BREAST CANCER

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Clearing up fact from fiction

Don't let misinformation about breast cancer keep you from doing the right thing.

Karen Garloch
kgarloch@charlotteobserver.com

What you don't know can hurt you when it comes to breast cancer prevention.

We asked two experts – Mary Keefe, breast health navigator at Presbyterian Hospital, and Dr. Terry Wallace, a diagnostic radiologist specializing in mammography with Charlotte Radiology – to explain the truth behind some myths.

Myth: Breast cancer affects only older women.

Fact: The risk of breast cancer increases with age, but it can occur at any age. “We've diagnosed people in their 20s, and lots in their 30s,” Keefe said. The often-repeated statistic that “1 in 8” women will get breast cancer is calculated over a lifetime to age 95.

Myth: If you don't have family history, you won't get breast cancer.

Fact: Family history of breast cancer increases the risk. But 80 percent of women with breast cancer have no known family history, Wallace said.

Myth: Radiation from mammograms cause cancer.

Fact: “It is said that mammography causes one cancer per 1 million women per year,” Wallace said. “That is obviously an extremely small number, but it's not zero. The other side of the coin is, look how many lives we save per million women per year by doing mammograms.… Getting the mammogram is the wise thing to do.”

Myth: Finding a breast lump means you have breast cancer.

Fact: Eighty percent of breast lumps are benign.

Myth: A monthly breast self-exam is the best way to diagnose breast cancer.

Fact: A combination of annual mammograms starting at age 40, annual exams by a doctor and monthly breast self-exams is the most effective way to find cancer early. (See story on 1E.)

Myth: Mammography is 100 percent accurate in early detection of breast cancer.

Fact: “We are able to see four out of five breast cancers (with mammography),” Wallace said. “It's the one out of every five that keeps us awake at night. For best results, find a mammography center accredited by the American College of Radiology.

Myth: Ultrasound should be used for screening.

Fact: Ultrasound used with mammography helps evaluate lumps that already have been detected, but it is not recommended as a stand-alone screening tool, Wallace said

Myth: Digital mammography does not require compression.

Fact: Digital mammography uses the same process as traditional mammography. Flattening the breast allows the maximum amount of tissue to be examined. The benefit of a digital mammogram is improved clarity and the radiologists' ability to enhance the image.

Myth: Women need a referral from their physician for a screening mammogram.

Fact: A referral is not needed. But if a woman finds a lump, she should contact her doctor, who might order a more comprehensive diagnostic mammogram, which requires a referral. “If you have a lump, go to your doctor,” Keefe said. “Don't get a screening mammogram.”

Myth: Breastfeeding prevents breast cancer. Or: Breastfeeding causes cancer.

Fact: Breastfeeding does not prevent or cause breast cancer, Wallace said. It provides a limited amount of protection, he said.

Myth: Antiperspirants cause breast cancer.

Fact: There is no evidence to support that.

Myth: Birth control pills cause breast cancer.

Fact: Today's birth control pills contain low doses of the hormones estrogen and progesterone. “They are not considered to be a risk factor by anyone I have spoken to,” Wallace said.

Myth: Eating high-fat foods causes breast cancer.

Fact: Studies have never demonstrated a clear connection. Excess body weight is a risk factor for breast cancer because the extra fat increases production of estrogen outside the ovaries and adds to the overall estrogen level.

Myth: Having a needle biopsy means cancer will probably be diagnosed.

Fact: Needle biopsy is the only definitive way to confirm if breast tissue is benign or malignant. But 65 to 80 percent of breast biopsies result in benign findings, Wallace said.

Myth: A breast cancer diagnosis is a death sentence.

Fact: Eighty percent of women diagnosed with breast cancer have no signs that the cancer has spread beyond the breast or nearby lymph nodes. And 80 percent of these women live at least five years, and many much longer.

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