8 Things Your Breast Cancer Surgeon Wishes You Knew
By the end of 2019, it’s estimated that almost 270,000 American women will be diagnosed with invasive breast cancer, a number that’s climbed 0.3 percent for the last 10 years. More than 41,000 women are expected to die of the disease. And even though awareness and survival rates are improving, many of us still have misconceptions about this increasingly treatable condition.
“There’s a lot of hope for you,” says breast surgeon Renee Quarterman, MD, FACS, from St. Mary Medical Center in Langhorne, Pennsylvania. “There’s a lot of hope for all patients with breast cancer.” Find out the truth behind popular breast cancer myths, along with what Dr. Quarterman wishes everyone knew about the condition.
MOST CASES ARE NOT INHERITED
There’s no doubt: you have a stronger risk of breast cancer if there’s a family history of the disease. This includes having at least one close relative diagnosed before age 45, or multiple cases on the same side of the family—and it doesn’t have to be your mom’s. “A lot of people think, ‘Well, that breast cancer’s on my dad’s side so it doesn’t matter,'” says Dr. Quarterman. “But it does matter.” When assessing your risk, she adds, it’s important to get both family histories.
But overall, just 5 to 10 percent of breast cancers are directly related to genes inherited from a parent. In fact, approximately 15 percent of women who have breast cancer have a family member with the disease, according to the American Cancer Society. “Most breast cancers are not caused by genetic mutations,” says Quarterman. Rather, many cases can be linked to lifestyle factors.
IT’S LINKED TO LIFESTYLE
While family history plays a role, breast cancer is influenced in large part by lifestyle choices, says Quarterman. These include:
- Drinking alcohol in excess: The more you imbibe, the higher your risk; according to the American Cancer Society, women who have two to three drinks daily have about a 20 percent greater risk than those who don’t drink at all.
- Post-menopausal obesity: Though the relationship between fat and breast cancer is still being sussed out, it’s thought that excess weight after menopause ups your estrogen levels, raising your chances. Obese women are also more likely to have type 2 diabetes, which likely plays a role in cancer risk.
- Smoking cigarettes: Both first- and second-hand smoke may be linked to an increase risk of developing breast cancer, although more research is still needed. Some groups have higher risk, including women who began smoking before their first child or those who have been heavy smokers for many years.
- Breastfeeding: An analysis of 47 studies found that for every 12 months of breastfeeding, women reduced their breast cancer risk by 4.3 percent. Most American women breastfeed for less than a year, but it is not clear if a shorter duration is linked to reduced risk.
On the flip side, exercising—150 minutes of moderate or 75 minutes of vigorous activity weekly—and maintain a healthy weight through diet and activity might lower your chances of developing the disease.
IT DOESN’T NECESSARILY HURT
Though mammograms can pinch and treatments like radiation and chemotherapy often come with uncomfortable side effects, breast cancer itself isn’t typically painful. “Women will tell me that they have a lump, and we find out that it’s cancer,” says Quarterman. “They say, ‘It didn’t hurt. I didn’t think it was cancer.'”
While pain is possible, you may notice other symptoms first. Lumps and masses are the most common signs of the disease, though you should also keep an eye out for changes in the appearance of your breast. These include:
- A lump or mass
- Swelling
- Skin irritation, thickening, scaling, redness or dimpling of the breast or nipple
- Nipples turning inward
- Nipple discharge that isn’t breast milk
- Changes in shape and size
It should be noted that while a lump or mass may be a sign, most of them are not cancerous. However, if you’re experiencing one or more of these symptoms, contact your doctor as soon as you can.
YOUR BRA AND ANTIPERSPIRANT DON’T CAUSE IT
You may have heard from a friend—or, more likely, Facebook—that your antiperspirant can give you breast cancer. The theory goes that chemicals seep into your skin, or your roll-on prevents you from sweating, leading to a build up of toxins. Some even think that antiperspirant is absorbed through underarm shaving cuts, causing the disease. But it’s just not true.
“There has been concern about certain types of deodorants, or maybe having aluminum in your deodorant,” says Quarterman. “But that hasn’t been borne out yet in any study.” She suggests wearing whatever deodorant/antiperspirant works for you. And if you’re still worried, try brands that are labeled as natural or less processed.
The same goes for bras, which some say cause cancer by preventing lymph nodes from draining correctly. “We don’t have any evidence that the type of bra that you wear causes breast cancer,” says Quarterman. “Again, wear what works for you.”
EARLY DETECTION IS CRUCIAL
With treatment, the five-year survival rate of someone with localized breast cancer is 99 percent. Those with regional breast cancer—meaning the cancer has spread to nearby areas—have an 85 percent chance of surviving for five years. When breast cancer spreads to distant parts of the body, the survival odds drop to 27 percent. “The earlier we find breast cancer, the more successful we are in treating it,” says Quarterman. “So, I encourage women to stay on top of their mammograms.” Mammograms remain the most effective way of detecting the disease.
The official recommendation for mammograms is to have an informed talk with your doctor about the best time to begin screenings, based on family history and risk factors. Annual mammograms should start for most women at age 40 to 50. After that, screening guidelines vary a little.
IT’S DEADLIER FOR AFRICAN AMERICAN WOMEN
Black women are diagnosed with breast cancer at about the same rate as white women. However, black women are around 41 percent more likely to die of the disease. Access to healthcare and racial disparities in treatment each play a role; breast cancer is often detected at later stages, and follow-up care may be delayed. They are also more likely to develop the disease at a younger age. It’s not the only factor, however, says Quarterman.
“When you control for the stages of breast cancer, African American women still have worse outcomes than their white, or Latina, or Asian counterparts,” she says. “There’s something about the biology of breast cancer in a lot of African American women that confers a worse prognosis.” For example, black women are more likely to develop triple-negative breast cancer, which has a lower five-year survival rate than other kinds of the illness.
MEN CAN—AND DO—GET IT
Breast cancer isn’t just a woman’s health issue. In 2019, an estimated 2,670 American men will be diagnosed with the condition; it will kill around 500. Men don’t often realize they have it—or that they can develop it at all—and may be uncomfortable discussing the issue with their doctor.
“If you have a nipple, you could get breast cancer,” says Quarterman. “It’s important to check yourself and not be afraid to talk to somebody, not be embarrassed to talk to your doctor and get examined.” This is especially true if you find a lump in your breast area, which is the most common sign, or have other symptoms typical to breast cancer. Much like African American women, black men are less likely to be diagnosed with breast cancer but face worse outcomes.
IT’S NOT A DEATH SENTENCE
Thanks to a combination of increased awareness, early detection and better treatment, breast cancer death rates have dropped big-time in recent decades. Between 1989 and 2015, they fell about 39 percent.
“I tell my patients that you don’t need to change any of your long-term plans, because there’s a lot that we can do,” says Quarterman. That’s largely because treatment can be customized to the patient, now more than ever. “We can tailor therapy; we can predict who should have chemotherapy and who really doesn’t need it.”
Safety and technological advancements have helped, as well. “Our radiation delivery has become better and safer. Our surgery has become better and safer,” she says. “All of that comes together to improve outcomes.”
Sourcing: American Cancer Society, Breastcancer.org, National Cancer Institute, CDC, UptoDate, National Institutes of Health, National Breast Cancer Foundation, US Preventative Task Force