The truth about breast cancer: experts sort the facts from the fiction.
Are all lumps cancerous? Is eczema on your breast normal? Can men get breast cancer? We ask experts to separate fact from fiction. Christine Fieldhouse reports
Most women assume that a lump in the breast is the only indication of breast cancer. Or that all lumps are cancerous. Or if none of their close family members had cancer, they are risk-free and needn’t worry.
There are so many myths about breast cancer that it’s sometimes hard to separate fact from fiction. We put some of the most common myths surrounding breast cancer to the experts.
MYTH: You can’t have breast cancer if there’s no lump
While in most breast cancer cases, the first indication is a noticeable lump, there are several other telltale signs to look out for when checking your breasts, says Dr Simon Smith, a UK-based consultant oncoplastic breast surgeon. For one, skin puckering – which may look like a small dent in the breast – could also be a sign of cancer.
‘The tumour inside the breast causes the ligaments to shorten, which pulls the tissue and skin inwards,’ explains Dr Smith. ‘This gives the breast a puckered appearance, which is known as tethering.’
Other symptoms to look out for are an inverted nipple, discharge from the nipple and a swelling under your arm or around the collar bone. Orange peel skin on the breast could also be a sign of a more aggressive, though rarer form, of cancer called inflammatory breast cancer.
MYTH: If your mum didn’t have breast cancer, you won’t get it
Some breast cancer is hereditary, admits Dubai-based Dr Sanjay Parashar, a consultant plastic and reconstructive surgeon. ‘Yet up to 80 per cent of women who get breast cancer do not have a family history of it.
‘Hereditary breast cancer occurs due to a mutation in genes BRCA1 and 2. However, breast cancer can occur without a family history,’ says Dr Parashar, head of plastic surgery unit at Cocoona day care hospital in Dubai.
A cell needs to have a number of mistakes in its genetic code before it becomes cancerous, but it usually takes years to gather enough genetic mistakes and most abnormal cells die or are killed off by our immune system. But having the gene fault – which is the case for 1 per cent of the population would increase our risk of getting cancer.
MYTH: Eczema on your breast is normal
Eczema is a dry-skin condition, which can cause scaly, red and itchy skin, and at its worst, it can create sores that weep, crust and bleed. Nipple eczema can occur in pregnancy and when women breast-
feed. It also affects joggers whose breasts chafe against their clothing while they run.
But Lester Barr, a consultant surgeon specialising in breast cancer at the Christie Hospital in Manchester, UK, says any itchy red rash on the nipple must be checked out by a doctor.
‘Paget’s Disease of the nipple mimics eczema and it’s usually a sign that breast cancer is in tissue behind the nipple,’ says Dr Barr, who is also chair of Genesis Breast
Cancer Prevention in Manchester.
MYTH: Men can’t get breast cancer
‘That’s a huge myth,’ says Dr Parashar. ‘Men do get breast cancer, despite them having very little breast tissue compared to women. Figures from the American Cancer Society reveal that men have a lifetime risk for breast cancer of one in 1,000. However, Dr Parashar points out that a high percentage of men in the UAE have gynaecomastia, an enlargement of the male breast tissue. These ‘man boobs’ as they are also called, could be caused by obesity and a high-fat diet, both of which are risk factors in breast cancer. The bad news is breast cancer is likely to have spread before it’s picked up in men, and it’s more common in men over 60 and men who have a family history of breast cancer.
Dr Parashar’s message to men is clear – get all breast lumps checked out immediately.
MYTH: Antiperspirants cause breast cancer
There’s a school of thought that antiperspirants stop our bodies from sweating out poisons, which then build up in the lymph glands under the arm and cause breast cancer.
Dr Sally Norton, a UK-based weight loss consultant and health expert, says some studies have suggested that there may be an increased risk due to the use of aluminium compounds in antiperspirants. ‘These compounds temporarily block sweat glands, but can build up in breast tissue and produce some oestrogen-like effects,’ she says.
‘There is a possible link but if the risk was very high, we would know about it by now. However, the increasing use of chemical products on ourselves, around the home and in our wider environment is almost certainly causing some harmful effects and we should try to reduce them wherever possible.’
MYTH: All breast lumps are cancer
A breast lump is a swelling or thickening in your breast, yet nine out of 10 lumps are benign (non cancerous).
The most common form of breast lumps are fibroadenoma, which occur in teenagers and young women. They’re formed when the tissue and ducts around a milk-producing lobe grow over it and thicken.
‘Breast lumps can be due to many things – general lumpiness around period time, cysts or infection,’ says Dr Sally. ‘These lumps can get quite large and may be tender.
‘Benign breast lumps can be removed if necessary, but may often improve with little, if any, treatment. However, any lump should be checked out by your doctor – particularly if it is hard and irregular and doesn’t improve after your period.’
MYTH: Only overweight women get breast cancer
Research suggests that about five out
There may be an increased risk due to ANTIPERSPIRANTS, as aluminium compounds in them temporarily BLOCKS WEAT glands but can buildup in breast tissue and produce OESTROGEN-LIKE effects
of 100 cancers could be avoided by maintaining a healthy body weight. A study published in the medical journal,
The Lancet, in 2014 looked at the medical records of 5.24 million people in the UK, where the doctor had recorded their height and weight.
The researchers found that postmenopausal women who were overweight or obese had a higher risk of breast cancer.
Dr Norton says: ‘Being overweight can increase your chances of breast cancer, and other types of cancers too. Fat isn’t just stuff that spills over your waistband and sends your scales in the wrong direction. It’s also an organ of the body that produces chemical messengers (hormones), one of which is oestrogen.
‘Oestrogen is thought to be a major part of the pathway leading to breast cancer so it follows that the more overweight you are, the greater your risk of breast cancer, especially after the menopause when fat is a more important source of oestrogen than the ovaries.’
MYTH: Your father’s family history doesn’t count regarding breast cancer as much as your mother’s
We tend to look at our mother’s medical history to gauge our cancer risk, but the genes we get from our father’s side of the family are just as important.
‘Genetic susceptibility can come from either parent,’ explains Dr Houriya Kazim, consultant breast surgeon at the Well Woman Clinic, Dubai. ‘We know of two main mutations in our DNA (called BRCA 1 and 2) which make us more susceptible to breast cancer. If either parent has one of these mutations, each child has a 50-50 chance of inheriting that mutation and susceptibility.’
MYTH: Underwired bras cause breast cancer
The suggestion that having wires so close to the breast could be dangerous has been around for many years.
Dr Norton explains: ‘The theory was that over-tight bras could reduce the lymph drainage from the breast and therefore cause an accumulation of toxins that could then lead to cancer. There is no proof whatsoever that this occurs. A wire rubbing against an already present breast lump could make you aware of it, hence the concern that the pressure may have caused it in the first place. But fear not, it’s just coincidence!’ The type of bra nor tightness pose any risk, say experts.
MYTH: Breast cancer affects only postmenopausal women
Dr Kazim says this is true to an extent because in most western countries, breast cancer is a disease of menopausal women, with about 80 per cent of cases occurring after the age of 50.
‘But in the Middle East, North Africa and the Indian subcontinent, the pattern is different, with cases occurring at least 10 years younger,’ she says.
There hasn’t been any research into why this happens as yet, but some experts have put the problem down to a poor diet, obesity and a lack of regular exercise.
MYTH: Mammograms raise our risk of breast cancer
Most women who have had their breasts squashed into an X-ray machine for a mammogram will have been left wondering how safe the procedure is. After all, X-rays contain radiation, which is a carcinogen.
Dr Kazim says: ‘Mammograms are X-rays and X-rays can cause cancer. However, the amount of radiation in a mammogram is small. You’re exposed to less radiation than you would get flying to New York.’
On average the total dose for a typical mammogram with two views of each breast is about 0.4 mSv (a mSv millisievert is a measure of radiation dose). To put this in perspective, the worldwide average natural dose humans receive from what is called background radiation (detectable amounts occur naturally in soil, rocks, water, air, and vegetation, from which it is inhaled and ingested into the body) is about 2.4 millisievert (mSv) per year.
Strict guidelines ensure that mammography equipment is safe and uses the lowest dose of radiation possible. Many people are concerned about the exposure to X-rays, but the level of radiation from a mammogram today does not significantly increase the breast cancer risk for a woman who gets regular mammograms.
The GENES we get from our FATHER’s side of the family are just as important as our mother’s. ‘If either parent has one of two MUTATIONS, each child has a 50-50 chance of inheriting that, and SUSCEPTIBILITY’
All breast lumps don’t mean cancer, but should still be checked out by your doctor – especially if it is hard and irregular
Mammograms are X-rays, but the amount of radiation in them is small – lesser than what you’d be exposed to flying to New York