By Judy O’Gorman Alvarez |
October may be the month of pink ribbons, pink socks and plentiful ad campaigns on breast cancer awareness.
But for every statistic we think we know – 1 in 8 women will have breast cancer in her lifetime and each woman has a 12.5 percent risk – myths, misunderstandings and mistaken beliefs still exist.
Nicole Saphier, M.D., radiologist and director of breast imaging at Memorial Sloan-Kettering Monmouth (MSK), is making it her business to correct much of the misinformation and make sure every woman knows the truth about her risks of breast cancer.
Mammograms may be the most efficient way to detect early breast cancers, yet only 65 percent of women over the age of 40 have had a mammogram in the past two years, according to the Centers for Disease Control.
MSK recommends annual mammograms for women age 40 and older.
The comment that concerns Saphier the most is when women say: “I don’t get mammograms because I don’t have a family history of breast cancer,” she said. “Only 30 percent of women diagnosed have a family history.”
“On top of that there are such conflicting recommendations,” she said. The American Cancer Society, American College of Radiology and Society of Breast Imaging may give different guidelines on how often a woman should have a mammogram.
“My goal in life is to end that confusion,” she said.
Another reason some women do not get screened regularly, according to Saphier, is fear. “A lot of people are nervous and they don’t want the bad news,” she said. In most cases, “you are healthy when you’re given a breast cancer diagnosis.”
The earlier a malignant mass or nodule is discovered and diagnosed, the better the prognosis. And as a result, the sooner treatment can be started.
“To help take away the discomfort and anxiety, we do everything the same day,” she said. After an initial mammogram, films will be reviewed and if additional testing –such as ultrasound, MRI or even biopsy – is needed, it will be done quickly. “If possible, I’ll do it the same day so you’re not waiting at home for results,” she said. “It’s the best gift I can give.”
“My goal is to take the anxiety away.”
Developments in breast cancer screening have made screening easier and more accurate. For example, breast tomosynthesis – also called 3-D mammography – takes images of the breast from different angles and creates a three-dimensional picture of the tissue. “It’s a great thing. Not only is it finding smaller cancers, it’s decreasing false positives. If we see something benign on 3-D, we don’t necessarily have to do additional images.”
Saphier says she’s heard the myriad myths of breast cancer causes: deodorants, the drinking water, alcohol.
“The truth is: it’s possible,” she said. “But being a woman that gets older is the greatest risk. All these external factors may or may not contribute.
“You can do everything possible to decrease your risk, but don’t put yourself in a bubble.”
Even moderate use of alcohol – one to two glasses – has been loosely linked to breast cancer. But Saphier said her interpretation is that certain actions, such as cigarette smoking, have been proven to be extremely harmful.
“Having a glass of wine is not nearly as detrimental,” she said. “If someone enjoys something I am very hesitant to take that away if it’s not directly associated,” she said.
Keeping that in mind, she says, eating well and exercising is important. She says we know that fat cells produce estrogen and can fuel certain breast cancers to develop and grow.
“We should always try to live our healthiest.”
Manpreet Kohli, M.D., a fellowship-trained breast surgeon from The Jacqueline M. Wilentz Breast Center at Monmouth Medical Center, has also heard the misconceptions. “There are a ton of myths that range from wearing a certain bra will bring increased risk or wearing certain deodorants,” she said.
The internet can be the source of many of these misconceptions – some outrageous and some with a germ of truth. For example, the idea that underwire bras can cause breast cancer is untrue, but as Kohli points out, “If you’re in an ill-fitting bra you have underwire that can dig into you.”
“Many cancers are found in the upper outer quadrant part of the breast,” she said. Coincidentally that may be the most common area an ill-fitting bra is causing discomfort.
And that discomfort may bring a woman to the doctor’s office, which is a good thing, Kohli said, but if the result is breast cancer, it is completely coincidental.
If nothing else, a myth like that may inspire some women to do more self-examinations and get to know their breasts.
(Men, too, are at risk; 1 in 833 men are at risk of getting breast cancer, according to the American Cancer Society.)
Similarly, the myth that underarm deodorants and antiperspirants are linked to breast cancer has been disproven.
“We know that our body absorbs everything,” Kohli said. “We did a study looking at lymph nodes and we found deodorants don’t increase the risk. The myth has been studied and debunked.”
Fear of too much radiation from the mammogram screening is another concern for some women. “The dose is so low,” Kohli points out. “We have radiation exposure in all sorts of things in our environment, including air travel. And you would never scrap that long trip to Australia.”
“Mammograms give the same dose as if you walked around New York City for two weeks,” she said. “
“I think there’s something to environmental reasons,” she said. “We always think of breast cancer as an older woman’s disease, but we’re seeing it more frequently in younger and younger women.”
Incidences of breast cancer in young women under age 40 is particularly disconcerting as Kohli points out because they’re not being regularly screened with mammograms. So it’s even more important that “they’re listening to their bodies.”
“We don’t know all the reasons and we can’t predict why” some women get breast cancer.
“It’s frustrating but we can do things to protect ourselves,” Kholi said.
“Keeping a healthy weight is important with a BMI less than 25,” she said. “People should maintain a good level of activity. You don’t have to go crazy with boot camp but a 20-minute walk every day to get your heart rate up is good enough to lower your risk.”
“There are women who do everything right and get a breast cancer and others who do everything wrong and never get one.”
But Kohli, Saphier and other medical professionals agree, the most important step for taking care of your breast health: showing up for that mammogram.
This article was first published in the Oct. 4-10, 2018 print edition of The Two River Times.
