- Breastfeeding does not prevent but reduces breast cancer risk
- Family history of breast cancer can increase your risk
- It is a myth that mammography is painful
October is recognised as International Breast cancer Awareness month. With over 162, 000 new cases being diagnosed annually, the incidence of breast cancer has overtaken cervical cancer to become the most common cancer affecting women in India. Some 78, 000 women succumb to breast cancer every year and a woman succumbs to breast cancer every 10 minutes in India. More than 60% present in advanced stages. Lack of awareness and absence of organized nationwide population-based breast cancer screening programme are the main reasons accounting for late presentation.
Breast cancer awareness month: Know the myths
1. Myth: Most breast lumps are cancers
Fact: 9 out of 10 breast lumps are not cancers. However, it is vitally important to visit a specialist is there are any new changes in the breast. A triple assessment - clinical breast examination, bilateral mammography and ultrasound and preferably an ultrasound guided core needle biopsy will be able to accurately determine whether a lump in the breast is benign or cancerous.
2. Myth: Breast cancer affects only older women
Fact: Although majority of breast cancers occur in women over the age of 50 in the western world, it can in fact occur at any age. It is alarming to note that breast cancer is increasingly being diagnosed at a much earlier age in India. Most breast cancers in India are diagnosed between the ages of 40 - 60 years.
3. Myth: If a woman is pregnant, she cannot get breast cancer
Fact: Breast cancer can occur during pregnancy. When women are pregnant or breastfeeding, their breasts are generally more tender and may feel more "lumpy' than during normal time, which may make it harder to find a discrete lump or notice other change in the breast and hence there may be a delay in diagnosis.
4. Myth: Breast cancer does not occur in men
Fact: Many people are unaware that men can develop breast cancer because they do not think men have breasts. In fact, both men and women have breast tissue. It is important to be aware that a small proportion of men do get breast cancer each year. Although precise statistics in India are unknown, approximately 300 new cases of breast cancer are diagnosed in men each year in the United Kingdom (approximately 1% of breast cancers).
5. Myth: We don't know what causes breast cancer
Fact: Any factor that increases the exposure of estrogen hormone for a prolonged period upon the breast can potentially cause breast cancer. There are well-recognised risk factors. Being a woman and increasing age are the two most important factors.
Other known risk factors are:
- Previously diagnosed breast cancer in the same or other breast
- Family history of breast cancer (close relatives with breast cancer)
- Early onset of menstrual period (before age 12)
- Late menopause (after age 55)
- Not having children and having first child after age 30
- Long term use of hormone replacement therapy
- Obesity (overweight particularly after menopause)
6. Myth: If you have a risk factor for getting breast cancer, you are likely to get the disease
Fact: The risk of getting breast cancer is not a certainty, even if you have one of the strongest risk factors
7. Myth: Family history of breast cancer is the most important risk factor for getting breast cancer
Fact: The vast majority of women with breast cancer do not have a family history of breast cancer. Strong family history (hereditary breast cancer) accounts for only 5-10% of breast cancers due to abnormality in the Genes (BRCA1, BRCA2, P53)
8. Myth: Breastfeeding prevents breast cancer
Fact: Breast feeding does not prevent breast cancer, but reduces the risk.
9. Myth: Birth control pills causes breast cancer
Fact: Modern day birth control pills contain a low dose of estrogen and progesterone and hence are not associated with an increased risk of getting breast cancer.
10. Myth: Wearing a bra especially an underwire bra can cause breast cancer
Fact: There is absolutely no evidence to that wearing any type of bra can cause breast cancer
11. Myth: Carrying your cell phone in your bra can cause breast cancer.
Fact: There is no evidence of a connection between cell phones and breast cancer, but the safety of mobile phones is still being studied. As a general rule, it is advisable to keep the mobile phone away from your body as much as possible.
12. Myth: Breast cancer always presents with a lump that you can feel in the breast
Fact: Although the commonest presentation of breast cancer is a painless lump in the breast, breast cancer might not cause a lump, especially when it first develops. People are sometimes under the mistaken impression that breast cancer always causes a lump that can be felt. They might use this as a reason to skip mammograms, thinking they will be able to feel any change that might indicate a problem.
Breast cancer can also present with recent retraction of the nipple, blood stained discharge from the nipple or a rash around the nipple areola region or just as a thickening of skin overlying the breast or dimpling of skin overlying the breast.
13. Myth: Breast self-examination is no different from Breast Awareness
Fact: Breast self-examination (BSE) is a regular and repetitive monthly self examination of the breast performed by a woman at the same time each month to a set method. The concept of BSE has not proven to be beneficial.
Breast Awareness is about becoming familiar with the breasts and the way they change throughout a woman's life. It is a concept that encourages women to know how their breasts look and feel normally so that they gain confidence about noticing any change which might help detect breast cancer early.
Changes in breasts that one should be aware of
- Painless lump or thickening in the breast that feels different from the rest of the breast tissue
- Change in size - it may be that one breast has become noticeably larger or noticeably lower
- Nipple has become inverted (pulled in) or changed its position or shape
- Rash on or around the nipple
- Blood stained discharge from one or both nipples
- Puckering or dimpling of the skin
- Swelling under the armpit or around the collarbone (where the lymph nodes are)
14. Myth: Breast cancer screening is effective in all age groups
Fact: Whilst it is important for women of all ages to be 'Breast Aware', Breast Screening is effective only in women over the age of 40 years. Routine breast screening for women under 40 and without symptoms is not effective.
15. Myth: Mammography is painful
Fact: Whilst Mammography may cause momentary discomfort, it is not painful.
16. Myth: Mammography is not safe. It causes radiation hazard.
Fact: Mammography involves a tiny dose of radiation - the risk to health from this is insignificant.
17. Myth: Breast screening prevents breast cancer
Fact: No, breast screening only helps find breast cancer if it already there
(Dr. P Raghu Ram, Director, KIMS-USHALAKSHMI Centre for Breast Diseases, Hyderabad; Founder, CEO & Director, Ushalakshmi Breast Cancer Foundation, Hyderabad; President, The Association of Surgeons of India)
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