Scott Webb (Host): Today, we're going to bust some myths about breast cancer and breast cancer screening with Dr. Tolga Ozmen. He's a breast surgeon and occasional myth buster with Southern New Hampshire Health.

This is On Call with Southern New Hampshire Health. I'm Scott Webb. Dr. Ozmen, it's so nice to have you here today. We're going to bust myths about breast cancer, and I love a good myth-busting podcast. So, let's start with myth number one: If you don't have a family history, you won't get breast cancer.

Dr. Tolga Ozmen: Most people diagnosed with breast cancer actually do not have a family history. While genetics like BRCA mutations increase the risk, lifestyle, environment, and aging also play a role, and actually a much bigger role than family history. That's why screening guidelines apply broadly, not just to those with a family history. Only about 15-20% of breast cancer patients have a strong family history. So, that's a myth that is not correct.

Host: Right. So, we busted our first one here. So, onto myth number two: A mammogram causes breast cancer or causes cancer to spread.

Dr. Tolga Ozmen: Yeah, that's another myth that actually is not true. This is a persistent but false belief, Scott. Mammograms use very low-dose X-rays, and they do not cause cancer to spread. They do not cause cancer. On the contrary, mammograms are actually one of the best tools we have for early detection. And thanks to the screening guidelines using mammography now, we detect 60-65% of breast cancers at a very early stage and save lives. Breast cancer mortality decreased by 40% because of these mammography-based screening guidelines.

Host: As you're saying, it leads to early diagnosis, early treatment, saving more lives, all things that, you know, bring a smile to someone's face, of course. And, you know, in busting myths, sometimes it's unclear where folks see these things. Is it social media? Is it the news? Do they just want to believe these things? So, it's great to have an expert here and go through these. So, myth number three, doctor: Breast cancer always presents as a lump that you can feel.

Dr. Tolga Ozmen: Yeah, not always. Some breast cancers show up as changes in the skin texture, skin color, or swelling. Sometimes, there is nipple discharge, especially bloody nipple discharge. Blood-tinged or blood-colored nipple discharge is concerning and can be a sign of breast cancer, or it might just be detected as an abnormality on the imaging and no palpable or no examination finding. That's why mammography is very important and getting yearly mammograms after the age of 40 is very important to detect them early. It does not always present as a lump, breast cancers.

Host: Right. All right. Myth number four: If you have dense breasts, you can't really rely on mammograms.

Dr. Tolga Ozmen: Dense breasts do decrease the performance of mammograms and make it harder for mammograms to detect abnormalities. But mammography is still useful. What do we do in these cases if a patient has a dense breast? We add additional imaging studies, adjunct imaging modalities like ultrasound or breast MRI. Dense breasts don't make mammograms useless, but sometimes we have to support them with additional imaging findings.

Host: Right. I know myth number five is one that a lot of people believe, probably a lot of males, but only women get breast cancer.

Dr. Tolga Ozmen: No. So, women get 99% of breast cancers, but there's that 1% cohort of breast cancers that happen in men.

Host: Yeah.

Dr. Tolga Ozmen: Unfortunately, because awareness is low among men, men often present at later stages, which makes early detection and awareness just as important in men. So no, not only women get it. One percent of breast cancers happen in men.

Host: Right, 1%. And with billions of men in the world, 1% is a lot, right? I wanted to give you a chance at the end; you've referenced the screening guidelines. I just wanted to have you go through that for everybody listening.

Dr. Tolga Ozmen: Right. So, for screening guidelines, there are different societies recommending different regimens. But usually, at Mass General, and here at Southern New Hampshire Medical Center, which is a Mass General-affiliated hospital, we recommend starting mammograms at age 40 and then continuing them, doing it annually with an annual physical exam.

Now, obviously, screening should also be personalized. If you have a strong family history or a genetic mutation, then we personalize your screening methods. But for an average risk woman, the recommendation is, at least our group recommends, starting at age 40 and doing it annually.

Host: That's perfect. Well, doctor, it's been a pleasure to have you here. As I said, I always enjoy a good myth-busting podcast. There's just a lot of false information, bad information, and misunderstood information in the world. And I like to put my faith in experts. I'm sure many listeners do as well. So, thank you so much.

Dr. Tolga Ozmen: Thank you. Thank you, Scott. Thank you for this opportunity and for having me. Bye-bye.

Host: And for more information, go to snhhealth.org/breasthealth. And if you enjoyed this podcast, please be sure to tell a friend and share on social media. This is On Call with Southern New Hampshire Health. I'm Scott Webb. Stay well, and we'll talk again next time.