October is National Breast Cancer Awareness Month. The next issue of “Medical Myths of Breast Cancer Misconception” is devoted to the main prejudices and misunderstandings that have accumulated around this serious medical and social problem.

According to the World Health Organization (WHO), 685,000 people died of breast cancer in 2020 , and 2.3 million new diagnoses were made. The WHO also reports: “As of the end of 2020, there were 7.8 million women worldwide with breast cancer diagnosed in the past five years, making it the most common type of cancer in the world.”

Such statistics can explain why so many different myths are associated with breast cancer ( the term “breast cancer” is colloquial and is not used in scientific and medical texts). Here we will try to analyze the fifteen most persistent of them.

Three experts helped us in our search for truth:

— Dr. Michael Seidman, Associate Professor, Department of Breast Surgery, Icahn Medical Institute, Mount Sinai Medical Complex, New York;

— Dr. Crystal Fancher, Specialist in Breast Cancer Surgery at Margie Petersen Center, Associate Professor of Surgery at Saint John Cancer Institute, Santa Monica, California;

— Dr. Richard Reiterman, Medical Director, Imaging Department, Orange Coast Medical Center, Fontaine Valley, California.

1. Breast injury can cause cancer

“No, trauma is not a direct cause of cancer,” explains Dr. Seidman. “However, changes in tissue that mimic cancer on tomograms are possible. This process is called fat necrosis and may look like an irregular mass with indistinct contours, which is very similar to malignant neoplasia in the breast. The best way of differential diagnosis is a fine needle aspiration puncture biopsy .”

1. Underwired bras increase risk of breast cancer

No, they don’t increase. M. Seidman always recommends wearing bras without wires, but the reason is different: “The sewn-in wire can irritate the skin under the breast, which is fraught with infection, abscess formation  and other rather serious problems.”

1. Artificial insemination increases the risk of breast cancer

As part of the technology of in vitro fertilization (IVF), specialists often prescribe drugs that stimulate ovarian function. These drugs mimic the activity of estrogen*.

Therefore, the question was raised and studied as to whether these drugs can provoke the growth of a cancerous tumor, in particular, having estrogen receptors on cell membranes.

“Randomized controlled trials** on this issue are not yet available,” says Michael Seidman, “but a recent meta-analysis of publications over the past 30 years showed that women taking ovarian stimulants do not have a higher risk of breast cancer than the general population “.

* Estrogens are female sex hormones.

** Controlled randomized trials are the modern standard for research organization, minimizing any bias.

1. No woman in my family has had breast cancer, and I never will.

This myth is familiar to Dr. Seidman: “It is very common for a woman with a primary diagnosis of breast cancer to talk about how shocked she is and refer to the absence of such cases in the family history. I have to answer that the vast majority of patients I see with initially diagnosed cancer of this type had no history of risk factors at all. In fact, the most significant risk factor is the female gender itself. In the United States, one in eight women will develop breast cancer in their lifetime.”

Dr. K. Fancher added to this, referring to the data of the American Cancer Society, that “only 10-15% of cases of breast cancer are due to inherited genetic mutations. This means that the majority of new cases are sporadic or non-heritable.”

Since family history is only one of the risk factors, and not the main one, screening (mass, general) regular examinations are very important. According to Dr. R. Reiterman, “every woman over 40 should have an annual mammogram, regardless of family history. If there is a family history of breast cancer or ovarian cancer, regular screening should begin at age 30.”

Dr. M. Seidman agrees with his colleagues: “If you are a woman and you are over forty, please go through screening mammography regularly!”

1. Breast cancer is caused by stress

Given the stressfulness of modern life as such, it is not surprising that people consider stress to be the  culprit of all ills, including breast cancer. However, Dr. M. Seidman tells us that “there is absolutely no evidence of a link between stress and breast cancer. In fact, there is evidence that stress does NOT increase the risk of this type of cancer.”

However, this does not mean that stress does not have any effect on health. “An integral component of human existence,” the expert continues, “is the search for effective ways to overcome the stress that we all face inevitably and constantly. Healthy and effective ways to compensate for stress (coping strategies) are extremely beneficial for physical and mental well-being.

But coping strategies do not reduce the risk of breast cancer, while stress, we repeat, does not increase it.

1. A healthy lifestyle eliminates the risk of breast cancer

“While it is true that menopausal women, especially those who are overweight, are at an increased risk of breast cancer, there is really nothing a woman can do to eliminate this risk altogether,” explains Michael Seidman. “This probability remains even for those women who have undergone bilateral mastectomy ( removal of both mammary glands.).”

Nevertheless, this is not a reason to fall into fatalism, give up on yourself, start smoking and eating exclusively fast food, the expert writes to us. “Taking care of your body in any case is extremely important, because you will not have another body. But even world-class athletes have been diagnosed with breast cancer.”

1. Breast cancer only develops in the elderly

“The risk increases with age, that’s right. The average age of detection of new cases of breast cancer is 61 years However, the oncoprocess of such localization can begin much earlier. About 5% of all new cases are diagnosed in women under 40, and, unfortunately, there are reports of earlier cases in women in their early twenties and even teenage girls. As a rule, these are cases with a burdened family history,” M. Zaidman writes to us. “Therefore, if you have reason to suspect a hereditary predisposition, you should begin medical genetic studies and regular screening no later than the age of 25.”

Although breast cancer is less common in young women, Dr. C. Fancher strongly advises “to bring to the attention of the attending physician everything that happens to your breasts, and listen to all recommendations regarding screening.”

1. Any formation in the breast turns into cancer

No, it’s not like that at all. According to Dr. M. Seidman, “Most breast growths are benign, and – especially if the recent mammogram was normal – there is no need to panic.”

Nevertheless, with any neoplasm in the breast that you notice, you should, of course, see your doctor.

1. Abortion increases the risk of breast cancer

“The reason why people ask this question again and again,” writes M. Seidman, “is that today everyone knows the connection between estrogen and cancer risk, and abortion interrupts the normal cycle of hormonal changes inherent in pregnancy. And although controlled randomized trials have not yet been conducted, a review analysis of a huge number of publications on this topic has been carried out in Denmark. The total sample size was 1.5 million women, and no associations were found between abortion and breast cancer. This same conclusion has been confirmed by several other large-scale statistical studies.”

1. Mobile phones, if worn on the upper body, can cause breast cancer

Michael Seidman: “The question has been studied, and all the data received to date refute this claim. But if you still have concerns, why not just put your smartphone in your jeans pocket or purse?

1. Nipple piercing increases risk of breast cancer

Dr. M. Seidman writes that nipple piercing is not directly related to breast cancer. At least, the oncological risk does not increase from this. “However,” the expert recalls, “piercing in this area leads to infections, abscesses, difficulties with breastfeeding due to fibrosis of the milk ducts. Nerve endings are damaged, the formation of cysts and keloid scars is high. Somewhat less often, but there are cases of infection with HIV and hepatitis B and C. Considering all this, I personally am categorically against nipple piercing, and I strongly recommend that all my patients who have made this dubious jewelry get rid of it.

1. Sugar causes breast cancer

Again, to quote Dr. Seidman: “Sugar should be limited in principle. It is one of the addictive substances. In addition, excessive consumption of sugar leads to severe mood swings and spikes in blood insulin levels, which plunges the body into a pro-inflammatory state. In turn, this is fraught with the development of cardiovascular diseases, diabetes and other similar diseases. Finally, excess sugar in the diet is a direct path to obesity ., and obesity is indeed a cancer risk factor. Cancer cells divide very quickly and need a constant supply of energy; apparently, this is where the myth of a direct link between sugar and cancer comes from. In fact, such a connection has not yet been confirmed by scientific research. And yet, for the sake of the general well-being of the body, I highly recommend abstaining from sugar consumption as much as possible.

1. Men don’t get breast cancer

“Men have mammary glands, and therefore, cancer can begin in them,” writes Michael Seidman. “Approximately one in 100 cases of breast cancer in the United States occurs in men.”

In 2017, there were 2,300 new cases of male breast cancer and 500 deaths, according to the Centers for Disease Control and Prevention.

“Of course, this disease is much more common in women,” confirms Dr. K. Fancher, “however, men are by no means insured. Therefore, no matter what gender you belong to, it is very important to pay attention to any suspicious lumps or sensations in the chest in time, and see a doctor with them.

Dr. Richard Reiterman adds that cases of breast cancer in men are usually associated with a genetic factor. According to the PubMed Central database , the likelihood of developing a breast tumor is especially high in men who are carriers of the mutated BRCA2 gene.

1. Mammography accelerates the spread of breast cancer

“I hear this myth from my patients, perhaps more than any other,” says Dr. Seidman. – For some reason, many people believe that mechanical compression of an existing tumor during a mammogram, or (another myth) a fine needle biopsy procedure will cause the cancer to quickly spread to other parts of the breast. In reality, however, there is absolutely no evidence to support such concerns.”

Dr. Reiterman emphasizes that mammography is safe in this and in all other aspects: “The method itself involves the use of extremely low doses of radiation and very slight compression, and neither of these can affect the oncological process. Indeed, so far, even the theoretical possibility of such a possibility has never been reported, let alone actually documented cases.

1. If no lump is palpable, there is no cancer

“If it were so, there would be no need for mammography,” Dr. M. Zaydman remarks reasonably. “However, over the years, there has been more and more evidence that mammography saves lives by detecting cancer at its earliest stages, when it is not even palpable yet. In cases of early diagnosis, the curability approaches 100%, but in the future, survival decreases depending on the stage of the process. In fact, even metastasized cancer can be non-palpable.”

According to Dr. K. Fancher, “In many cases, breast cancer, especially at an early stage, can only be detected through screening mammography, and this should not be neglected. This is especially true for non-invasive cancer or ductal carcinoma, which may only show up as calcifications on a mammogram.”

 

What do we note

Breast cancer is a widespread and very dangerous disease. And although a healthy lifestyle to some extent reduces the overall cancer risk, your vigilance still plays a key role. The sooner the tumor is detected, the higher the chances of a complete cure.