True or False?




Some things you've heard about breast cancer are myths The discomfort we feel when grappling with something that is beyond our control or understanding can prompt us to insert logic where none exists, or gratefully accept an unproven explanation because it puts our mind at ease. A survival or coping mechanism? Perhaps. But it sometimes does more harm than good. For instance, an awful lot of rumors and myths swirl around the topic of breast cancer, leading to many misconceptions and confusion. Nearly 200,000 women are diagnosed with breast cancer each year, and with much remaining unknown about the disease, apparently some folks are doing their best to connect the dots on their own. The misinformation is meant to be helpful and is passed down from one person to another, sometimes spanning generations. But, in a nod to Breast Cancer Awareness month, let's set the record straight.The Myths Antiperspirants cause breast cancer. This idea probably stems from concerns regarding repeated exposure to chemicals or aluminums in antiperspirants, but is completely unfounded. “There is no truth to it at all,” says Kari M. Rosenkranz, M.D., medical director of the Comprehensive Breast Program at Dartmouth-Hitchcock Medical Center in Lebanon.If you have no family history of breast cancer, you don't need to worry about breast cancer. Although having a family history of breast cancer does increase a woman's chances of getting breast cancer, lacking a family history does not mean you won't get the disease, says Gary Proulx, M.D., medical director of Radiation Oncology at the Center for Cancer Care at Exeter Hospital. In fact, only about 10 percent of breast cancers are genetic.Mammograms cause breast cancer. This idea seems to be based on worries about the radiation a patient receives during mammography, but mammography delivers “a very, very, very low dose of radiation,” Rosenkranz says, and there is no evidence of a causal link between mammograms and breast cancer. A woman who avoids mammograms due to concern about radiation is doing herself a disservice. “The benefits clearly far outweigh any risks,” says Proulx.If my mammogram results are normal, I can be less vigilant in watching for signs of breast cancer. “Mammography is only about 80 percent accurate,” Rosenkranz says. “It misses about 20 percent of cancers and particularly in younger women and more dense-breasted women, that number is probably actually significantly bigger.” So, if you discover a lump in your breast at some point after your mammogram reveals normal results, don't feel convinced that you are OK; have the lump checked out by a medical professional. Young or old women don't get breast cancer. Although breast cancer knows no age boundaries, Rosenkranz says, most instances of breast cancer occur in patients between the ages of 50 and 80. And while it's true that very young women are less likely to get breast cancer, when they do, the cancer is often more dangerous, Proulx and Rosenkranz say. “Pre-menopausal women in their early 30s and younger can often have a more aggressive cancer,” Proulx says. Trauma or injury to the breast causes breast cancer. This is often a case of coincidence being mistaken for cause and effect. Sometimes a patient who bangs or injures her breast examines the breast, notices a lump that she thinks is from the injury and goes to the doctor. A professional evaluation reveals that she has breast cancer, and the woman mistakenly assumes that the trauma caused the breast cancer, Proulx says. Although an injury can cause a breast mass or lump, it does not directly cause breast cancer, Rosenkranz says. Rather, injury can lead women to pay more attention to the area and discover an unrelated problem. Wearing a tight or underwire bra causes breast cancer. Some women believe that pressure from a bra can cause toxins to accumulate, leading to cancer. “Patients think if they've worn something over the years that it might have caused irritation or something, but no,” Proulx says. This fear is completely unfounded. Breast implants cause cancer. Implants can make examinations more difficult, and can affect the ability to notice and interpret changes in a woman's breast, Proulx says. However, implants do not, in and of themselves, cause breast cancer, he says. There is nothing a woman can do to lower her risk of getting breast cancer other than watching for signs of it. Regularly watching and screening for early signs of breast cancer is the most important preventive step for breast cancer, experts say, but there are other ways to lower risk. For example, women should be especially careful to avoid weight gain after menopause, Rosen-kranz says. Gaining less than 10 pounds after menopause has been shown to decrease the risk of breast cancer, she says. It is also widely recommended that women forgo long-term hormone replacement therapy with estrogen and progestin, Rosenkranz adds. Breast biopsies cause cancer. It's true that a woman who has had a breast biopsy might be considered more likely to develop breast cancer than a woman who has not had a breast biopsy, Rosenkranz says, but that's not because breast biopsies cause cancer. A biopsy increases a patient's risk level because having a breast biopsy suggests that there was something questionable going on in the patient's breast, some cause for concern that required her to have a biopsy, Rosenkranz says. Breast cancer always presents itself as a lump. Nope. In fact, “the vast majority of breast cancers are picked up on a screening mammogram before they're large enough to be a palpable lump,” Rosenkranz says. They are usually less than a centimeter in size and as a result are not noticed during a manual exam. (This is why mammograms are an essential part of breast cancer prevention.) All lumps are cancerous. This is also untrue. “Particularly in younger women, most breast lumps are not going to be breast cancer,” Rosenkranz says, but rather a cyst, benign tumor or lactational change. “As women get into their 60s, 70s and 80s, however, the concern is much greater that a breast lump will represent breast cancer,” she says. NH

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