lumpy’ or uneven. If you feel areas that are harder, irregular, or ‘gritty,’ schedule an appointment with your physician or OB/GYN. If you’ve never done a breast self-exam, don’t be discouraged. You will become familiar with your normal breast pattern. If you feel anything new or different, see a doctor.”
15Myth: Breast pain = cancer.
“Most breast cancers are actually completely painless.”
16Myth: Breast cancer symptoms are always obvious.
“Short answer is no. Many breast cancers have no symptoms associated with them and they are detected by screening mammograms. Most symptoms of breast cancer overlap normal physiology. This includes soreness, pain, or a mass that’s palpable, for example, a breast cyst or a mass called a fibroadenoma.”
17Myth: I found a lump in my breast and I can move it. That means it is not cancer.
“In the past, cancers were often found much later—typically after they had attached to the chest wall and were immobile. Now, due to awareness and early detection, when someone finds a lump, it is usually mobile, whether it is cancer or not.”
18Myth: An annual mammogram is all I need to do to as a preventive measure against breast cancer.
“Mammograms alone are not enough. Mammography detects around 84% of breast cancers in women without symptoms. If you add in an ultrasound, that number increases to 89%. By adding clinical breast exams, that number increases to 92%. I have found a lot of breast cancer through clinical exams. Technology isn’t perfect. The brain is a computer, too, and experienced doctors can feel when something isn’t right.”
19Myth: A mammogram could put me at higher risk of developing cancer.
“It’s an extremely low dose of radiation, especially because nowadays all the mammograms are digital. They’ve gotten super, super high-resolution with less and less radiation. It’s such a low dose that it’s basically negligible and it would have no effect on you whatsoever. Even if you’re pregnant and you need a mammogram, you can get it done safely, as long as your belly is shielded. There’s no risk at all.”
“According to the American Cancer Society, flying across the country exposes a woman to roughly the same amount of radiation as one mammogram. The benefits of a mammogram outweigh the potential risks.”
20Myth: I don’t need to prepare for my mammogram.
“It’s suggested that women schedule their mammogram at the time when their breasts are the least tender, which is usually the week after their menstrual cycle. If they have had mammograms at another facility in the past, it may be a good idea to bring those images and reports in with them so that the radiologist can use them as a comparison. They should let the technician know if they have had previous biopsies, or if they have breast implants. Deodorants, perfumes, and lotions should be avoided under the arms or on the breasts. If they have previously experienced pain with mammogram it may be helpful to take a mild pain medication such as Tylenol or ibuprofen beforehand as long as your physician approves its use.”
—Ami A. Chitalia, M.D., breast medical oncologist at Medstar Washington Hospital Center
21Myth: If you operate on cancer or expose it to air, the cancer will spread.
“That’s not true. Sometimes, unfortunately, people have advanced cancer. It’s not surgery or cutting it that made it spread, it was more the biology of it anyway.”
— Dr. Nangia
22Myth: Herbal products can treat or cure cancer.
“The answer is no. Some people think that vitamins and herbs and essential oils can cure cancer. It’s really important to eat a healthy diet and a lot of these products can help with patients having not as many side effects or feeling more in control or a bit more relaxed. But there’s actually no scientific evidence that taking these instead of traditional therapy can cure you. In fact, a lot of patients will do that instead and then their cancer will continue to grow and by the time they do show up for therapy, their cancer is much more advanced. You can talk to [your] team about what kind of things you can do during treatment in addition to traditional medicine, but we recommend that you don’t substitute complementary medicine or alternative therapies for traditional.”
“There’s not good data on whether taking vitamins and antioxidants after you’re diagnosed is good or bad. But theoretically, it could be bad to suddenly go on all these ‘cell-protective’ things because antioxidants are good in preventing cancer, but once you have cancer, there’s this fear that you can actually protect the cancer cells by taking these types of things. So we don’t recommend high doses of antioxidants or high doses of vitamins or herbal meds during treatments.”
23Myth: Breast cancer always requires a mastectomy.
“The surgical decision to perform a complete breast removal (mastectomy) versus a procedure which is called a lumpectomy (just removing the tumor) is most often based on the size of the tumor relative to the breast size. If the tumor can be safely removed with reasonable cosmetic results, the lumpectomy can be performed. There are, of course, many other considerations which lead the surgeon and patient to choose a mastectomy or lumpectomy. These include the particular type of cancer as well as the need to perform postoperative radiation.
In general, breast conservation (lumpectomy) requires postoperative radiation to the remaining breast. Mastectomy, on the other hand, most often does not require postoperative radiation. For example, some patients choose mastectomy because they do not want radiation therapy. Other patients choose lumpectomy with radiation because they have a desire to preserve their breast. Current practice and standards suggest that a rate of over 50% for breast-conserving surgery is considered good care. It is critically important to understand that generalizations do not dictate individual patient care decisions. This process should be one of individualization with appropriate information and options for treatment. This process is currently called ‘shared decision-making.’”
“A lumpectomy followed by radiation is equally as effective as a mastectomy for people who have one site of cancer in their breast and tumors that are smaller. For early-stage breast cancer, radiation treatments now are typically three to four weeks instead of five to seven weeks as they used to be. We usually only recommend mastectomies in patients who have breast cancers that are in multiple areas throughout the breast or they’re larger breast cancers, inflammatory breast cancers, or they have genetic breast cancers. The most important thing is to talk to a surgeon who has a lot of experience in breast cancer surgery. Cancer is a really serious diagnosis and my recommendation is that you go someplace that specializes in cancer. You want to make sure you’re being treated by the best when it comes to cancer.”
24Myth: A double mastectomy is always the safest option.
“There are going to be patients out there who do want a double mastectomy and they really do know what it’s all about and they really do come informed. But there’s a lot of patients that that’s all they know. What it really comes down to for a mastectomy—and, for that matter, a bilateral mastectomy—is that all things being equal, a lumpectomy with radiation is just as safe as a mastectomy.
The American Society of Breast Surgeons has a statement that we should not be routinely offering removal of healthy breast, meaning if your cancer is on the left side, we shouldn’t be routinely removing the right side because the data shows that does not save you from cancer. But it does increase your risk of surgical complications significantly. A mastectomy is a big surgery and now you’re doing two and you’re probably choosing reconstruction, so that’s four. So it does not save you from cancer to remove a healthy breast, but it does significantly increase your risk of surgical complication.”
25Myth: Sex will be normal after treatment.
“Sex almost always changes after treatment for cancer. Many of the interventions that are used to treat and cure cancer such as surgery, chemo, and radiation all affect hormonal balance, sleep, and sexual drive. Breast cancer is unique in that, for many women, breasts represent the most outward sign of femininity. When women have surgery on their breasts or have them removed, that sign of womanhood is impacted and can make a woman feel a sense of loss. It’s important to know about your own anatomy as well as to talk to your doctor about how your treatments can affect sexual function. All sex takes work if it is pleasurable for both partners. Because libido can take a hit after treatment, especially after chemo, it may require more planning than spontaneity.”
26Myth: Breast conservation is about vanity.
“It isn’t about vanity, it’s about survivorship. I inherit plenty of patients who’ve had a double mastectomy and they’ve had a beautiful reconstruction that looks amazing. But they don’t care because they didn’t factor in what their sensation [of the breast] was and what it meant to their sexual play with their spouse, for example. Because when you have reconstruction, it’s never going to be a breast. Sexual play will be different. Hugging your children will be different. You won’t have that sensation. So I’m in favor of a patient understanding what a surgery gets you and what it doesn’t get you.”