9 Major Breast Cancer Myths—Debunked
Breast cancer is one of the most talked about cancers, and research is at an all-time high. Yet there’s some chatter experts wish would stop: the potentially dangerous misconceptions about BC that keep making the rounds. Here, a top breast cancer surgeon and oncologist help us take down some of the biggest myths—and speak the truth.
Myth: Antiperspirants Cause Breast Cancer
Your oncologist breaks a sweat every time she hears this. “Every new patient asks this, but we don’t have any data to support it,” says Sarah Cate, M.D., a breast surgeon at Mount Sinai Hospital in New York City. An ingredient in question is aluminum, which plugs up your sweat glands. The worry started after an animal study suggested that aluminum can cause DNA damage. It’s also thought to be absorbed and act like an estrogen, triggering breast cancer. But this finding hasn’t been replicated in any good human studies, says Dr. Cate. And if there were a link, she adds, “we would also see a lot more cases in men.”
Myth: You Must Have a Family History to Get Breast Cancer
“While it’s true that breast cancer can run in families, less than 15% of patients have a true genetic link such as the BRCA gene mutation,” says Marleen Meyers, M.D., a medical oncologist at NYU Langone Perlmutter Cancer Center. That means the majority of people who get breast cancer have no familial or genetic connection, so other risk factors must be at play. According to breastcancer.org, these breast cancers may stem from gene mutations that happen with age, not inherited mutations.
Myth: You Don't Need a Mammogram Until 50
The answer to the when-to-get-a-mammo question depends on whom you ask. The United States Preventive Services Task Force (USPSTF) suggests that most women get a mammogram every other year starting at age 50. The American Cancer Society says annually starting at 45. “But we breast cancer specialists suggest mammograms annually starting at age 40, and even earlier if you have a gene mutation or a family history,” says Dr. Cate. The National Comprehensive Cancer Network (NCCN) recommends starting ten years earlier than the age your family member was when diagnosed with BC. Getting pushback on a pre-age-50 screening? By law, you can get a preventative mammogram without a prescription. Also, the Affordable Care Act mandates that health plans cover preventative screenings starting at 40.
Myth: All Cases Require Chemotherapy
Not all breast cancers are the same, and so not all respond to the same treatment. For example, the cancer cells in hormone-receptor positive breast cancers are fueled by hormones estrogen or progesterone, which bind to receptors on the cancer cells. Hormonal therapy drugs—like Nolvadex and Soltamox (tamoxifen), Faslodex (fulvestrant), and Femara (letrozole)—can stop this process, halting the spread. In the case of HER2+, an aggressive type of breast tumor that contains a protein called human epidural growth factor receptor 2, treatments include drugs that target this specific protein, and may be given with or without standard chemotherapy.
Myth: A Mastectomy Is More Effective Than a Lumpectomy
With a mastectomy, which means removing the entire breast, the chances of your cancer coming back is extremely low. And while you might have a slightly higher risk of recurrence with a lumpectomy, research has shown those who have a lump removal followed by radiation therapy afterwards have the same survival rate as those who have a mastectomy. “If a person is a candidate for lumpectomy, which means the lump is not too large or they don’t have more than one, there is no survival advantage to going for a mastectomy,” says Dr. Meyers.
Myth: Surgery Can Cause Breast Cancer to Spread
“This rumor comes from your grandparents’ generation, who believed you shouldn’t open cancer up to the air or it would spread,” says Dr. Meyers. “That’s just not true.” There was also a rodent study in 2018 published by Massachusetts Institute of Technology researchers that suggests surgery may trigger an immune response causing breast cancer to metastasize. But—and this is a big but—experts say that this one mice study isn’t enough to change clinical care. Surgery is still the best way to prevent metastases. Plus, the study conclusion wasn’t that surgery was bad, but that anti-inflammatory meds may reduce the risk of post-surgery spread.
Myth: Discharge Is Always a Sign of Cancer
Nipple discharge can be an alarming sight, but in most cases it’s completely normal, especially if it came out only after you squeezed your nipple. “When they squeeze, 70% of women will see some discharge,” says Dr. Cate. It’s often caused by hormonal fluctuations in premenopausal women. You may even see a milky discharge for up to three years after breastfeeding. The discharge your doctor is most concerned about is blood, and even in most cases, that is caused by a papilloma, a benign tumor, says Dr. Cate. To play it safe, bring any discharge to the attention of your physician.
Myth: Breast Cancer Lumps Aren't Painful
Women are often told breast cancer isn’t painful. But while pain isn’t a common sign of the disease (one study showed it’s a symptom for just 6% of women), some types can cause it, says Dr. Meyers. Inflammatory breast cancer can cause swelling and breast tenderness; Paget’s disease, a breast cancer of the nipple, can come with irritation and a burning sensation. Bottom line: Any new, persistent discomfort that’s not related to menstrual-cycle soreness shouldn’t be ignored.
Myth: There's Always a Lump
Monitoring your breasts for lumps is important, but doctors want you to know that’s it's not the only symptom to look out for. And, in fact, there may not be a detectable lump at all. Other warning signs include changes to your nipples (such as sudden invertedness or flatness); changes to breast skin (such as discoloration, dimpling, or thickening); or new, unremitting pain, especially when just in one breast. Knowing these signs can be a life-saving measure. A study published in Cancer Epidemiology found that those with non-lump symptoms waited more than 90 days to see a doctor versus those with a lump.
Myth: You're Too Young for Breast Cancer
Women in their 20s and 30s are often brushed off by their doctors, told they’re too young to get breast cancer. “Sometimes pregnant women feel a lump, and their doctor will dismiss it as a milk duct,” says Dr. Meyers. “That is never the right answer; every lump should be checked out.” It’s true that BC isn’t as common as it is in older women (the Center for Disease Control and Prevention says 11% of all new breast cancers occur in women under 45 years of age), but research has suggested that certain types of breast cancer in younger women can have worse outcomes than in older women with the same type.
- Antiperspirant and Breast Cancer (1): Journal of Inorganic Biochemistry. (2005). “Aluminum, antiperspirants, and breast cancer.” ncbi.nlm.nih.gov/pubmed/16045991/
- Antiperspirant and Breast Cancer (2): Critical Reviews in Toxicology. (2014). “Systematic review of potential health risks posed by pharmaceutical, occupational and consumer exposures to metallic and nanoscale aluminum, aluminum oxides, aluminum hydroxide and its soluble salts.” ncbi.nlm.nih.gov/pubmed/25233067
- Genetics and Breast Cancer: Breastcancer.org. (n.d.). “Genetics.” breastcancer.org/risk/factors/genetics
- Mammogram Guidelines (1): U.S. Preventive Services Task Force. (n.d.). “Final Recommendation Statement Breast Cancer: Screeening.” uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening1
- Mammogram Guidelines (2): American Cancer Society. (n.d.). “American Cancer Society Breast Cancer Screening Guideline.” cancer.org/latest-news/special-coverage/american-cancer-society-breast-cancer-screening-guidelines.html
- Breast Cancer Treatments: American Cancer Society. (n.d.). “Treating Breast Cancer.” cancer.org/cancer/breast-cancer/treatment.html
- Mastectomy vs. Lumpectomy: New England Journal of Medicine. (2002). “Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer.” ncbi.nlm.nih.gov/pubmed/12393820
- Surgery and Cancer Spread in Mice: Science Translational Medicine. (2018). “The systemic response to surgery triggers the outgrowth of distant immune-controlled tumors in mouse models of dormancy.” stm.sciencemag.org/content/10/436/eaan3464?rss=1
- Breast Cancer Pain and Other Symptoms: Cancer Epidemiology. (2017). “Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis.” ncbi.nlm.nih.gov/pmc/articles/PMC5482318/
- Breast Cancer and Age: Journal of Clinical Oncology. (2016). “Subtype-Dependent Relationship Between Young Age at Diagnosis and Breast Cancer Survival.” ascopubs.org/doi/full/10.1200/JCO.2015.65.8013