“But nobody in my family has breast
cancer...”
“You are too young to have cancer.”
“Thank God I am a male...”
Have you often heard these lines and wondered
if these people were actually safe?
October is the Breast Cancer Awareness Month.
Let us increase our awareness about breast cancer by trying to differentiate
the myths from the facts. A part of this list had been published in 2008 on EzineArticles. But this is a more extensive list.
1.
Men
do not get breast cancer.
Men are lucky but not totally immune to
breast cancer. In rare cases, men may get breast cancer. For every 100 women
with breast cancer, only one man may get it. If they notice any unusual change
in their breasts, men should consult their healthcare providers without too
much delay.
2.
Breast
cancer occurs only in elderly ladies in their postmenopausal age.
Recent trends in metros show younger women
falling prey to breast cancer. It is not very uncommon to find ladies in their
30s being diagnosed with breast cancer. It can even happen to girls who are
just 15-16 years of age. No age is immune to breast cancer.
3.
The
family history from only the mother’s side is important.
If somebody from your mother’s side of the
family has breast cancer you have a higher chance of having it too. However,
the history of breast cancer in the father’s side of the family is also
important. In about 5% of cases, breast cancer may have genetic link. Such
genetic traits may be transmitted from either the father or the mother’s side.
4.
Nobody
from either side of my family ever had breast cancer. So my family history is
not really significant.
Not just a history of breast cancer...a
history of ovarian or prostate cancer in the family is also important. If
somebody in the family had either of these cancers, the risk of breast cancer
is also increased among members of the family.
5.
Nobody
in my family ever had any kind of cancer. So, I am safe.
Not really! Family history is just one of the
multiple factors that can increase your risk of breast cancer. There may be
other factors involved that can increase your risk of breast cancer.
6.
Breast
cancer always presents as a lump in the breast.
A lump in the breast is one of the most
common presentations of breast cancer. However, the condition can also present
as any unusual change in the breast such as
- Swelling of all or part of the breast
- Skin irritation or dimpling
- Breast pain
- Nipple pain or the nipple inversion
- Redness, scaliness, or thickening of the nipple
or breast skin
- A nipple discharge other than breast milk
- A lump in the underarm area
7.
All/most
breast lumps are cancer.
Nearly 8 out of 10 breast lumps are benign
and not cancerous. Benign lumps in the breast may be due to cysts, lipomas,
fibromas etc.
8.
Breast
cancer is painful.
In most cases, breast cancer presents as a
painless lump. That is the main reason why women tend to delay consulting a
doctor. For an early detection of breast cancer, it is important that we
encourage women to seek medical advice for just about any change they notice in
their breasts, whether or not it is painful.
9.
A
painful breast lump is not cancer.
If a breast lump is painful, it is more
likely to be due to a benign condition. Most cancerous lumps in the breast are
painless. But pain alone cannot rule out cancer. A painful breast lump CAN BE cancer.
10. An injury to breasts can
cause cancer
An injury to the breast does not cause
cancer. It may simply draw attention to an underlying lump that may eventually
be diagnosed as malignant. If the breast is bruised badly, there may be an
accumulation of blood under the skin that can feel like a lump. The body will
reabsorb this over time, just as any bruise heals. Sometimes an injury may
cause fat necrosis. The body’s repairing mechanism may cause a firm scar over
it. This may be visible on a mammogram as a solid lump. Further investigations
often rule out cancer.
11. Fibroadenomata are benign
tumors and do not increase the risk of cancer.
Fibroadenoma is a benign tumor to start with. However, it is a
long-term risk factor for breast cancer. The
risk is increased in women with complex fibroadenomas, proliferative disease,
or a family history of breast cancer.
12. If there is no lump seen in
a mammogram, it means there is no cancer.
A mammogram is a sensitive investigation to
detect a lump. However, ‘no lump’ in a mammogram does not mean ‘no cancer’. In
early stages of breast cancer, there may be no lump. Only microcalcifications
and parenchymatous changes may be seen.
13. Annual mammograms expose you
to radiation and thus increase the chance of cancer.
Mammography does expose a woman to some
amount of radiation. It is at a level far below any regulatory limits. However,
if a woman is pregnant she should notify her health care provider prior to
having a mammogram. Also mammograms should be avoided in women who haven’t
reached menopause unless there is a real need for one. Routine annual screening
mammograms are recommended only for women in the peri- and postmenopausal age
group.
14. Mammography is painful.
Mammography does cause a little discomfort to
some women when the breasts are slightly pressed between the plates of the X-ray
machine. However, mammography per se is not painful unless the woman has a
painful cyst already present. To avoid any pain or discomfort, it is best to
get a mammography done a couple of days after the menstrual bleeding stops as
some women complain of tenderness in the breasts prior to their menstrual
periods.
15. Birth control pills are
dangerous as they increase the risk of breast cancer to a great extent.
The pill has gone through many permutations
since its invention. Earlier pills used much more estrogen and progestrerone
than today’s pills do. Earlier findings of an increased risk of breast cancer
are not necessarily applicable to the pill used today. ‘Total months of use’
and the time when it is used are also important factors. There is a small increase
in risk of breast cancer if the pill is taken before the first full term
pregnancy. According to the Society of Obstetricians and Gynecologists, for
every 10,000 women who use OCPs, there would be:
·
About 2 additional cases of
breast cancer if OCP was used before the first full-term pregnancy
·
About 1 additional case of
breast cancer if OCP was used after the first full-term pregnancy.
Also,
10 years after stopping the birth control pill, a woman's risk of breast cancer
appears to be the same as a woman who never used OCPs. Thus, in the Indian
context, OCPs do not pose a major problem of increasing the risk of breast
cancer. Population control is a bigger issue here!
16. In that case, hormone
replacement therapy (HRT) is also safe and does not increase the breast cancer
risk significantly.
Study
published in New England Journal of Medicine, Feb 2009, says postmenopausal
women who take combined estrogen plus progestin HRT, for at least five years,
are doubling their risk of breast cancer. It also says that women can quickly
reduce their risk of breast cancer by stopping HRT. This fall in risk occurs
within one year. Menopause is a physiological change and if HRT can be avoided,
it is should not be prescribed.
17. Wearing an underwire bra or
wearing a bra at night increases the risk of breast cancer.
It
is a rumor that underwire bras block the drainage of lymphatic fluids from the
bottom of the breast and that this leads to the breast tissue being ‘soaked’ in
toxic fluids which increase the risk of cancer. There is no scientific evidence
to support this claim. In fact, the lymphatics from the breast drain upwards
towards the arms and not downwards where they can be blocked by the pressure of
an underwire bra.
18. Size matters! Women with
small breasts have less chance of getting breast cancer.
There
is no connection between the size of the breast and the risk of getting breast
cancer. It is more difficult to examine very heavy breasts than to examine
smaller breasts. But irrespective of the breast size, all women need to go for
regular screenings and check- ups along with the monthly self-examination.
19. If you are at risk of breast
cancer, there is nothing much you can do other than watching out for signs of
cancer.
Even
if you are at risk of breast cancer, there is a lot you can do to lower the
risk.
·
If you are obese, exercise
regularly.
·
Lower or eliminate
consumption of alcohol.
·
Be rigorous about examining
your breasts and having regular clinical exams and mammograms.
·
Preventive medications such
as tamoxifen are also available. But they are accompanied by several side
effects.
20. Breast cancer is
preventable.
Sadly, no! Breast cancer is not completely
preventable. It is possible to identify risk factors and make lifestyle changes
in order to decrease your risk. However, nearly 70% of women diagnosed with
breast cancer have no identifiable risk factor. The disease occurs largely due
to ‘as-yet-unexplained’ factors.
So, what’s in your hands? A regular
self-exam, clinical exam and screening that can help in early detection of
cancer! Once detected, do not panic. Get yourself a timely and adequate treatment.
A modified Hindi version of this article is available at http://www.punjabkesari.com/E-Paper/Magzine/adv_1.pdf for download. Copy the link address and paste it on your browser's address field.
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