Examine Mammography: Fact or Fiction?

Dispelling popular breast cancer myths

Email Print

One longstanding myth is that breast cancer is a new disease. In fact, the earliest known case of breast cancer was recorded on a papyrus dating back to 1600 B.C.

This document was found in 1862 by American Egyptologist Edwin Smith and reported on a breast tumor. It even listed the treatment – cauterization of the diseased tissues.

In today's world there are still a lot of facts, myths and misconceptions with regard to breast cancer.

Myth #1: Older women do not need to undergo regular mammograms.

Fact: As a woman ages, her risk of getting breast cancer will increase. In fact, as seen by the statistics, age is one of the strongest risk factors for developing breast cancer.

• Younger than 30: 0.3 percent of breast cancer cases
• 30s: 3.5 percent of breast cancer cases
• 40s: 18 percent of breast cancer cases
• 50s and older: 77 percent of breast cancer cases

Myth #2: Antiperspirants can cause breast cancer.

Fact: The theory behind the claim is that antiperspirants clog pores and prevent the armpits from purging cancer-causing toxins or they contain harmful chemicals that are absorbed through the skin; the toxins then allegedly accumulate in the lymph nodes and lead to cell mutation.

This myth also contends that antiperspirants applied immediately after shaving will increase risks of cancer because nicks in the skin give the chemical a chance to enter the body.

According to scientists at the National Cancer Institute and the U.S. FDA, aluminum zirconium tetrachlorohydrex GLY is the chemical that reduces sweating. And, there is no association between it and breast cancer.

Also, the kidneys – not sweat – are the major means by which toxins are eliminated from the body. Sweat is mostly water, sodium, potassium and magnesium – not toxins.

The Journal of the National Cancer Institute conducted a study in October 2002 of the possible relationship between the use of products for underarm perspiration and the risk of breast cancer in women ages 20 to 74.

They found that the risk did not increase with antiperspirant or deodorant use, use of a product right after shaving or using products one hour after shaving.

Myth #3: A woman is not at risk for breast cancer if there is no family history of the disease.

Fact: Every woman has some risk of breast cancer. Approximately 80 percent of women who get breast cancer have no known family history of the disease. Increasing age – normal aging – is the biggest single risk factor for breast cancer.

Myth #4: Only the mother's family history of breast cancer can affect a woman's risk factor.

Fact: A history of breast cancer in both the mother or father's family will influence a woman's risk factor equally. Remember: Half of all genes come from each parent.

However, a man with a breast cancer gene abnormality is less likely to develop breast cancer than a woman with a similar gene. To track cancer risks on the father's family history, a check would have to be made of women on the father's side, not just the men.

Myth #5: Women with fibrocystic breast have an increased risk for breast cancer.

Fact: Fibrocystic change is a benign breast condition and does not increase a woman's risk of developing breast cancer.

However, because of the breast density associated with fibrocystic breasts, mammography may not detect some cancers. Patients with fibrocystic breast are encouraged to have regular breast self-exams, clinical breast exams and, in some cases, additional breast imaging, such as ultrasound.

Myth #6: Having the BRCA1 or BRCA2 gene means the patient will get breast cancer.

Fact: Researchers have identified two genes on chromosome 17, BRCA1 and BRAC2, which may increase breast cancer risk.

Of women with a BRCA1- or BRCA2-inherited genetic abnormality, 40 percent to 80 percent will develop breast cancer over their lifetime; 20 percent to 60 percent won't.

Therefore, only about 5 percent to 10 percent of breast cancer cases are related to mutated BRCA1 or BRCA2 genes. Also, up to 80 percent of women who develop breast cancer have no identifiable risk factors.

Myth #7: Males will not get breast cancer.

Fact: Breast cancer in men is rare – only approximately 1,600 men are diagnosed each year, and the disease in men accounts for less than 1 percent of all breast cancers.

But, breast cancer kills 25 percent of the men who develop it, largely because men – and often their physicians – don't know they can get it. Because of this, men with breast cancer often go untreated until their disease has progressed. Also, the incidence of breast cancer in males has increased 25 percent in the past 20 years.

Myth #8: High-fat foods increase the risk of breast cancer.

Fact: A number of studies have found that women who live in countries where diets tend to be lower in fat have a lower risk of breast cancer. But the majority of studies focusing on women in the United States haven't found a solid link between eating high-fat foods and a higher risk of breast cancer.

Ongoing studies are attempting to clarify this issue further. The problem is that the link is complex and researchers are still not sure of the relationship. Still, avoidance of high-fat foods is always a healthy choice.

However, excess body weight is a risk factor for breast cancer, because the extra fat increases the production of estrogen outside the ovaries and adds to the overall level of estrogen in the body.

Myth #9: Trauma or injury to the breast can cause cancer.

Fact: Injury or trauma to the breast does not cause breast cancer. However, the breast may become bruised or develop a fat necrosis as the result of an injury. The patient then feels a lump – resulting in a diagnostic mammogram check.

A cancer can be found after the injury, but the two events are not related. Also, fat necrosis may be mistaken for cancer on the mammogram; however, symptoms of fat necrosis usually resolve over time.

Myth #10: EMF sources can cause breast cancer.

Fact: Electro-magnetic fields (EMFs) are emitted from devices that produce, transmit or use electric power (i.e., power lines, transmitters and household electronics such as televisions, microwave ovens and electric blankets).

During the past 15 years, there have been several studies evaluating children's and adults' residential exposures to electric and magnetic fields in relation to risks of brain cancer, leukemia, lymphomas and breast cancer.

And most findings have been inconclusive. Nevertheless, the National Institute of Environmental Health Sciences recommends limiting exposure to EMFs.

Myth #11: Nipple discharge is always cancerous.

Fact: Most nipple discharge does not indicate a cancerous condition. Up to 60 percent of women experience nipple discharge during breast self-examination. Usually, if the discharge is clear, milky, yellow or green, it does not indicate cancer.

Bloody or watery nipple discharge is considered abnormal; despite that up to 20 percent of women may experience spontaneous milky, opaque or clear fluid discharge, only 10 percent of abnormal discharges are cancerous.

Although most bloody discharges are due to non-cancerous papillomas, women should report any worrisome nipple discharges to their physician for clinical examination.

Myth #12: Oral contraceptives cause breast cancer.

Fact: The higher-dose contraceptive pills used in the past were associated with a small increased risk for breast cancer, but a definitive new study of 9,000 women, published in the June 2002 issue of the New England Journal of Medicine, found that use of the modern birth control pill had no effect on lifetime breast cancer risks.

The results showed that neither the length of time women had been on the pill (even after prolonged use of more than 10 years), nor the dose of estrogen in their contraceptive of choice could predict the disease.

Still, women at high risk of developing breast cancer should discuss any concerns about oral contraceptives with their physicians.

Myth #13: A painful breast lump is always benign.

Fact: Bilateral breast pain is less likely to be associated with breast cancer than unilateral breast pain. However, up to 10 percent of breast cancers are associated with pain; pain may accompany a breast lump.

If a patient has breast pain, but physical exams and mammography do not reveal an abnormality, most physicians will not pursue further breast imaging because the likelihood of breast cancer is very small. Breast pain is the third most common non-cancerous breast complaint, and it may be caused by a variety of conditions.

Myth #14: Because high estrogen levels during pregnancy will cause cancers to grow, women who have had breast cancer should not become pregnant.

Fact: Studies show that the hormonal and metabolic changes that occur during pregnancy do not typically pose any significant risk of recurrent breast cancer.

Additionally, neither the number of pregnancies nor the time lapsed between treatments for breast cancer and pregnancy appear to have any noticeable effect on long-term breast cancer prognosis.

However, breast cancer survivors who are thinking of becoming pregnant should discuss their medical situation with their physician.

Myth #15: A prophylactic mastectomy will prevent breast cancer.

Fact: Although some studies have shown that having a prophylactic mastectomy can reduce a woman's risk of breast cancer by 90 percent, it does not guarantee that her breast cancer will not occur or recur. Eight percent to 10 percent of women will have a recurrence in the scar after a mastectomy.

Additionally, it's possible that the cancer has spread to the lymph nodes or other areas of the body. Breast tissue also extends up toward the neck, under the arms and to the chest wall. And, a woman is at risk of developing breast cancer as long as breast tissue remains in her body.

Myth #16: Underwire bras have been linked to breast cancer.

Fact: This urban legend got its start in a 1995 book titled Dressed to Kill, by Sydney Ross Singer and Soma Grismaijer. The authors claimed that tight bras constrict the lymphatic system, causing cancer-promoting toxins to accumulate in breast tissue. As evidence, they pointed out that breast cancer rates are higher in Western societies.

However, medical experts say that the science in Dressed to Kill doesn't take into consideration other variables that might affect breast cancer risks, such as diet and environment, age, family history, obesity, not having children and more.

—Olive Peart, MS, RT(R)(M), is the clinical instructor of the radiology program at Stamford Hospital in Connecticut, as well as an editorial consultant for and regular contributor to RT Image. Questions and comments can be directed to editorial@rt-image.com.

References:

1. Greenlee RT, Hill-Harmon MB, Murray T, Thun M, "Cancer Statistics, 2001," A Cancer Journal for Clinicians 2001; 51:15-36.
2. American Cancer Society. "Myths and Facts" Accessed online at www.cancer.org/ 
3. "Myths Abound on the Internet," Breast Cancer Action Newsletter #56, October/November 1999.
4. National Alliance of Breast Cancer Organizations, "Facts About Breast Cancer in the USA." February 2001.
5. National Center for Health Statistics. "National Vital Statistics Reports." Vol. 48, No. 11, July 24, 2000.

Have a question about Mammography?

E-mail editorial@rt-image.com for answers from the experts.