Tackling some of the myths about breast cancer

By Ann Hughes M.D.

Breast cancer is the most common cancer in American women, after skin cancer.The lifetime risk of women who live to age 80 being diagnosed with invasive cancer is 1 in 8.

The American Cancer Society’s most recent estimates for breast cancer in the United States for 2012:

 about 226,870 new cases of invasive breast cancer in women

 about 63,000 new cases of carcinoma in situ (CIS) will be found (CIS is noninvasive and is the earliest form of breast cancer).

 about 39,510 deaths from breast cancer (women)

The five-year survival rate for breast cancer is now above 90 percent. Much of that is due to widespread use of screening mammography.

Let’s look at some myths and undecided issues.

There is a lot of cancer information out there. Many of us self educate and use the internet as our main resource. Not all of the information is complete, true or up-to-date.That said, below are some common misconceptions.

Does any change in the breast mean cancer?

Lumps are common. Not all breast changes or lumps are cancer. From the teens to old age, a woman’s breast undergoes normal changes. Most of these changes are hormonal. Increasing levels at the onset of menstrual cycles or during pregnancy can cause the breast to feel swollen, tender or painful. With the onset of menopause, the decreasing levels may cause the breast to lose fat and tissue.The breasts may feel smaller and lumpy. Most of these changes are benign (normal, nonmalignant) and are not related to breast cancer. However, any persistent change should be checked by your doctor.They will best be able to assess the changes and decide if you need additional testing such as diagnostic mammography, breast ultrasound, breast MRI or biopsies.

Changes to look for are changes in size or shape of a breast, lumps or firmness in the breast or armpit.Worrisome changes in the nipple such as dipping inward (inverted), tenderness, scaling, redness, swelling or abnormal fluid coming from the nipple warrant a visit to your doctor.

Does dense breast tissue mean a higher risk of breast cancer?

For years the answer to this question has wavered from yes to no and back again. Certainly, very dense breast tissue limits the accuracy of mammography and may make it hard to distinguish between normal and abnormal lumps on physical exam.You might assume that because the breast has so much more dense glandular tissue that the relative risk of one area evolving into cancer would be higher but we are still not absolutely certain that this is true.

Do breast implants hide cancers?

While implants placed behind the glandular tissue of the breast do limit visualization of some of the breast tissue, specialized mammographic views are performed to optimize the exam. Retropectoral implants allow better imaging of the breast tissue since the implant is behind the muscle of the chest wall. Digital mammography minimizes the affect of implants on images and has significantly improved imaging patients with implants.

Do women with a family history of breast cancer have a much higher risk for developing the disease?

The two greatest risk factors for being diagnosed with breast cancer are being female and getting older. Family history is a complex problem. Individuals with a gene negative family history of cancer in a close relative are only at a slightly higher risk than the general population and make up only 5-7 percent of cases. On the other hand, women with BRCA gene mutation have a considerably higher risk and require closer monitoring.

Do calcifications mean there is a cancer?

Most calcifications in the breast are normal changes. Others may be suspicious. If your radiologist finds calcifications on the mammogram that are not typically normal in appearance, they can do one of two things. If they appear more suspicious, they may recommend a biopsy. Others may look more like normal calcifications.These can be safely followed with mammography in six months to ensure they stay normal in appearance.

Is breast cancer only a women’s disease?

Men do get breast cancer.Although for the most part men’s breast tissue is not well developed, the tissue is present and can develop for a number of reasons. About 1,700 new male breast cancers are diagnosed each year and 400 men will die each year from the disease.

Is there anything you can do to lower your risk of breast cancer?

Experts agree that there are several things that can lower your risk of developing cancer of many types. Maintaining a healthy weight, low fat diet, exercise and lower consumption of alcohol and tobacco products are all rec- ommended. Routine yearly mammography can help by leading to early diagnosis and removal of cancers. Routine visits to you primary health care provider with breast exam are important as well.

Breast cancer deaths have been going down.This likely is the result of earlier diagnosis with routine mammography and earlier treatment of the disease. With an approximate census of 150 million women, there are more than 2 million breast cancer survivors in the United States today.

If you have concerns regarding your breast health or have a strong family history of breast cancer, consult with your physician about the benefits of digital mammography.

At Freehold Radiology Group, all exams are interpreted by universitytrained, board certified radiologists.The radiologists are fellowship trained and have years of experience. Same-day mammography results are provided to patients, by 5 p.m. if you have an appointment before noon and by the next morning if you have an afternoon or evening appointment. Freehold Radiology Group is a designated Breast Imaging Center of Excellence by the American College of Radiology.

Dr.Ann Hughes is on staff at Freehold Radiology Group, Freehold MR Associates, and CentraState Medical Center. Freehold Radiology Group has locations in Marlboro and Freehold. For more information or to schedule an appointment, call 732-462-4844 or visit