Breast Cancer: 10 Common Misconceptions

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1. Mammograms are no longer necessary.”

There is no disagreement among experts that mammograms save lives, reducing mortality by 20 percent. Early detection leads to less harmful treatment and improved survival in all age groups.

Hopefully, we will see the day when we can identify low-risk women who may not need mammograms as early or as often. But now, 70 percent of women who get breast cancer do not have a family history of the disease. Risk is difficult to predict.

The American Cancer Society, National Comprehensive Cancer Network, American College of Radiology, American College of OB-GYN and Cleveland Clinic all continue to recommend annual screening mammograms beginning at age 40.

2. The self breast exam is a thing of the past.”

Breast self awareness has replaced our recommendation for self exam. Awareness includes reporting any changes in your breast tissue to your healthcare provider.

But the best way to know if there are changes is to check yourself regularly, preferably the week after your menstrual cycle. Check particularly for breast lumps that may feel hard, like a frozen pea or lima bean.

Awareness also includes knowing your family history and updating it yearly, and knowing about behaviors that will reduce your risk.

3. I feel something in my breast, but I recently had a normal mammogram. I’m sure I am OK.”

It’s important to understand mammograms aren’t perfect. Up to 15 percent of women have false negative mammograms; cancer may be present even if the mammogram is normal.

A study conducted over an eight-year period looked at 1,222 patients with newly diagnosed breast cancer. It found that 13 percent of these patients had a normal mammogram within 12 months before their diagnosis. Knowing your breasts can play a critical role in the early detection of breast cancer, even when you also have annual screening mammograms.

“Breast cancer represents a wide range of disease, so there are many different treatment options.”

4. I don’t need annual mammograms — I need MRI.”

Screening breast MRI is much more sensitive for detecting breast cancer early. But it’s not for everyone and does not replace the screening mammogram.

A mammogram is the only imaging technique that picks up microcalcifications, which may be the earliest sign of cancer. Mammograms are also better at detecting subtle changes in the breast shape, called architectural distortion.

In 2007, the American Cancer Society made recommendations for screening breast MRI, endorsing its use in certain groups of high-risk women. It is typically not otherwise covered by insurance and has a high false-positive rate. If you are concerned that your personal or family history puts you at greater risk for breast cancer, talk with your doctor to see if MRI is right for you.

5. Thermography is an effective substitute for a mammogram.”

Thermography makes images of the breasts’ radiant infrared energy for the purpose of detecting cancer.

In June 2011, the Food and Drug Administration reported it “was not aware of any valid scientific data to show that thermographic devices, when used on their own, are an effective screening tool for any medical condition, including the early detection of breast cancer or other breast disease.” The FDA report also noted it was “concerned that women will … not receive needed mammograms” if they rely solely on thermography.

6. Genetic mutations are common.”

Awareness about hereditary cancer syndromes has improved, in large part thanks to the courage of Angelina Jolie in telling her story.

Because her mother had ovarian cancer, Jolie had BRCA testing, which showed a mutation in her BRCA1 gene. That mutation meant a very high risk for developing breast and ovarian cancer. She took brave steps to reduce her risk, including removal of her breast tissue and ovaries.

Only about 10 percent of breast cancers and 15 percent of ovarian cancers are linked to genetic mutations. BRCA mutations are the most common. These gene changes are found in about 1 in 400 people in the population.

7. Prophylactic mastectomy is the only way to reduce your risk for breast cancer.”

All women should know this: Early detection is key, with survival rates for early breast cancer being over 95 percent. But all women should also know that there are other ways to reduce breast cancer risk.

For example, alcohol consumption and post-menopausal obesity are two risk factors that many don’t know about. And while studies about exercise are mixed, exercise reduces body fat, which can reduce your risk. Recommendations include maintaining an ideal body weight and limiting alcohol consumption to fewer than seven drinks per week.

8. All women should have the most aggressive breast cancer treatments possible.”

Breast cancer represents a wide range of disease, so there are many different treatment options. With personalized care, women often can be spared mastectomy or chemotherapy if it will not alter their prognosis. Alternatives to the traditional course of radiation are also now available.

Find a healthcare provider who takes time to explain the risks and benefits of any treatment options to you. You need to understand the best choice for your particular disease and body.

Breast cancer awareness has grown by leaps and bounds since 1974, when First Lady Betty Ford was diagnosed with the disease and broke all social taboos by talking about it in public. But despite the increased availability of information, misconceptions about both breast cancer itself and its treatment abound. Here are 10 “facts” that just aren’t true.

1. Breast cancer is the most common type of cancer in women.

While breast cancer gets an enormous amount of hype, the National Cancer Institute notes that skin cancer is actually more common in women than breast cancer.

2. Breast cancer always starts with a lump.

A lump is the most typical early symptom of breast cancer. However, the disease can also first evidence itself with skin changes (such as a red rash, bruise, or dimpling); an inverted nipple, or a band of thickened tissue.

3. Breast cancer is a killer.

Breast cancer can kill, but according to the American Cancer Society’s Breast Cancer Facts & Figures 2015-2016, the death rate has been steadily falling since 2003. Across all diagnoses, both invasive and non-invasive, 86 percent of women diagnosed with breast cancer will survive the disease.

4. You can get breast cancer at any age.

Close to true; children as young as 10 years old have been diagnosed with breast cancer. However, just five percent of breast cancer diagnoses are in women under age 40. The incidence rises precipitously as you age. At age 14, your chance of having breast cancer is about 1 in a million. At age 70, it’s one in 26. (Statistics courtesy of the American Cancer Society’s Breast Cancer Facts & Figures 2015-2016.)

5.Breast cancer is a woman’s disease.

While it’s much more common in women than men, the National Cancer Institute reports that about 2,300 men are diagnosed with breast cancer each year. That’s about 1 percent of the total.

6. Breast cancer is breast cancer; there’s only one type.

According to , there are actually a dozen types of breast cancer, not including male breast cancer. These can range in severity from non-invasive DCIS (ductal carcinoma in situ) to aggressive inflammatory breast cancer. Types can center on milk ducts, milk lobules, the nipple, and the breast’s lymph system.

7. Having a mastectomy eliminates breast cancer risk.

If you’re considering a prophylactic mastectomy (breast removal when there’s no sign of cancer), the operation will reduce your risk of breast cancer by about 90 percent, but won’t eliminate it. Breast tissue isn’t confined to the breast itself, but stretches up under the arms and around the torso a bit; thus a mastectomy doesn’t remove all of your breast tissue.

8. You’ll go back to normal after treatment.

If you go through breast cancer treatment, be prepared for a “new normal.” At a minimum, you’ll bear the scars (and sometimes divots) of surgery. You may also suffer lasting effects from chemo or radiation, including neuropathy (“tingling toes”); the challenges of chemo-induced menopause or, in rare instances, permanent heart damage.

9. Breast cancer always starts in the breast.

Breast cancer grows in breast tissue, but breast tissue isn’t just in the breast; it’s under your arms, too. Beware an underarm lump; while it’s probably an infected lymph node, it can also be a breast cancer tumor.

10. Breast cancer can turn into another type of cancer.

Breast cancer can metastasize (spread) to many places in the body, but its most common destinations outside the breast are lungs, liver, bones, or brain. If it spreads, though, it remains breast cancer; you don’t have liver cancer or bone cancer, you have breast cancer that’s spread to your liver or bones. This is an important distinction, as treatment options are different.

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