1. MYTH: The best place to practice breast self-examination (BSE) is in the shower.
FACT: BSE can be performed while in the shower. However, wet, soapy hands may make it difficult for a woman to feel the intricacies of her breast. Cold air or water also causes the breasts and nipples to contract. Women over twenty years of age should practice monthly BSE in three positions: lying down, standing up, and standing in front of the mirror (to check for visual breast changes). (source 1, 2)
2. MYTH: Breast cancer always presents itself in the form of a lump.
FACT: While a breast lump can certainly be a sign of breast cancer (as well as a number of non-cancerous conditions), not all women who are diagnosed with breast cancer will have a noticeable lump. Therefore, women should check for all of the following warning signs while performing their monthly BSE:
• Any new lump or hard knot found in the breast or armpit
• Any lump or thickening that does not shrink or lessen after your next period
• Any change in the size, shape or symmetry of your breast
• A thickening or swelling of the breast
• Any dimpling, puckering or indention in the breast
• Dimpling, skin irritation or other change in the breast skin or nipple
• Redness or scaliness of the nipple or breast skin
• Nipple discharge (fluid coming from your nipples other than breast milk), particularly if the discharge is bloody, clear and sticky, dark or occurs without squeezing your nipple
• Nipple tenderness or pain
• Nipple retraction: turning or drawing inward or pointing in a new direction
• Any breast change that may be cause for concern
While one or more of these changes warrants clinical examination, these changes do not necessarily mean that a woman has breast cancer. On the other hand, it is also important to know that breast cancer can be present without any symptoms. Screening mammography often detects breast cancer before a lump can be felt which is why mammography is also important. (source)
3. MYTH: Mammography is 100% accurate in early breast cancer detection.
FACT: It is estimated that mammography detects 85% to 90% of all breast cancers. While the vast majority of abnormalities are detected by mammography, some are simply not detectable. For example, sometimes an irregularity goes undetected because surrounding breast tissue is the same density as the irregular tissue. If a patient has a lump or other change and the mammogram is “negative” (interpreted as not suspicious or cancerous), the patient should still follow-up with her physician to discuss that finding. While both BSEs and mammograms are not full-proof methods of detecting breast cancer, they are among the best detection tools currently available. Clinical breast exams performed by your physician are also important. In general, the earlier breast cancer is diagnosed, the better the chances for successful treatment and survival. (source 1, 2)
4. MYTH: Nipple discharge indicates breast cancer.
FACT: Most nipple discharges do not indicate a cancerous condition. Up to 20% of women may experience spontaneous milky, opalescent, or clear fluid nipple discharge. Up to 60% of women experience nipple discharge during breast self-examination. Usually, if the discharge is clear, milky, yellow, or green, it does not indicate cancer. Bloody or watery nipple discharge is considered abnormal; however, only 10% of abnormal discharges are cancerous. Most bloody discharges are due to non-cancerous papillomas. Nipple discharge may be a concern if it is:
• bloody or watery (serous) with a red, pink, or brown color
• sticky and clear in color or brown to black in color (opalescent)
• appears spontaneously without squeezing the nipple
• on one side only (unilateral)
• a fluid other than breast milk
Women should report any worrisome nipple discharges to their physician for clinical examination. (source)
5. MYTH: If you get breast cancer, you will probably die.
FACT: While breast cancer is the second leading cause of cancer death in women (after lung cancer), a breast cancer diagnosis is not an automatic death sentence. 80% of women diagnosed with breast cancer have no signs of metastases (no cancer has spread beyond the breast and nearby lymph nodes). Of those women, 80% live at least five years, most longer, and many live much longer. Even women with signs of cancer metastases can live a long time. Plus promising treatment breakthroughs are becoming available each day. (source 1, 2)
6. MYTH: If a woman is diagnosed with breast cancer, she will lose her breast.
FACT: Many women who are diagnosed with breast cancer will undergo some type of surgery as part of their treatment. However, breast-conserving therapy (lumpectomy, usually followed by radiation therapy) is becoming common treatment for early stage breast cancers (such as ductal carcinoma in situ (DCIS)). Lumpectomy is the surgical removal of a breast lump and a surrounding margin of normal breast tissue. To date, women with DCIS have chosen equally among lumpectomy and mastectomy (removal of the affected breast), though specific cases may sometimes favor lumpectomy over mastectomy or vice versa. Chemotherapy (the use of anti-cancer drugs) is also being used in some cancer patients to shrink the size of a breast tumor so that a woman may have lumpectomy instead of mastectomy. Recent studies of the drug tamoxifen and other alternative treatments show a growing trend toward less invasive breast cancer treatment. (source 1, 2)
7. MYTH: Mastectomy ensures breast cancer will be eliminated forever.
FACT: Mastectomy (removal of the affected breast) does not guarantee that breast cancer will not recur. Some women experience breast cancer recurrence at the site of the mastectomy scar. There is also that possibility that the cancer has spread to the lymph nodes or other areas of the body, in which case a mastectomy alone will not eliminate all cancer. It is also important to know that breast tissue also extends up towards the neck, under the arms, and to the chest wall, so even after a mastectomy some breast tissue remains. While a mastectomy greatly reduces the chance of recurrence, a woman is at risk of developing breast cancer as long as breast tissue remains in the body. (source 1, 2)
8. MYTH: Older women diagnosed with breast cancer do not need “full” treatment.
FACT: The mortality rate among older women with breast cancer is increasing because many older women do not receive full breast cancer treatment at the time of diagnosis. Though breast cancer in older women generally has a slow rate of growth, it can also be an aggressive, fast-moving disease that can metastasize (spread) quickly to other parts of the body. (source)
9. MYTH: If you are cancer-free five years after a diagnosis, you are cured.
FACT: While five-year survival after some cancers does signify a cure, it is not the case for breast cancer. The risk of recurrence of breast cancer is greatest in the first two years after diagnosis, but breast cancer can and does recur at any time, regardless of how many years have passed since an initial diagnosis. (source)
10. MYTH: Positive thinking will prolong your life after breast cancer.
FACT: While maintaining a positive outlook in the face of a breast cancer diagnosis can greatly improve your quality of life, there is no evidence to show that an optimistic attitude can increase the chances of survival. There are times when a positive attitude is the only thing that gets you out of bed in the morning, but it is also perfectly normal and healthy to feel sadness, anger or fear after a breast cancer diagnosis. Falsely putting on a happy face can actually increase your sense of isolation and interfere with your ability to cope. Being real and honest with your feelings and seeking out the support you need is one of the healthiest ways to deal with the emotional ups and downs that often accompany any difficult life challenge. (source)