MYTHS ABOUT BREAST CANCER

FACT: Most people diagnosed with breast cancer have no known family history. 

Many people think of breast cancer as an inherited disease. But only about 5–10% of breast cancers are believed to be hereditary, meaning they’re caused by abnormal changes (or mutations) in certain genes passed from parent to child. 1 The vast majority of people who get breast cancer have no family history, suggesting that other factors must be at work, such as environment and lifestyle. But doctors often can’t explain why one person gets breast cancer and another doesn’t. The biggest risk factors are simply being a woman and growing older. Over time, healthy breast cells can develop mutations on their own, eventually turning into cancer cells. Still, if you have a strong family history of breast cancer on either your mother’s or your father’s side, this is an important risk factor that should be taken seriously. If there are one or more cases of breast cancer in close blood relatives, especially before age 50, and/or other cancers such as ovarian and prostate cancer in your family, share this information with your doctor.

FACT: Although these behaviors can help lower breast cancer risk, they can’t eliminate it.

It’s something we hear again and again from newly diagnosed women: “I eat healthy, I’m at a healthy weight, I’m active, and I barely drink. So how did I end up with breast cancer?” Yes, there is evidence that all of these behaviors can help lower your risk. However, they can’t guarantee you’ll never get the disease. There are so many examples of people who do everything right and still get breast cancer.

It’s certainly worth managing the risk factors you can control, such as what you eat and drink and how physically active you are. But it’s still important to get regular screenings, perform breast self-exams, and pay attention to any unusual changes in your breasts. And if you have any “health-nut” friends or relatives who think there’s no way they’d ever get breast cancer, help them understand that no one is 100% safe.  Community member Beesie says: “I think the heavy focus on lifestyle and environmental factors can be misleading since most breast cancers are caused by factors outside of our control.”  “There’s a myth that it’s your fault,” adds Community member Illimae. “It is not your fault, there is risk with everything in life, don’t beat yourself up.”  

FACT: There is no evidence that bras cause breast cancer. 

From time to time, media coverage and the internet have fueled myths that wearing a bra can increase breast cancer risk. The theory was that wearing a bra — especially an underwire style — could restrict the flow of lymph fluid out of the breast, causing toxic substances to build up in the tissue. However, there is no evidence to support this claim. A 2014 study of roughly 1,500 women with breast cancer found no link between bra-wearing and breast cancer.

FACT: There is no evidence of a connection between underarm antiperspirant and breast cancer, but the safety of antiperspirants is still being studied. 

There have been persistent rumors that underarm antiperspirants, especially those containing aluminum and other chemicals, are absorbed into the lymph nodes and make their way into breast cells, increasing cancer risk. Shaving the underarms was thought to make this worse by creating tiny nicks that allow more of the chemicals to enter the body. Another theory was that antiperspirants, by stopping underarm sweating, can prevent the release of toxic substances from the underarm lymph nodes, also increasing cancer risk. However, there is no evidence of a link between antiperspirant use and breast cancer. Still, some studies have found that women who use aluminum products under their arms are more likely to have higher concentrations of aluminum in breast tissue. 2 Learn more in Common Fears With No Evidence: Antiperspirants and Bras.

FACT: There is no evidence of a connection between cell phones and breast cancer, but the safety of cell phones is still being studied. 

Media reports have raised concerns that carrying a cell phone in your bra might increase breast cancer risk. There have been some cases of younger women developing breast cancer after habitually carrying their cell phones in their bras. In 2013, the Dr. Oz Show further fueled these concerns by warning women never to carry their cell phones in their bras.  The research simply isn’t there to support this claim, though. To date, most studies have focused on whether the radiofrequency radiation given off by cell phones can increase the risk of brain tumors. (This is low-energy radiation, unlike the high-energy radiation used by X-rays, for example.) This research hasn’t found a link, but the issue is still being studied.  Still, cell phone manufacturers often do recommend keeping your device away from your body as much as possible. Although there is no proven breast cancer link, you may wish to avoid wearing your cellphone in your bra or chest pocket until more research is available.    

FACT: There is no evidence that sugar in the diet causes breast cancer. 

Not just with breast cancer but with all types of cancer, there’s a common myth that sugar can feed the cancer and speed up its growth. All cells, whether cancerous or healthy, use the sugar in the blood (called glucose) as fuel. While it’s true that cancer cells consume sugar more quickly than normal cells, there isn’t any evidence that excessive sugar consumption causes cancer.  There was a study in mice that suggested excess sugar consumption might raise the risk of breast cancer 3, but more research is needed to establish any link in animals as well as in people.  That said, we do know that eating too much sugar can lead to weight gain, and being overweight is an established risk factor for breast cancer. In addition, some studies have linked diabetes with a higher risk of breast cancer — especially more aggressive, later-stage cancers. Researchers aren’t sure if the link is due to that fact that people with diabetes tend to be overweight, or that they have higher blood sugar levels.  For health reasons, it’s always a good idea to cut down on desserts, candy, cakes, sweetened beverages, and processed foods that contain sugar. Reading labels is important, as many foods can have “hidden” added sugars like high-fructose corn syrup. 

FACT: Although mammography is the best early-detection tool we have, it doesn’t always find breast cancer at an early stage. 

It’s certainly normal to breathe a sigh of relief any time your mammogram comes back clean. Most women think, “I’m good for another year” and put breast cancer out of their minds. Although mammography is a very good screening tool, it isn’t foolproof. It can return a false-negative result, meaning that the images look normal even though cancer is present. It’s estimated that mammograms miss about 20% of breast cancers at the time of screening. 4 False-negative results tend to be more common in women who have dense breast tissue, which is made up of more glandular and connective tissue than fatty tissue. Younger women are more likely to have dense breasts. The reality of false negatives explains why a woman can have a normal mammogram result and then get diagnosed with breast cancer a few months later. Some women can have a series of normal mammograms and still be diagnosed with advanced breast cancer. Also, there are cases where breast cancer develops and grows quickly in the year or so after a true negative mammogram. Mammography does catch most breast cancers, though, and that’s why regular screenings are essential. But it’s also important to pay attention to any changes in your breasts, perform monthly breast self-exams, and have a physical examination of your breasts by a health professional every year.

FACT: Breast cancer might not cause a lump, especially when it first develops. 

People are sometimes under the impression that breast cancer always causes a lump that can be felt during a self-exam. They might use this as a reason to skip mammograms, thinking they’ll be able to feel any change that might indicate a problem. However, breast cancer doesn’t always cause a lump. By the time it does, the cancer might have already moved beyond the breast into the lymph nodes. Although performing breast self-exams is certainly a good idea, it isn’t a substitute for regular screening with mammography. There are some other myths about what types of breast lumps are less worrisome, such as: “If the lump is painful, it isn’t breast cancer,” and “If you can feel a lump that is smooth, and/or that moves around freely under the skin, it’s not breast cancer.” Any lump or unusual mass that can be felt through the skin needs to be checked out by a healthcare professional. Although most lumps are benign (not cancer), there is always the possibility of breast cancer.

FACT: Even with early-stage breast cancer, there is always some risk the cancer will return. 

Many people believe that early-stage breast cancer — cancer that hasn’t moved beyond the breast and underarm lymph nodes — has almost no chance of recurring, or coming back. Although most people with early-stage breast cancer won’t have a recurrence, the risk never goes away completely. Another myth: If the breast cancer doesn’t come back within 5 years, it will never come back. While it’s true that the risk of recurrence is greatest in the first 2 to 5 years, later recurrences can happen. Because of these myths, some women with early-stage breast cancer report feeling completely blindsided when they have a recurrence. Even at 20 years after diagnosis, people with stage I, low-risk hormone-receptor-positive breast cancer have a 15–20% chance of recurrence. 5 Recurrent breast cancer can be local or regional, meaning it comes back in the breast or chest area where the original cancer was found, or distant, meaning it comes back in another part of the body, such as the bone, liver, or lungs. Distant recurrence is also called metastatic or stage IV breast cancer. If you’re diagnosed with early-stage breast cancer, your treatment team can help you understand your risk of recurrence. Many different factors can influence risk, such as: the size of the original tumor the number of lymph nodes involved the grade of the cells (how abnormal they were in appearance) whether or not the cancer tested positive for hormone receptors and/or extra copies of the HER2 gene the specifics of your treatment plan If you had a genomic test such as Oncotype DX, which analyzes a group of genes to predict the risk of recurrence, that information also can be helpful.

FACT: Treatment plans vary widely depending on the characteristics of the cancer and patient preferences.

If you’ve never had breast cancer or haven’t been close to someone who does, there’s no real reason to learn the ins and outs of treatment. Many people have some vague idea that breast cancer requires some combination of surgery, radiation therapy, and maybe chemotherapy, but they don't know much beyond that. They might not realize that they can speak to five different people with breast cancer and discover that they have five different treatment plans. This is because each person’s treatment plan really is tailored to his or her needs. So many different factors can come into play when choosing treatments, such as: 

•the size, stage, and grade of the cancer, as well as the location (ducts vs. lobules) 

•whether the cancer is known or believed to be linked to an inherited genetic mutation, such as BRCA1 or BRCA2 

•whether the cancer tests positive for estrogen or progesterone receptors (meaning its growth is fueled by hormones) 

•whether the cancer tests positive for extra copies of the HER2 gene 

•results of tests that can predict the likelihood of recurrence, such as Oncotype DX or MammaPrint 

•patient preferences about avoiding specific side effects or the timing of treatment sessions

FACT: Younger women can and do get breast cancer, as do men. 

It is true that being female and growing older are the main risk factors for developing breast cancer. In 2017, about 4% of invasive breast cancers were diagnosed in women under age 40, while about 23% were diagnosed in women in their 50s and 27% in women ages 60 to 69. 6 While 4% might sound small, it isn’t zero: This percentage means that one in every 25 invasive breast cancer cases occurred in women under 40.  Women of all ages need to pay attention to their breasts, perform self-exams, and report any unusual changes to their doctors — and insist that breast cancer be ruled out if there’s a concerning symptom. Even some doctors buy into the myth that women in their 20s and 30s don’t get breast cancer. Women with a strong family history of breast cancer, especially cancers diagnosed in relatives before age 40, may wish to start screenings sooner.  Breast cancer is even rarer in men, but it does happen. People often think that men can’t get breast cancer because they don’t have breasts — but they do have breast tissue. Male breast cancer accounts for less than 1% of all breast cancers diagnosed in the U.S. In 2019, about 2,670 men are expected to be diagnosed with the disease. 7 Even though male breast cancer is rare, it tends to be diagnosed at a more advanced stage because breast changes and lumps typically don’t lead men and their doctors to think “breast cancer.” Changes in male breasts need to be checked out, too.   

FACT: Breast cancer can have a long-term impact on people’s lives and well-being. 

People with breast cancer often report that their family and friends expect them to be ready to move on after treatments such as surgery, radiation therapy, and chemotherapy end. In reality, targeted therapies such as Herceptin (chemical name: trastuzumab) may be prescribed for a year or more. Hormonal therapies, such as tamoxifen and aromatase inhibitors, are often prescribed for up to 10 years. If a woman has decided to have her breasts reconstructed, this may require a series of surgeries over several months. And for those with metastatic or stage IV breast cancer, treatment will last for the rest of their lives. Even after main treatments are done, people can experience long-term side effects. Some of these side effects can be physical: pain and tightness, fatigue, skin changes, neuropathy (tingling and numbness in the hands and feet), menopausal symptoms, and others, depending on the treatment regimen. Other side effects can be mental and emotional: anxiety, fear of recurrence, and relationship changes, among others. For many people, the effects of the breast cancer experience last for years — or for life, in the case of metastatic breast cancer — but their loved ones just don’t get it.