I asked my colleagues at the Cleveland Clinic Breast Center what they perceive to be patients’ most common misconceptions about breast cancer diagnosis, treatment and care.
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Combining our list, these six misconceptions rose to the top:
1. “If I have an annual mammogram, I don’t need to examine my breasts.”
It is important to understand that effective breast cancer screening includes both mammograms and self-breast awareness. A recent study conducted by Mayo Clinic and published in the American Journal of Surgery, conducted over an eight-year period, looked at 1,222 patients with newly diagnosed breast cancer. It found that 13 percent of these patients had a normal mammogram within the 12 months prior to their diagnosis of breast cancer. Knowing your breasts can play a critical role in the early detection of breast cancer, even when a woman has annual screening mammograms.
2. “I feel something in my breast, but my mammogram and/or ultrasound were normal. I’m sure I’m okay.”
Feeling a lump, nodule or anything of concern should always prompt consultation with your doctor. Palpable areas often turn out to be normal breast tissue, but they could also be cancerous even though a woman has recently had a normal mammogram and/or ultrasound. For this reason, it is best to have a health professional perform a breast exam on you and consider both the imaging and “feeling” characteristics to determine if further treatment is needed.
3. “I don’t need annual mammograms – I need MRIs.”
Many national health groups, including the American Cancer Society, have endorsed screening breast magnetic resonance imaging (MRI) as useful adjunct (not substitute) for women with a 20 percent or greater lifetime risk of developing breast cancer. However, MRI has a significant false positive rate. These same groups have explicitly recommended against annual MRI screenings because the average American woman has only a 1 in 8 (12.5 percent) lifetime risk of developing breast cancer. If you are concerned because your personal and family history puts you at greater risk for breast cancer, you should talk with your doctor about breast MRI.
4. “I shouldn’t have a yearly mammogram because the radiation dosage is too high.”
There is no scientific evidence that associates annual mammograms beginning at age 40 with an increased risk from radiation. The effective dosage received from a routine screening mammogram is similar to the amount of background radiation exposure that a woman normally receives from sources in her environment over a three-month period.
5. “Thermography is an effective substitute for a mammogram.”
Thermography is the making of images of the breasts’ radiant infrared energy for the purpose of detecting cancer. In a June 2011 report, the Food and Drug Administration released its views on thermography. This report said the FDA “was not aware of any valid scientific data to show that thermographic devices, when used on their own, are an effective screening tool for any medical conditions, including the early detection of breast cancer or other breast disease” and that it was “concerned that women will….not receive needed mammograms” if they relied solely on thermography.
6. “I should have the same breast cancer treatment my friend had.”
This is a misconception I encounter almost daily in my practice and the one I dislike the most. Since breast cancer consists of a wide range of diseases, there are many different treatment options. Moreover, there have been many advances in treatment over the past 20 years. What was the standard of care even a few years ago may be obsolete today. It is important for a woman to select a healthcare provider who provides evidence-based treatment options and takes time to explain the risks and benefits of each in order to help her understand the best choice for her particular disease and body.
As some of the most common misconceptions, I hope this helps you stay informed. Knowing the facts can help safeguard your health.
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