Top Doctors' Most-Asked Questions About Breast Cancer
Whether you’ve recently received a breast cancer diagnosis or are concerned about getting one in the future, it’s normal to have a lot of worries about the disease. We asked top breast cancer experts to tell us the most common Qs they’re asked by patients—and their best advice for each—because you know the old adage: If you have a question, chances are someone else is thinking it, too.
Does Hair Dye Cause Cancer?
In short: We’re not sure. A recent study linked breast cancer with permanent hair dye, as well as hair-straightening treatments, especially among African American women, who were more likely to use both. But doctors say they need more info. “Some details in this study haven’t been fully parsed out, and we’ve seen other studies showing no link,” says Marleen Meyers, M.D., a medical oncologist at NYU Langone Perlmutter Cancer Center in New York City. Plus, the participants in the study each had a sister with breast cancer, so family history was already a factor. If you’re worried, know that using semi-permanent or temporary hair colors posed little to no increase in risk.
Will My Implants Give Me Breast Cancer?
Implants and cancer made big headlines in 2019 when the FDA announced that there’s a low, but increased, risk of anaplastic large cell lymphoma, a rare type of non-Hodgkin’s lymphoma, associated with a specific type of textured breast implants, thee BIOCELL Textured Breast Implant, from pharmaceutical brand Allergan, which voluntarily recalled these products. However, “the current recommendation is not to remove textured implants from patients,” says Dr. Meyers. The risk of developing the cancer is small, and the surgery to remove them is extensive. If you have them, regularly monitor your breasts for swelling and pain, and get an MRI without contrast every three or four years.
What Do Itchy Breasts Mean?
Itchy breast skin can be embarrassing and annoying, and can stem from a lot of things. You might start scratching from seasonal skin dryness. Or maybe you’ve recently switched laundry detergent or body wash. Most of the time, itch is absolutely nothing to be concerned about. However, inflammatory breast cancer, a rare type of the disease that accounts for only 1% to 5% of all cases, can make breast skin itchy. If you’re also experiencing other symptoms—like swelling, thickening or dimpling breast skin, and/or swollen lymph nodes—make an appointment with your doctor.
What Do I Do When I Feel a Lump?
First of all, don’t panic. “Keep an eye on it; if it disappears after your period, it was probably a benign breast cyst,” says Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology, and reproductive services at Yale School of Medicine. If your period comes and goes and the lump is still there, it’s time to see a doctor, she says. But, still, know that about 80 percent of breast lumps turn out to be benign cysts or growths.
Should I Worry About Sore Breasts?
If your breasts are tender during the second half of your cycle, it’s likely nothing more than hormonal fluctuations associated with PMS. Or you may have fibrocystic changes triggered by caffeine or chocolate. So breathe easy: This type of soreness isn't dangerous and “doesn’t increase your risk of breast cancer,” says Dr. Meyers. When is soreness a concern? If it’s persistent regardless of your menstrual cycle, it’s in just one breast, or it’s accompanied by other symptoms such as swelling, discharge, a lump, or changes to your breast skin, it warrants a call to your doctor.
Do Mammograms Increase My Risk of Cancer?
Mammograms use radiation, which, yes, can contribute to cancer (one 2016 study found that annual screenings of 100,000 women were projected to cause 125 cases of radiation-induced breast cancer and 16 deaths). But it’s generally agreed that the benefits of early BC detection here far outweigh the risks of radiation. “A mammogram is like an X-ray; it has a very low level of radiation,” says Sarah Cate, M.D., a breast surgeon at Mount Sinai Hospital in New York City. “And we have a lot of studies to show that it doesn’t cause secondary cancers,” she says.
Should I Have Genetic Testing?
If you have a family history of breast or ovarian cancer on either your mother’s or your father’s side, you should consider a blood test to see if you carry the BRCA gene mutations linked to these cancers. “Many women think breast cancer or the gene mutation comes only from their mother’s side, but it’s irrespective of sex,” says Dr. Cate. “Knowing your family history on both sides really matters.” If you don’t have a family member with the disease, genetic testing typically isn’t offered because it’s not necessary.
Can I Have a Mammogram While Pregnant or Nursing?
Mammograms with protective shielding over your abdomen (not standard practice—so ask!) are considered safe during pregnancy since they use low levels of radiation. Still, most doctors err on the side of caution and check out suspicious lumps via an ultrasound, which doesn’t use radiation (though ultrasound isn’t the first choice for BC detection because it can miss early signs). MRIs without contrast can also be safely used to detect breast tumors during pregnancy. If you’re nursing? You can get a mammogram as long as you nurse or pump one hour beforehand.
Should I Stop Eating Soy?
The plant-based estrogen has gotten bad press ever since it was shown to increase levels of estrogen and cancerous breast tumors in mice studies. But experts say you can have your edamame and eat it, too. Human studies have shown the estrogen-like effects in soy-containing foods have no effect on breast cancer risk, and could even potentially reduce your risk of breast cancer. “I probably wouldn’t eat soy three times a day, but we’re certainly not seeing higher rates of breast cancer in vegetarians,” says Dr. Cate.
What Are the Side Effects of Hormone Therapy for Breast Cancer?
Hormone therapy is the use of drugs that block estrogen or progesterone, two hormones that fuel hormone-receptor positive cancers, causing them to grow and spread. Hormone therapy is often prescribed instead of chemotherapy for these types of cancers, and gives patients a better quality of life than chemo, but it’s not without side effects. The most common are hot flashes, vaginal dryness, fatigue, nausea, and joint pain. The more serious, but rare, complications include blood clots, stroke, osteoporosis, heart disease, and an increased risk of endometrial cancer.
- Hair Dye Study: International Journal of Cancer. (2019). “Hair Dye and Chemical Straightener Use and Breast Cancer Risk in Large US Population of Black and White Women.” onlinelibrary.wiley.com/doi/abs/10.1002/ijc.32738
- Textured Implant Recall: FDA.gov. (n.d.). “Allergan Recalls Natrelle Biocell Textured Implants Due to Risk of BIA-ALCL Cancer.” fda.gov/medical-devices/medical-device-recalls/allergan-recalls-natrelle-biocell-textured-breast-implants-due-risk-bia-alcl-cancer
- Mammograms and Cancer Risk (1): Annals of Internal Medicine. (2016). “Radiation-Induced Breast Cancer Incidence and Mortality From Digital Mammography Screening: A Modeling Study.” annals.org/aim/fullarticle/2480762/radiation-induced-breast-cancer-incidence-mortality-from-digital-mammography-screening
- Mammograms and Cancer Risk (2): Radiology. (2011). “Risk of Radiation-Induced Breast Cancer From Mammographic Screening.” ncbi.nlm.nih.gov/pubmed/21081671
- Soy and Breast Cancer: Medicines. (2017). “Dietary Isoflavones and Breast Cancer Risk.” ncbi.nlm.nih.gov/pmc/articles/PMC5590054/
- Hormone Therapy: American Cancer Society. (n.d.) “Hormone Therapy for Breast Cancer.” cancer.org/cancer/breast-cancer/treatment/hormone-therapy-for-breast-cancer.html