October is Breast Cancer Awareness Month, and it seems you can’t pick up a magazine or check your social media feed without bumping into a wealth of information – some of it conflicting. To help dispel some of the more common myths about breast cancer risk, screening and treatment, we asked the experts at White Plains Hospital’s Center for Cancer Care.
Myth 1: A lump = breast cancer.
The good news is that many lumps are benign. “Very often, they turn out to be cysts or benign fibroadenomas,” explains Dr. Preya Ananthakrishnan, Director of Breast Surgery at White Plains Hospital. “If you do feel something unusual under your skin, get it checked out. Further testing, using imaging, can determine whether a given lump is a solid mass that needs more attention or a fluid-filled sac that can be drained or even left alone.”
Myth 2: If I don’t have a family history of breast cancer, I am not at risk for it.
Most people with breast cancer have no family history. “Up to 85 percent of women who get breast cancer have little or no family history,” says Dr. Karen Green, a hematologist/oncologist at the Hospital. “And in those cases that are hereditary, many people think breast cancer risk comes only from their mother’s side of the family, but inherited genes can come from either the mother or father’s side.”
For that reason, Dr. Green recommends genetic testing for those with high prevalence of breast cancer on either side of the family, which “provides a good estimate of cancer risk and can help with discussion of prevention options, screening options and treatment strategies. Testing can also help us determine if other members of the family are at risk."
Myth 3: A mammogram and an ultrasound are recommended for all women.
At White Plains Hospital, screening for all patients is conducted with 3-D mammography, which creates 3-D images from a series of X-rays of the inside of the breast. This method enables a more detailed analysis than the older, 2-D method still in use at some medical facilities. Using 3-D makes it easier to find breast tumors or other changes in the breast, says Dr. Pamela Weber, the Hospital’s Director of Breast Imaging.
As of September 2024, a new FDA ruling requires that all healthcare facilities providing breast imaging services notify patients of their breast density in mammography reports. For women with dense breasts — where the breasts have more glandular tissue and fibrous tissue than fatty tissue — even a 3-D mammogram may not be able to “see” enough to detect potential signs of developing cancer and an ultrasound may be recommended. Ultrasound technology uses high-energy sound waves to look at tissues and organs inside the body. Those sound waves make echoes that form pictures of the tissues and organs on a computer screen, providing a clearer view for physicians to detect any abnormalities.
While ultrasound is an impressive tool, Dr. Weber cautions that it is not for everybody. “Ultrasound is good for women with dense breasts, but we do not recommend it for all women.” A prevalence of false positives — where an indeterminate lesion is biopsied — is one of the downsides to ultrasounds. Such an outcome can lead to needlessly increased patient anxiety and additional imaging procedures, surgical biopsies, and associated costs.
Myth 4: Drinking alcohol won’t make much difference in terms of breast cancer risk.
An occasional drink is fine, but bear in mind that drinking alcohol does increase breast cancer risk. According to experts, women who have two or three drinks a day have a 20 percent higher risk of developing the disease. Your best bet? “Stay under 3 drinks per week,” recommends hematologist/oncologist Dr. Abraham Mittelman.
Myth 5: All breast cancers are treated the same way.
“Breast cancer treatment is no longer a one-size-fits-all approach, and the good news about getting a breast cancer diagnosis today is that treatments are more tailored to each individual’s cancer, thereby limiting side effects as much as possible,” says Dr. Mittelman.
Many different factors impact how breast cancer is treated, including cancer size and type, grade and stage, and specific receptor testing on the cancer. Genetic testing results can also impact treatment recommendations. Every week, the Tumor Board at the Hospital meets to discuss complex cases and uses a multidisciplinary approach to ensure the best patient outcomes. At White Plains Hospital’s Center for Cancer Care, patients have access to a variety of personalized treatments and therapies, including a multitude of clinical trials that offer new approaches to treatment while advancing cancer treatment for patients everywhere.
Myth 6: Breast cancer only happens to older women.
The main risk factors for getting breast cancer are being female and growing older. However, according to a study published in the Journal of the American Medical Association Network Open, cancer cases in adults under 50, especially women, are rising, and breast cancer remains the most common cancer diagnosed in women.
“Regular mammograms, beginning at age 40 for women at average risk, can help detect breast cancer early, when it is most treatable,” says medical oncologist and hematologist Dr. Yael Zack, who founded and leads White Plains Hospital’s Young Women’s Program for Cancer Care, which is designed to specifically care for women under 50 who have received a cancer diagnosis. Patients in the program have access to robust multi-disciplinary services at every stage of their care as well as family, career and other concerns that should be addressed alongside their treatment.
With flexible appointments and multiple locations, it has never been easier to fit breast cancer screening into your schedule. Visit wphospital.org/mammo to schedule your mammogram.