Separating fact from fear: common breast cancer myths

Dr Lyronne Olivier

Breast cancer is one of the most common cancers diagnosed in women, yet it remains surrounded by many myths and misconceptions which may influence a patient’s willingness to seek care, whether or not they have been diagnosed.

In the age of the internet, there is an abundance of information and misinformation about the causes, symptoms and risk factors for breast cancer on social media networks, blogs and casual conversation with friends and family. Moreover, misunderstandings surrounding breast cancer are often perpetuated by rumours and mistaken beliefs passed on through generations.

Confusion and fear can arise when patients are unable to separate fact from fiction, often missing key symptoms or unknowingly engaging in behaviour which may increase their risk, reducing the likelihood of early detection, diagnosis and treatment. I have identified and debunked some common misconceptions to help others make better-informed healthcare decisions.

Myth: I won’t get breast cancer because none of my relatives have it.

False. Most people diagnosed with breast cancer have no family history of the illness.

Only ten per cent of breast cancers are hereditary or arise because of a person’s inherited genetic makeup. Therefore, ninety per cent of breast cancers are not related to gene mutations passed on from parent to child, and are thus deemed “sporadic,” often linked to environmental and other factors.

Myth: I don’t have any pain in the breast, so I can’t have cancer.

False. It’s human nature to assume that a link exists between a painful body part and an abnormality or disease.

However, this doesn’t hold true of most breast cancers.

Breast cancer may present itself as a painless lump for many years – so even painless lumps require clinical appraisal before symptomatic pain starts.

During this time, the window for early treatment slowly closes, negatively affecting overall survivability chances.

Myth: Mammograms will expose me to an unsafe level of radiation.

False. This myth is particularly harmful in that it perpetuates fear and often discourages patients from seeking breast-cancer screening altogether.

The radiation dosage is equal to the exposure one experiences during an flight between two destinations such as New York and California.

Moreover, the radiation dosage per mammogram is 0.4mSv, and the yearly daily environmental background radiation is approximately 3mSv. There is background radiation daily around us, produced by the sun, rocks, gases in the air and radioactive substances in water and other organic substances.

So the radiation exposure from mammography is minimal and outweighs the risk-to-benefit ratio.

Myth: I feel a breast lump and so I must have cancer.

False. Most breast lumps are not cancerous. Breast lumps can be solid or cystic and characteristics of a breast mass can be differentiated by breast imaging such as mammograms and breast ultrasound.

Solid masses are the most worrisome and harbour the greatest potential for malignancy. However, most solid breast masses found in breast clinics may very well be non-cancerous.

Cystic lumps, on the other hand, are basically “bags” of fluid produced by the breast gland.

There are three types of cystic masses: simple cysts, complicated cysts and complex cysts. The complex cysts possess the “bag of fluid” characteristics as well as solid components. They also harbour the potential for cancerous cells.

Overall, all solid breast lumps should be assessed by your breast surgeon with the principle of triple assessment: clinical history and examination, radiological investigation and tissue sampling for testing.

Myth: I can’t get breast cancer if I have a healthy lifestyle of diet and exercise.

False. While a healthy diet and exercise reduce the risk of developing breast cancer, they do not prevent or eliminate it entirely.

Regular screening and early detection are important, even if you eat well, exercise regularly and don’t smoke.

Myth: Men can’t get breast cancer

False. The male chest includes breast tissue behind the nipple. So men can potentially develop breast cancer, though it is very rare. Male breast cancer accounts for only one per cent of all breast cancers.

Still, it is important for men to be aware of changes and lumps, as this is imperative for early diagnosis and treatment.

Myth: Removing the breast is the only treatment for breast cancer.

False. Though this “dogmatic” surgical approach has been selectively used by breast surgeons, it is not the only viable option for most patients.

Aggressive and sometimes excessive surgery to remove a breast (mastectomy) often results in post-traumatic stress, body-image struggles and feelings of loss of femininity. The scar serves as a daily reminder of the stress and trauma of a surgery and diagnosis which changed the course of the patient’s life forever.

Oncoplastic breast surgery allows the option of breast preservation via surgical removal of breast cancer, alongside plastic surgical techniques to maintain the shape and symmetry of the breast.

Initial medical studies historically indicated there was no difference in survival outcomes between removing the breast and preserving it.

However, more recent medical literature has shown that applying breast-preservation principles may actually improve overall survival.

Myth: All breast cancers are the same.

False. There are several sub-types of breast cancer. Understanding the sub-type helps doctors determine the most effective treatment and management protocols for the individual patient.

Unique differences in breast cancer are based on:

● Staging of the cancer

● Size of the breast mass

● Grade (microscopic) of the cancer

● Any masses/lymph nodes in the armpit (axillary)

● Receptors on the cancer – oestrogen receptors/progesterone receptors/HER-2

● Cancer spread to other organs

Myth: Mammograms cannot be done on patients with breast implants

False. There are breast imaging techniques which can be applied to push the implant backward and permit imaging of the breast tissues.

It is entirely possible to perform mammographic screening safely and effectively in patients with breast implant augmentation.

Myth: Antiperspirants, deodorants or underwire bras cause breast cancer.

False. There is no scientific evidence linking these products to breast cancer.

Myth: Avoiding sugar will starve and kill breast cancer.

False. The body cannot selectively starve cancer cells of sugar.

Other cells in your body need sugar/glucose to function, and the body will make sugar from its stores of fat and protein. Removing sugar from the diet does not stop cancer growth.

Myths and misconceptions surrounding the causes, risk factors and even treatment for breast cancer have been around for a long time, hindering early detection and perpetuating fear and stigma in our communities.

The key to early diagnosis and treatment is public education, as well as individual awareness of the signs, treatment and causes.

Consult a breast surgeon if you have any issues or concerns. Early detection and immediate action are key.

Dr Lyronne Olivier is an associate lecturer at the University of the West Indies, St Augustine, and a consultant breast surgeon at the St James Medical Complex.