Deodorant and antiperspirants cause breast cancer; sugar feeds cancer;. hormone replacement can cause breast cancer; mammorgrams spread existing cancer. These are a few of the myths that surround breast cancer. There are many myths that have made their way into the public thought, but how are you to know what to believe.
Listen as Lisa Schneider, MD, puts to rest some of these myths and explains the real facts about breast cancer.
Selected Podcast
Busting Breast Cancer Myths
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Learn more about Lisa Schneider, MD
Lisa Schneider, MD
Dr. Lisa Schneider is a board-certified radiologist at Piper Breast Center in Minneapolis and Consulting Radiologists in Plymouth, Minneapolis and Edina as well as Twin Cities Medical Imaging in Edina. She specializes in breast imaging such as MRI and mammography.Learn more about Lisa Schneider, MD
Transcription:
Busting Breast Cancer Myths
Melanie Cole (Host): Deodorants and antiperspirants cause breast cancer. Sugar feeds cancer. Men don’t get breast cancer. These are a few of the myths that surround breast cancer. There are many myths that have made their way into the public thought, but how are you to know what to believe? My guest today is Dr. Lisa Schneider. She’s a Board Certified Radiologist at Piper Breast Center, a part of Allina Health. Welcome to the show, Dr. Schneider. Let’s start and let’s try and bust up some of these myths, deodorants, and antiperspirants being the first one. During our mammograms, we are told not to put deodorant on, but that’s just because it can cloud the picture, correct?
Dr. Lisa Schneider (Guest): Good morning, Melanie, absolutely correct, yes. Deodorant can cloud the picture. It can show up as little white dots called calcifications because there is a metal, or calcium and metal fragments in deodorant, so it can sometimes look like little metal fragments in your breast then if you have it on. However, the National Cancer Institute has done some exhaustive studies on deodorant causing breast cancer, and it’s just simply not true. Deodorants and antiperspirants do not cause breast cancer.
Melanie: So let’s go to the second one I mentioned, sugar because boy we sure hear a lot about sugar, and certainly we have an obesity epidemic, and there’s also an epidemic of diabetes in this country related to sugars, but do sugars feed cancer?
Dr. Schneider: They do not. There is no data to support that increased sugar intake causes cancer or encourages its progression. Now, you’re correct about the obesity epidemic, and you’re correct about Americans being larger in general, and obesity is associated with an increased risk of breast cancer. Keeping the weight off is important, but sugar itself, per se, does not feed cancer.
Melanie: People have heard that mammograms and the radiation can cause cancer, but one I’ve heard a little bit more often is that a mammogram can cause breast cancer -- if you do have I -- to spread, because of the squishing technique and that it’s like popping the tumor and spreading it around the breast. Bust that one up.
Dr. Schneider: Right, no, mammograms do not cause breast cancer. In fact, since mammograms have been widely introduced into the United States in the 1980s and the 1990s, the death rate -- the mortality rate of breast cancer has decreased. It’s because of that early detection. It’s because of finding those cancers early when they’re treatable and curable, and you have less aggressive options and more options for treatment. Mammograms themselves do not cause breast cancer. If mammograms did cause breast cancer, we would have seen an increase in the mortality rate of breast cancer, not a decrease. There is absolutely no evidence in any literature that I am aware of that having a yearly annual mammogram after the age of 40 has caused a woman’s breast cancer.
Melanie: And a big one, women are afraid because over the years we have heard about hormone replacement therapy as you start to enter perimenopause and menopause when yes, your risk of breast cancer is increased because of menopause, but hormone replacement therapy, and even in younger women, birth control pills, do these contribute to breast cancer?
Dr. Schneider: Well, and the answer is a little gray here, it depends. You’re correct, the older age group – the older we get, the increased risk of breast cancer goes up until about age 80 and then it starts to drop off again. Regarding hormone replacement therapy, it depends. The combined estrogen and progesterone increases the risk of developing breast cancer, and there are some studies that show that there is a higher risk associated with the longer use of those combined hormonal replacement therapies in women that start soon after menopause. However, the risk diminished after five years of discontinuation, so if women are taking this combined therapy just to get them through some perimenopausal symptoms for a couple of years, and they’re off of it then after five years their risk really goes down.
The estrogen-only hormone replacement therapy is less clear, and there’s conflicting studies on this. One study that was part of a World Health Initiative Study showed that estrogen alone – that there was actually a decreased risk of breast cancer of about 23%, but there are some observational studies that have shown that there’s a slightly increased risk in estrogen users, particularly in lean women who started soon after menopause. It’s not exactly clear -- this is where it’s just important for a woman to talk to her doctor about her personal risk of developing breast cancer versus her perimenopausal symptoms.
Melanie: And while we’re talking about personal risk, and we will get into the BRCA Gene, but what about alcohol consumption and cigarette smoking, exercise, lifestyle choices – because we’ve heard both ends of the spectrum that they do contribute -- we’ve also heard that things like folic acid can help negate some of the effects of alcohol on that risk for breast cancer.
Dr. Schneider: Right, so I call these the modifiable risk factors. I always tell women, “We can’t change our sex. We can’t change our aging process. We can’t change our genetic profile. But we can change things like postmenopausal obesity and alcohol consumption and breastfeeding.” Numerous studies have confirmed that alcohol consumption increases the risk for breast cancer in women by about 7-10% for each 10 grams and that’s roughly one drink of alcohol consumed per day. The American Cancer Society and a lot of bigger health groups recommend that women only have one drink per day. They've shown that women who have two to three drinks per day have a 20% higher risk for breast cancer compared with non-drinkers. Alcohol use increases our estrogen and our androgen levels, which promotes a potential environment for breast cancer. In terms of the breastfeeding, it’s beneficial and helpful. Most studies suggest that breastfeeding for one year or more reduces a woman's overall risk of breast cancer.
Melanie: So then what about the BRCA gene? Does that mean if you are someone who gets tested that you will definitely develop breast cancer or are you just being told that you now have an increased risk?
Dr. Schneider: You are being told that you have a significant increased risk relative to the rest of the population. We really try to get aggressive with these women in terms of screening for breast cancer and other cancers, such as ovarian and colon and even take it to the point of when these women have completed their childbearing years considering undergoing a prophylactic mastectomy and oophorectomy to prevent the possibility of developing breast or ovarian cancer and just to do everything they can. Women with the BRCA Gene still can develop breast cancer and ovarian cancer even after undergoing a prophylactic mastectomy or ovarian cancer, but right now the data suggests that if you do these things then I think at the end of the day you can say you’ve done absolutely everything despite having what we would consider an unfavorable genetic profile. But no, not all women who have the BRCA Gene get it, but once you do have that gene, we in the medical community, like I said, we get aggressive about our recommendations to these women.
Melanie: Breast cancer is always in the form of a lump, and if you feel a lump in your breast, wow, you should freak out because you have cancer?
Dr. Schneider: Absolutely not, the majority of the times when women feel a lump in their breast, it’s either normal fibro-glandular tissue or a benign lump, such as a cyst or a fibroadenoma, so don’t freak out, stay calm. If you’re a person that doesn’t worry, it’s not going to keep you up at night. I tell a lot of women that are still menstruating to follow it through a menstrual cycle. If it goes away, then fine, you don’t need to do anything because it’s gone. If it gets bigger, if it starts to keep you up at night, or if it becomes fixed, those are things that maybe you want to go in for a little bit sooner rather than later.
Melanie: When we’re looking at our breasts what should we be looking for as far as skin irritation and nipple inversion, scaliness? What do you want women to look for?
Dr. Schneider: It’s just always great for women just to be familiar with their bodies and if they notice a change. If they notice a change, and exactly, skin changes, nipple inversion – we hear a lot of women that come in for a mammogram and say “I’ve had this nipple inversion for five years, don’t worry about it,” and so I don’t. I usually let the woman tell me and if they’re uncertain, again, go to your doctor and let your doctor direct what next step needs to happen. I know there’s a lot of conflicting information out there about whether or not a self-breast exam is useful. I don’t think it’s ever an unhelpful thing for a woman to be familiar with their body and if she feels something that just doesn't feel right, to get it checked out. There’s little harm in doing that.
Melanie: And the last one is mammograms because this being one of your areas of expertise I would assume, 3D mammograms, tomosynthesis, whole breast ultrasound, regular 2D mammogram, are we supposed to be getting them every year after a certain age -- ACOG, there was a whole, big controversy about when you should be getting your mammograms and how often – clear up this last bit of confusion for us, Dr. Schneider.
Dr. Schneider: Well, I wish I had an hour, it is a confusing topic. I will say that all of the bodies of information that are out there, the American Cancer Society, the United States Preventative Services Task Force, the American College of Radiology, ACOG, they all agree on one thing. They absolutely all agree that the most lives are saved if women start screening mammogram commencing at age 40 and annually thereafter. However, where they disagree is the potential harms of mammography, the potential false positives, and unnecessary biopsies that we have to sometimes do to make sure there’s not cancer there once we find an abnormality on the mammogram. That's where they disagree and recommend women start at different ages and perhaps not every other year. I work in a breast center every day. I see the benefits of women getting a mammogram starting at age 40 and every year thereafter. I have seen the status of the death rates going down for breast cancer by 30% because of early detection and improved therapy. I work in this area, and it is not a frightening or scary area for me. I see very little downside to having a mammogram after the age of 40. There’s just not a lot of downside to a woman to do that.
Melanie: So wrap it up for us with your best advice from women when they hear these myths and their girlfriends and they’re all talking about these things – birth control and hormone replacement and all of these things put together – what do you tell women that you really want them to know about good breast health?
Dr. Schneider: You are in control of certain things. You are in control of your lifestyle and what you put in and your exercise routine. I would just urge the woman to talk to their doctor and go to the American Cancer Society. They’ve got some great guidelines for healthy living and a healthy lifestyle. Those are things we can control. I just usually give this work back to the woman herself to do. I think that’s empowering, and I think we also can give women knowledge and so I always urge women to talk to their doctors and go on reliable websites like the American Cancer Society, or WebMD. Another one that I really like for women is called EndTheConfusion.org, and it just spells out about screening mammography and what ages are considered optimal to start.
Melanie: Thank you, so much, Dr. Lisa Schneider, that was really great, amazing information for women to hear and so important. You’re listening to the Well Cast with Allina Health, and for more information, you can go to AllinaHealth.org, that’s AllinaHealth.org. This is Melanie Cole. Thanks, so much, for listening.
Busting Breast Cancer Myths
Melanie Cole (Host): Deodorants and antiperspirants cause breast cancer. Sugar feeds cancer. Men don’t get breast cancer. These are a few of the myths that surround breast cancer. There are many myths that have made their way into the public thought, but how are you to know what to believe? My guest today is Dr. Lisa Schneider. She’s a Board Certified Radiologist at Piper Breast Center, a part of Allina Health. Welcome to the show, Dr. Schneider. Let’s start and let’s try and bust up some of these myths, deodorants, and antiperspirants being the first one. During our mammograms, we are told not to put deodorant on, but that’s just because it can cloud the picture, correct?
Dr. Lisa Schneider (Guest): Good morning, Melanie, absolutely correct, yes. Deodorant can cloud the picture. It can show up as little white dots called calcifications because there is a metal, or calcium and metal fragments in deodorant, so it can sometimes look like little metal fragments in your breast then if you have it on. However, the National Cancer Institute has done some exhaustive studies on deodorant causing breast cancer, and it’s just simply not true. Deodorants and antiperspirants do not cause breast cancer.
Melanie: So let’s go to the second one I mentioned, sugar because boy we sure hear a lot about sugar, and certainly we have an obesity epidemic, and there’s also an epidemic of diabetes in this country related to sugars, but do sugars feed cancer?
Dr. Schneider: They do not. There is no data to support that increased sugar intake causes cancer or encourages its progression. Now, you’re correct about the obesity epidemic, and you’re correct about Americans being larger in general, and obesity is associated with an increased risk of breast cancer. Keeping the weight off is important, but sugar itself, per se, does not feed cancer.
Melanie: People have heard that mammograms and the radiation can cause cancer, but one I’ve heard a little bit more often is that a mammogram can cause breast cancer -- if you do have I -- to spread, because of the squishing technique and that it’s like popping the tumor and spreading it around the breast. Bust that one up.
Dr. Schneider: Right, no, mammograms do not cause breast cancer. In fact, since mammograms have been widely introduced into the United States in the 1980s and the 1990s, the death rate -- the mortality rate of breast cancer has decreased. It’s because of that early detection. It’s because of finding those cancers early when they’re treatable and curable, and you have less aggressive options and more options for treatment. Mammograms themselves do not cause breast cancer. If mammograms did cause breast cancer, we would have seen an increase in the mortality rate of breast cancer, not a decrease. There is absolutely no evidence in any literature that I am aware of that having a yearly annual mammogram after the age of 40 has caused a woman’s breast cancer.
Melanie: And a big one, women are afraid because over the years we have heard about hormone replacement therapy as you start to enter perimenopause and menopause when yes, your risk of breast cancer is increased because of menopause, but hormone replacement therapy, and even in younger women, birth control pills, do these contribute to breast cancer?
Dr. Schneider: Well, and the answer is a little gray here, it depends. You’re correct, the older age group – the older we get, the increased risk of breast cancer goes up until about age 80 and then it starts to drop off again. Regarding hormone replacement therapy, it depends. The combined estrogen and progesterone increases the risk of developing breast cancer, and there are some studies that show that there is a higher risk associated with the longer use of those combined hormonal replacement therapies in women that start soon after menopause. However, the risk diminished after five years of discontinuation, so if women are taking this combined therapy just to get them through some perimenopausal symptoms for a couple of years, and they’re off of it then after five years their risk really goes down.
The estrogen-only hormone replacement therapy is less clear, and there’s conflicting studies on this. One study that was part of a World Health Initiative Study showed that estrogen alone – that there was actually a decreased risk of breast cancer of about 23%, but there are some observational studies that have shown that there’s a slightly increased risk in estrogen users, particularly in lean women who started soon after menopause. It’s not exactly clear -- this is where it’s just important for a woman to talk to her doctor about her personal risk of developing breast cancer versus her perimenopausal symptoms.
Melanie: And while we’re talking about personal risk, and we will get into the BRCA Gene, but what about alcohol consumption and cigarette smoking, exercise, lifestyle choices – because we’ve heard both ends of the spectrum that they do contribute -- we’ve also heard that things like folic acid can help negate some of the effects of alcohol on that risk for breast cancer.
Dr. Schneider: Right, so I call these the modifiable risk factors. I always tell women, “We can’t change our sex. We can’t change our aging process. We can’t change our genetic profile. But we can change things like postmenopausal obesity and alcohol consumption and breastfeeding.” Numerous studies have confirmed that alcohol consumption increases the risk for breast cancer in women by about 7-10% for each 10 grams and that’s roughly one drink of alcohol consumed per day. The American Cancer Society and a lot of bigger health groups recommend that women only have one drink per day. They've shown that women who have two to three drinks per day have a 20% higher risk for breast cancer compared with non-drinkers. Alcohol use increases our estrogen and our androgen levels, which promotes a potential environment for breast cancer. In terms of the breastfeeding, it’s beneficial and helpful. Most studies suggest that breastfeeding for one year or more reduces a woman's overall risk of breast cancer.
Melanie: So then what about the BRCA gene? Does that mean if you are someone who gets tested that you will definitely develop breast cancer or are you just being told that you now have an increased risk?
Dr. Schneider: You are being told that you have a significant increased risk relative to the rest of the population. We really try to get aggressive with these women in terms of screening for breast cancer and other cancers, such as ovarian and colon and even take it to the point of when these women have completed their childbearing years considering undergoing a prophylactic mastectomy and oophorectomy to prevent the possibility of developing breast or ovarian cancer and just to do everything they can. Women with the BRCA Gene still can develop breast cancer and ovarian cancer even after undergoing a prophylactic mastectomy or ovarian cancer, but right now the data suggests that if you do these things then I think at the end of the day you can say you’ve done absolutely everything despite having what we would consider an unfavorable genetic profile. But no, not all women who have the BRCA Gene get it, but once you do have that gene, we in the medical community, like I said, we get aggressive about our recommendations to these women.
Melanie: Breast cancer is always in the form of a lump, and if you feel a lump in your breast, wow, you should freak out because you have cancer?
Dr. Schneider: Absolutely not, the majority of the times when women feel a lump in their breast, it’s either normal fibro-glandular tissue or a benign lump, such as a cyst or a fibroadenoma, so don’t freak out, stay calm. If you’re a person that doesn’t worry, it’s not going to keep you up at night. I tell a lot of women that are still menstruating to follow it through a menstrual cycle. If it goes away, then fine, you don’t need to do anything because it’s gone. If it gets bigger, if it starts to keep you up at night, or if it becomes fixed, those are things that maybe you want to go in for a little bit sooner rather than later.
Melanie: When we’re looking at our breasts what should we be looking for as far as skin irritation and nipple inversion, scaliness? What do you want women to look for?
Dr. Schneider: It’s just always great for women just to be familiar with their bodies and if they notice a change. If they notice a change, and exactly, skin changes, nipple inversion – we hear a lot of women that come in for a mammogram and say “I’ve had this nipple inversion for five years, don’t worry about it,” and so I don’t. I usually let the woman tell me and if they’re uncertain, again, go to your doctor and let your doctor direct what next step needs to happen. I know there’s a lot of conflicting information out there about whether or not a self-breast exam is useful. I don’t think it’s ever an unhelpful thing for a woman to be familiar with their body and if she feels something that just doesn't feel right, to get it checked out. There’s little harm in doing that.
Melanie: And the last one is mammograms because this being one of your areas of expertise I would assume, 3D mammograms, tomosynthesis, whole breast ultrasound, regular 2D mammogram, are we supposed to be getting them every year after a certain age -- ACOG, there was a whole, big controversy about when you should be getting your mammograms and how often – clear up this last bit of confusion for us, Dr. Schneider.
Dr. Schneider: Well, I wish I had an hour, it is a confusing topic. I will say that all of the bodies of information that are out there, the American Cancer Society, the United States Preventative Services Task Force, the American College of Radiology, ACOG, they all agree on one thing. They absolutely all agree that the most lives are saved if women start screening mammogram commencing at age 40 and annually thereafter. However, where they disagree is the potential harms of mammography, the potential false positives, and unnecessary biopsies that we have to sometimes do to make sure there’s not cancer there once we find an abnormality on the mammogram. That's where they disagree and recommend women start at different ages and perhaps not every other year. I work in a breast center every day. I see the benefits of women getting a mammogram starting at age 40 and every year thereafter. I have seen the status of the death rates going down for breast cancer by 30% because of early detection and improved therapy. I work in this area, and it is not a frightening or scary area for me. I see very little downside to having a mammogram after the age of 40. There’s just not a lot of downside to a woman to do that.
Melanie: So wrap it up for us with your best advice from women when they hear these myths and their girlfriends and they’re all talking about these things – birth control and hormone replacement and all of these things put together – what do you tell women that you really want them to know about good breast health?
Dr. Schneider: You are in control of certain things. You are in control of your lifestyle and what you put in and your exercise routine. I would just urge the woman to talk to their doctor and go to the American Cancer Society. They’ve got some great guidelines for healthy living and a healthy lifestyle. Those are things we can control. I just usually give this work back to the woman herself to do. I think that’s empowering, and I think we also can give women knowledge and so I always urge women to talk to their doctors and go on reliable websites like the American Cancer Society, or WebMD. Another one that I really like for women is called EndTheConfusion.org, and it just spells out about screening mammography and what ages are considered optimal to start.
Melanie: Thank you, so much, Dr. Lisa Schneider, that was really great, amazing information for women to hear and so important. You’re listening to the Well Cast with Allina Health, and for more information, you can go to AllinaHealth.org, that’s AllinaHealth.org. This is Melanie Cole. Thanks, so much, for listening.