BREAST cancer is the leading cause of cancer-related deaths in Jamaican women above the age of 25 years, and with knowledge of this, various groups have worked ardently to build awareness around the disease. Unfortunately, these efforts are often thwarted by misinformation that consultant obstetrician-gynaecologist at ICON Medical Centre, Dr Keisha Buchanan, says can be a deterrent to women seeking screening or testing for breast cancer.
Below, Dr Buchanan debunks some myths highlighted that are often passed off as facts.
Myth: Pain in the breast is an early sign of breast cancer
Truth: Early stage breast cancer is painless. In fact, in many cases, Dr Buchanan said that pain is a symptom of the late stage of the disease, for example, when cancer has spread to underlying bone.
“Breast pain is more likely associated with hormonal changes such as during the period, pregnancy may cause breast pain or tenderness, fibrocystic breasts may cause pain, but these are not associated with cancer,” Dr Buchanan said.
Myth: Mammograms are painful
Truth: This is a very commonly propagated myth that makes many women shy away from doing their mammograms and this couldn't be farther from the truth.
“Mammograms are not painful. They may be uncomfortable, but the exam lasts for about 10 minutes. Additionally, newly designed mammography machines provide an even more comfortable experience,” Dr Buchanan shared.
Myth: Mammograms cause breast cancer
Truth : A mammogram is a screening test that is done to detect breast cancer. In the event that a screening test is positive, a biopsy is done to confirm the diagnosis.
“During a mammogram, each breast is exposed to a very low dose of radiation for less than 10 minutes. Now, contrary to what is being said, this dose of radiation cannot trigger breast cancer,” Dr Buchanan advised. With this said, she encouraged women to do their yearly mammograms since it has the ability to diagnose breast cancer in its earliest stage when it is curable.
Myth: You can't get breast cancer if you don't have a family history
Truth: The majority of Jamaican women who have been diagnosed with breast cancer have no known relatives who have the disease.
“The reality is most people who have breast cancer do not have a family history of the condition. In fact, only five to 10 per cent of patients who have breast cancer have a positive family history of the disease,” Dr Buchanan shared.
Myth: You have to feel a lump in your breast
Truth: Feeling a lump in the breast is usually a sure telltale sign of breast cancer, but Dr Buchanan said that not because you don't feel one means that you are free of the disease. She notes that in many cases the lumps are so small they cannot be felt.
“The fact that you don't always feel a lump is one reason why an annual mammogram is recommended because cancer can be detected early by mammogram or MRI. The reality is that some cancers present as a swollen lymph node under the arm without any lump in the breast, some present as a nipple discharge such as a bloody nipple discharge or a retraction or dimpling of the skin overlying the breast with no palpable lump, and lumps may be hidden under the nipple or areola and hence not easily felt,” Dr Buchanan outlined.
Myth: Bras cause breast cancer
Truth: “There is a fear that exists that ill-fitting bras that are too tight can damage the breast tissue and trigger cancer — this is not true. However, while this is not the case it is important to have properly fitting bras as they are more comfortable and better support the breasts,” Dr Buchanan reasoned.
Myth: Breast cancer is a death sentence
Truth: Many people believe that the moment you are diagnosed with cancer death is certain. Thankfully, with the improvements in technology, diagnosis and treatment of breast cancer, there is a significantly higher number of survivors in recent times.
“More people are being cured of breast cancers — the average five-year survival rate for breast cancer is 90 per cent, that means five years after breast cancer is diagnosed and treated 90 per cent of people will survive. The five-year survival rate for stage one breast cancer is 99 per cent. Early diagnosis and prompt treatment is the best way to beat breast cancer and live a cancer-free life,” Dr Buchanan said.
Myth: Men can't get breast cancer
Truth: Women may be at a higher risk of breast cancer, but like women, men also have breast tissue which means that they too can develop breast cancer.
“Breast cancer in men can present in the same manner — a lump that is felt in the breast, a discharge from the man's nipple, dimpling of the skin over the breast, or a lump under the man's arm,” Dr Buchanan pointed out. She advised that these need to be assessed by the doctor and also encouraged that as recommended for women, men should also do regular self-examinations.
Myth: X-rays can cause breast cancer
Truth: X-rays are vital in the medical field to assess a number of conditions such a chronic cough or to assess a patient for pneumonia or after a motor vehicle accident with trauma to the chest to check for broken ribs. Since X-rays are done on some areas such as on the chest, back or spine and the breast tissue will be exposed to some amount of radiation, people often assume that people are at an increased risk of breast cancer. But Dr Buchanan said this is not so.
“This radiation exposure is very low and for just a few seconds, hence it does not pose a risk of breast cancer. The benefit of doing the X-rays far outweighs any risk as making the diagnosis of broken bones or chest infection or a punctured lung can be lifesaving,” Dr Buchanan explained
Myth: Antiperspirants cause breast cancer
Truth: There is no scientific evidence to support the assertion that antiperspirants are linked to breast cancer.
Myth: Trauma to the breast causes breast cancer
Truth: Breast trauma can lead to scar tissue forming and scar tissue can mimic a lump or cause dimpling of the skin and be a source of great concern. Dr Buchanan advised that it's best to see your doctor and get any lump or skin distortions over the breast assessed.
Myth: Pregnant women can't get breast cancer
Truth: Breast cancer is the commonest type of cancer that is seen in women during their pregnancy and in the post-partum period. Dr Buchanan said that this is why a routine part of any early antenatal examination should involve breast examination and any lumps found should be assessed by your doctor by way of ultrasound or biopsy.
“Prompt treatment of breast cancer should be initiated, including surgery to remove cancer and chemotherapy (if indicated) has been safely administered in the second and third trimester of pregnancy with little or no adverse effect on the growth and development of the foetus,” Dr Buchanan said.
She reasoned that the pregnancy does not need to be terminated, neither does the treatment of breast cancer need to be delayed because chemotherapy can be given at 14 weeks or later in the pregnancy. If the pregnancy is very near the due date at the time of breast cancer diagnosis, Dr Buchanan said that an earlier delivery can be arranged at about 36 weeks so that chemotherapy can be started.
The Jamaica Cancer Society recommends annual mammograms starting at age 40 years for Jamaican women.