The Myths and Facts of Breast Cancer

Nervous about dire stats, flip-flopping advice, and whether you're doing everything you can to protect against the disease? With a little clarity, you can ease up on the worry and still do right by your body.


Breast Cancer Awareness Month is here — 31 days that do great things for fundraising and education on behalf of the disease. What it's not so great for? Peace of mind.

Your "I got this" confidence may not survive the spin cycle of reminders, warnings, and true patient stories. What women often don't hear is that the number of lives claimed by this disease has dropped since 1989. (Heart disease, on the other hand, remains women's number one threat.) Yet breast cancer wins the worry war — it's women's most feared health problem, and fear often leads to paralysis instead of self-care.

Now's the time for some perspective: We take on your biggest concerns one by one so you can take October, and every month, in stride and just focus on being your healthiest self.

Could We Worry a Lot Less About One Type of Cancer?

As science gets better at understanding how different cancers behave, some researchers think that certain troublesome cells in the breast may never turn into invasive cancer. The abnormal cells that make up stage 0 ductal carcinoma in situ (DCIS) may idle in the milk ducts of some women and never become anything harmful, they say.

The current standard of care for this type of cancer is a biopsy followed by a lumpectomy or a mastectomy. That could be too drastic for something that may not be symptomatic or life-threatening, say Shelley Hwang, MD, chief of breast surgery at Duke University School of Medicine, and Laura Esserman, MD, director of the University of California, San Francisco, Carol Franc Buck Breast Care Center. Both docs suggest that DCIS could one day be treated the way a growing number of prostate cancers are being handled: with a program of active surveillance, or "watchful waiting," in which you don't have surgery unless changes occur. Esserman has also written medical journal articles suggesting that unless the highest-risk cells are present, "DCIS should not be called cancer."

A sea change in treatment for DCIS is eight to 10 years off. Unless you want to enroll in a trial (the newest is called the COMET trial), experts say you should stick with the current standard of care for now. But it's promising that in the future, some patients may have options beyond serious surgery.

Who Needs More Screening?

It's women with dense breasts, simply because their scans are harder to read: Dense tissue looks white on an X-ray, and so does cancer.

What's the Deal With Alcohol?

Keep it to one drink a day; more than that raises risk. What experts mean by "one": 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits.

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The Scare: You think a diagnosis is a death sentence.

The Truth: When breast cancer is caught early, five-year survival rates (a benchmark that suggests you're safer from recurrence) are near 100 percent, according to the American Cancer Society. So if you see or feel a change in your breasts, speak up right away; early detection is one reason these statistics are so good, says Therese Bevers, MD, medical director of the cancer prevention center at MD Anderson Cancer Center in Houston.

"Early" means stage 0 cancers, but the numbers are getting better across the board, too. Survival rates for stage II cancers are 93 percent, "and even those diagnosed with advanced-stage breast cancer have more treatments available to them now," says Bevers.

The Scare: You don't really do self-exams.

The Truth: Afraid to do breast self-exams (BSEs) because you might find something? Or miss something? Or maybe you just never remember. Whatever the reason, know this: Breasts are naturally lumpy inside, and since it's easy to mistake a normal bump for a nasty one, some experts believe BSEs create more anxiety than they're worth. (Plus, as the American Cancer Society points out, they haven't been found to definitively save lives.) But it's always smart to get to know your own body, so poke around a bit to figure out what the ducts and different types of tissue generally feel like. (They'll be a little different throughout the month.)

You'll find some irregularities, and those can be fine: Docs usually aren't concerned about bumps that act like clumps in pancake batter, moving a bit when you touch them. What should get your attention is anything that's different from usual, like a lump that seems fixed in place. Don't delay calling your doctor, but stay calm: 80 to 85 percent of those lumps are benign, says Bevers.

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The Scare: You're not exercising as much as you should.

The Truth: So you don't get 150 minutes of moderate activity — and definitely not 75 minutes of vigorous exercise — a week? Nobody knows exactly how much exercise or what type may lower the risk of breast cancer, but everyone agrees that getting up and moving is better than sitting on the sofa. Exercise may reduce factors that raise the risk of cancer — estrogen, inflammation, and oxidative stress (that's the stuff antioxidants are so famous for countering) — and may boost immunity.

"If you're not doing anything, start with 10 minutes a day and work up to the recommended exercise goals," says Anne McTiernan, MD, PhD, a professor at the Fred Hutchinson Cancer Research Center in Seattle. Pick an activity you'll do (heck, yes, walking counts!) rather than one you think you "should" do, and aim for consistency.

The Scare: You're not eating the right "prevention" veggies.

The Truth: There's some evidence that carotenoids — compounds in orange, yellow, and red fruits and vegetables — may be linked to a lower breast cancer risk. But if sweet potatoes, carrots, and red bell peppers just aren't your style, give yourself a break. Eating a healthy diet overall is far more important than forcing yourself to down particular foods.

Plan meals that are loaded with all kinds of fruits and vegetables, plus a healthy dose of whole grains, legumes, nuts, fish, and poultry. Just stay light on red meat; some evidence suggests it may raise breast cancer chances. This is more of a Mediterranean style of eating than a classic American meat-and-potatoes approach, and it's delicious.

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The Scare: You aren't as diligent about screening as your friend is.

The Truth: Your pal may need to get screened more frequently than you do. She might have a first-degree relative with breast cancer, or her age, race, or past mammogram history could shift her screening schedule. Sure, there are official recommendations for how often the average woman should get screened (and as you know, they're frustratingly inconsistent — "start at 40! 45! No, 50!"), but you need to work out your best timing with your doctor.

Of course, if your stress is really about how you're not following through on that schedule, then put the baggage away about how you've been "so bad" about making the appointment (and keeping it), and call now. While you're at it, enter the center's number in your phone as a "contact" so it'll be there for next time, too.

The Scare: You've always been a little heavy.

The Truth: OK, there's real science behind this fear, because fat cells do a lot more behind the scenes than puff out in places you wish they wouldn't. They actually make some estrogen, a contributor to breast cancer risk. (In fact, after menopause, most of the estrogen in your body is produced by your fat cells.) Also, when you're carrying extra weight, you often have higher insulin levels, and that hormone may be fertilizer for cell growth — including cancer cells.

Having been a little bit heavy for your whole life concerns researchers less than letting pounds accumulate between the ages of 18 and 50. Studies suggest gaining in adulthood increases your breast cancer risk more. "And there's more risk with more weight gain," says McTiernan. "Most American women gain a pound or two a year, and that can add up." Staving off weight gain is ideal, but if the number on the scale has already put you into the overweight category, don't panic or think you have to take it all off. "We've shown that losing as little as 5 percent of your body weight reduces blood levels of estrogen and testosterone, as well as inflammation and insulin," she says. 

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The Scare: You think that one test will lead to more. Is it all really necessary?

The Truth: Additional scans shouldn't send you into a tailspin. Here's what a callback means: "Imagine you're hiking in the woods and you see a cave and wonder what's inside," says

Blaise Mooney, MD, director of breast imaging at Moffitt Cancer Center in Tampa, FL. "You turn on a flashlight and point it into the cave. That's a mammogram. It's a big overview of what's happening in the breasts." If you see something you want to know more about, "you'll hike back to that cave with multiple flashlights to have a better look around," he says. That's what additional views are. Know this: Of the 10 percent of women who get additional imaging, only about 20 percent of those get a biopsy — and almost 80 percent of those are benign, Mooney says. Pretty comforting facts.

The Scare: You went back, you got the scan… and now you have to wait all weekend for results.

The Truth: Everyone hates uncertainty. It's just plain uncomfortable. "A lot of us feel we'd rather have bad news than no news at all," says Kate Sweeny, PhD, an associate professor of psychology at the University of California, Riverside, who's currently studying what makes waiting for anything, including medical test results, so hard. Surprisingly, relaxing probably won't help — but distraction will. You need to reach that state of "flow" where you're so absorbed and engaged in what you're doing that the hours pass without your even realizing it. The projects that get you into that state are different for everyone, but activities like drawing, creating a week's worth of meals to freeze, or going on an all-out Internet hunt for your favorite discontinued sneakers could get you there.

Still jumpy? Go back and reread this story, because knowledge has the power to give fear the boot — or at least put a muzzle on it while you do the right thing for your body.

This story originally appeared in the October 2016 issue of Dr. Oz The Good Life.

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