Dr Shash­ta Sawh

Breast physi­cian, Pink Hi­bis­cus

At Pink Hi­bis­cus, I see many women of vary­ing ages who seem to share some of the same con­fu­sion and mis­con­cep­tions about breast can­cer screen­ing, di­ag­no­sis and treat­ment. This I've found con­tributes not on­ly to women be­ing mis­guid­ed and do­ing more harm to them­selves but al­so stirs up so much trep­i­da­tion and anx­i­ety which pre­vents them from even be­ing as­sessed.

Here are some of the com­mon mis­con­cep­tions I've en­coun­tered:

1. Breast im­plants hin­der screen­ing–Women who may have or wish to un­der­go breast aug­men­ta­tion with im­plants are of­ten un­der the as­sump­tion that hav­ing im­plants would make can­cer screen­ing im­pos­si­ble or dif­fi­cult. This is not so.

Hav­ing im­plants would not be a con­traindi­ca­tion or pre­vent a mam­mo­gram or ul­tra­sound from be­ing per­formed by a trained per­son­nel. Women with im­plants are al­so fear­ful of un­der­go­ing any breast biop­sies with the con­cern that the im­plants would be dam­aged. It is, how­ev­er, im­por­tant that these are per­formed by trained med­ical per­son­nel at spe­cial­ist breast units.

2. Mam­mo­grams cause can­cer–With years of re­search and study it has been shown than mam­mog­ra­phy is the num­ber one screen­ing tool for breast can­cer and in many in­stances it is sup­ple­ment­ed with a breast ul­tra­sound. The lat­ter does not re­place the need for mam­mo­gram and this is al­so a very com­mon mis­un­der­stand­ing.

The ra­di­a­tion dose giv­en in mam­mog­ra­phy is very low and there is no sci­en­tif­ic ev­i­dence prov­ing can­cers de­vel­op as a re­sult of this.The dosage re­ceived has been shown to be so low that it is com­pa­ra­ble with the amount of back­ground ra­di­a­tion a per­son nor­mal­ly re­ceives from the en­vi­ron­ment over a three-month pe­ri­od.

3. Breast can­cer surgery is on­ly mas­tec­to­my–In­deed, with the di­ag­no­sis of breast can­cer comes the im­por­tant ques­tion–what's next? This in most in­stances in­volve some form of breast surgery to re­move the can­cer. How­ev­er, the op­tions are many and does not al­ways need to be as dras­tic as a mas­tec­to­my. Breast can­cer surgery is nev­er the same for every woman.

Some com­pare their surgery with an­oth­er whom they may know with breast can­cer as well and be­lieve they should have had the same. Hav­ing a con­sul­ta­tion with a spe­cial­ist breast sur­geon can of­fer women with many choic­es and the best cho­sen for that giv­en pa­tient.

4. Breast can­cer oc­curs main­ly in women with a fam­i­ly his­to­ry–As star­tling as it may sound to many, this is quite the op­po­site. Sta­tis­tics show that most breast can­cer oc­curs in those with­out any fam­i­ly mem­bers hav­ing had breast can­cer, ac­count­ing for ap­prox­i­mate­ly 85 per cent of cas­es. Whilst the re­main­ing 15 per cent of cas­es oc­cur in pa­tients with a pos­i­tive fam­i­ly his­to­ry and of that on­ly five to ten per cent will have in­her­it­ed a ge­net­ic mu­ta­tion.

5. Breast lumps are the on­ly sign of breast can­cer–Whilst a lump may be the most com­mon pre­sen­ta­tion, it is in­deed not the on­ly sign. There are many changes with the breast which can be a red flag–rang­ing from changes in the shape and size of the breast, nip­ple dis­charge, a rash to no sign at all. It is for this lat­ter rea­son that screen­ing is vi­tal to help in ear­ly de­tec­tion.

So let's imag­ine for a minute with breast can­cer as com­mon as one out of every eight women be­ing af­fect­ed and there was no screen­ing avail­able for ear­ly de­tec­tion. This would in­deed be un­for­tu­nate, but luck­i­ly this is not so and it is avail­able with mam­mog­ra­phy. The mis­con­cep­tions about breast health and screen­ing should be one of the past and not hin­der screen­ing.