PERRYSBURG – How many women diagnosed with breast cancer believe, privately, that they got the disease
because "I had too many mammograms?"
What percentage still consider a breast cancer "survivor" to be someone who has been
cancer-free for five or more years?
What number of women who have had cancer diagnosed in one breast are sure that having both breasts
surgically removed will increase their survival odds?
All three of these are popular, and stubbornly held ideas. But all three are myths.
So says Anita Leininger, M.D., surgical director of the University of Toledo Medical Center Breast
Center.
Leininger spoke on the subject "Debunking the Myths" to a packed ballroom at the Hilton Garden
Inn last Saturday during the American Cancer Society’s 2011 kickoff breakfast for Making Strides Against
Breast Cancer. Present were women recently diagnosed, long-time survivors, their families, friends and
supporters.
The surgeon rapidly refuted a number of erroneous ideas about the risks, genetics, diagnosis and
treatment of the disease.
Whenever she meets with a new patient, Leininger finds out what the woman believes to be true about her
own condition.
Then, "I always ask, ‘Who gave you the information?’ We all have family, friends, people at the
service counter that are so willing to give us advice!"
But, alas, "there are so many false notions around breast cancer."
The fear that radiation from too many mammograms may have actually caused the breast cancer is just not
realistic.
"If you started too early – beginning every year in your 20s – you might have a slightly elevated
risk," but what woman does that?
Many women are pretty sure they know why they developed breast cancer.
Top reasons Leininger has heard are:
¥ Because my mother had breast cancer;
¥ I had cancer in the other breast;
¥ I had mastitis or trauma in that breast;
¥ Because I had a previous breast biopsy.
By contrast, true risk factors for breast cancer are aging, being younger when we get our first period or
having a later than average menopause, being older when we started having children, or a personal
history such as previously receiving radiation for Hodgkins lymphoma.
In actual fact, "two-thirds to 75 percent of people who get breast cancer have no known risk
factor."
People whose mother had breast cancer too often believe that their own breast cancer "isn’t a matter
of whether, but when. People wait all their life to get it."
That is misguided, though. The "breast cancer genes," BRCA 1 and 2, only account for 5 to 10
percent of all cancers.
Many women who do get breast cancer automatically assume they have one of those two genes. In fact, there
is a 90 to 95 percent likelihood that they are not carriers, Leininger said.
The most prevalent myth surrounding diagnosis?
"I want an open surgical biopsy. That’s the safest and most accurate."
Not so, said Leininger. "A guided-needle biopsy is how almost all biopsies should be done. They
allow the patient to have one surgery instead of two, are safer, cheaper and less invasive."
Another thing most women don’t realize is that "a biopsy that shows no cancer doesn’t rule out that
you aren’t at higher risk for cancer. Lesions may show something else of concern" such as atypical
hyperplasia (cell overgrowth) "that will need to be monitored on an ongoing basis."
Leininger often has patients confusing "stage" with "grade" of cancer.
"I hear people say ‘I just had a biopsy and I have stage 3 breast cancer!’
"No! It was really grade 3, not stage 3. What a difference!"
Stage is based on tumor size and location, and stage cannot be determined based on a biopsy.
Besides, "we are finding that stage may not be as important as we used to think."
In the area of treatment, there are two prevalent myths.
The first: "If I have breast cancer I will remove both breasts to increase my odds." Leininger
said "there is no increased life expectancy by removing both. There is no survival benefit or
decrease in distant (cancer) spread with mastectomy compared to lumpectomy and radiation."
Another mistaken notion some patients have is "I’ll do radiation therapy so I don’t have to have
chemo."
But they are two totally different things. Surgery and radiation are local therapies – directed to one
particular spot. "Chemotherapy is a systemic treatment, whose purpose is to prevent the spread of
cancer."
The audience laughed at the irony of the next myth the doctor shared:
"At least I’ll lose weight with chemo!"
In fact, there is an average weight gain between 5 and 20 pounds. "I’d like to think it’s all the
good food friends and relatives are bringing them," Leininger said, smiling.
Finally, for those who say "I will consider myself a breast cancer survivor when I am cancer-free
for five years," she disagreed: "You are a survivor from day one!"