Breast cancer: Keeping abreast of facts and urban legends

Q. I have heard and read so many different things on what to do or not to do to prevent breast cancer. These include not drinking coffee or wearing underwire bras.

I am confused about which piece of information is true and which is just an urban legend. Can you help to clarify?

A. There is a lot of information out there on the dos and don'ts when it comes to preventing breast cancer. Some are accurate, while some are not.

Here are some of the myths and facts about breast cancer:

Myth: Drinking coffee can cause breast cancer.

Fact: There is no evidence to suggest that coffee is associated with breast cancer.

Some studies have shown that caffeine may, in fact, lower the risk of certain cancers.

Myth: Wearing underwire bras can cause breast cancer.

Fact: There has not been any scientific evidence to show the connection between any type of bra and breast cancer.

Myth: If you are at risk for breast cancer, there is little you can do but to watch for the signs.

Fact: There is a lot that women can do to lower their risk of breast cancer. This includes losing weight if they are obese, regular exercise, regular clinical examinations and mammograms, and lowering or eliminating alcohol consumption.

Myth: Annual mammograms expose you to so much radiation that they increase your risk of cancer.

Fact: Radiation is used in mammography, but the amount is so small that any associated risks are tiny when compared to the huge preventive benefits reaped from the test.

Mammograms can detect lumps well before they can be felt or otherwise noticed, and the earlier the lumps are caught, the better the chances of survival.

Myth: Everyone's breast cancer is the same.

Fact: There are many sub-types of breast cancer and they require different types of treatment.

Different women have different breast cancer types with unique disease characteristics.

We also know that there are inherited gene mutations that affect breast cancer, such as BRCA 1 and BRCA 2.

Myth: Removing the entire breast is better than just removing the cancer and having radiation treatment, for a better chance of surviving.

Fact: Completely removing the breast - or mastectomy - is usually not more effective than just taking out the cancer or lumpectomy.

There are issues with both treatments and patients need to be well informed in order to make the right decisions for themselves.

Myth: Hormone replacement therapy (HRT) increases the risk of breast cancer, along with heart disease, stroke and blood clots.

Fact: Clinical trials by the Women's Health Initiative studied a group of 161,808 generally healthy post-menopausal women for the effects of HRT.

The studies found that the oestrogen-only replacement therapy did not increase the risk of breast cancer.

But the risks far outweighed the benefits when oestrogen was taken with progestin.

Overall, there was a 24 per cent increase in the risk for breast cancer due to estrogen-plus-progestin.

Dr Lo Soo Kien

Senior consultant medical oncologist at The Harley Street Heart & Cancer Centre

This article was first published on August 2, 2016.
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