A Surgeon to Patients: Stop Believing These 5 Breast Cancer Surgery Myths
Don’t let these breast cancer surgery misconceptions stand in the way of getting the best treatment available.
After learning that you or a loved one has been diagnosed with breast cancer, it’s normal to feel a rollercoaster of emotions, such as confusion, worry, and fear, to name a few.
This mixed bag of thoughts can make it easy to believe all the rumors, misconceptions, and myths that you hear about breast cancer and breast cancer treatment—no matter how out there they may seem.
In order to get the best breast cancer treatment available, it’s critical to not let these myths stand in the way of getting you closer to curing or preventing breast cancer.
“It’s always important for us to clear up these myths so that patients know the correct information,” says Jaime Alberty, MD, a surgical breast oncologist at Dubin Breast Center at Mount Sinai Hospital.
Here are some of the most common myths about breast cancer surgery, debunked by a breast cancer surgeon.
MYTH: Breast cancer surgery and biopsies cause cancer to spread.
“I think people are concerned that once we take the cancer out, because it’s microscopic, we may be leaving behind cancer, or maybe moving cancer around in the breast,” says Dr. Alberty.
Breast cancer surgery and surgical biopsies do not cause breast cancer to spread. “We do know from multiple studies, that once we do a biopsy, we’re not seeding or making the cancer move within the breast,” says Dr. Alberty.
After the surgery, doctors may suggest adjuvant therapy, such as radiation, chemotherapy, targeted therapy, or hormonal therapy, which helps eliminate any cancer cells left in the body after surgery. “When we take the cancer out, especially if we give treatment after including radiation, we take care of anything that is microscopic,” says Dr. Alberty.
If there is cancer in other parts of your body after surgery, it may be because cancer had already spread to other parts of the body before surgery (known as metastatic breast cancer) or a new cancer has developed.
MYTH: Everyone at high risk of breast cancer needs a mastectomy.
“It’s a myth that if you have a high risk or a family history of breast cancer that the only surgery that you need is a mastectomy,” says Dr. Alberty. “[Certain] patients with high risk for breast cancer can safely undergo lumpectomies as well.”
If you are tested for the BRCA genes, however, your risk of developing cancer in either breast at any point is high, so in that case your doctor may recommend a mastectomy. You and your doctor will weigh several factors in deciding which type of breast cancer surgery is right for you.
MYTH: Titanium clips left in the breast can damage my breast or travel to other parts of my body.
Titanium guiding clips (or markers) have been used since the late nineties to mark the location of a suspicious area in the breast. These small (2 to 3 mm) clips are inserted during an image-guided needle biopsy, and show up on X-rays and other images to help surgeons locate and remove breast tumors.
If you do need breast cancer surgery, these clips will be taken out during the surgery. If surgery isn’t needed, that means the area is benign. In this case, the clip is left in place since you would not have surgery just to remove the clip.
“It’s a myth that the titanium clips that are used for marking the areas after breast biopsies will cause problems in the future,” says Dr. Alberty. In fact, these clips can also help with follow up after breast cancer treatment.
MYTH: Everyone who gets lymph node surgery gets lymphedema.
Lymph node surgery can cause uncomfortable breast cancer treatment side effects, including lingering discomfort, numbness, and swelling in the arm or chest, called lymphedema.
“We do know that obviously lymphedema is a complication of lymph node surgery, but the majority of people will not get it,” says Dr. Alberty.
Lymphedema is less common after a sentinel lymph node biopsy (SLNB) than an axillary lymph node dissection (ALND), which is an older kind of surgery.
Sometimes the swelling lasts for only a few weeks, but in some women, it can last a long time. If your arm is swollen, tight, or painful after lymph node surgery, be sure to tell someone on your cancer care team right away. Caring for the affected arm properly can help manage lymphedema and reduce its severity.
MYTH: You don’t have to worry about recurrence after getting a mastectomy.
“We do know the rates of recurrence after mastectomy are lower when you compare them to lumpectomy, but they’re still not zero,” says Dr. Alberty. “It’s important to know that [patients] will have to continue follow up with their medical providers [after the surgery].”
Check out how these women got through treatment for breast cancer … and even managed to find some positivity along the way.
Dr. Alberty is a surgical breast oncologist at the Dubin Breast Center of the Tisch Cancer Institute at Mount Sinai Hospital.
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As a breast surgeon, I do get questions
about myths that exist out there about
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breast surgery, about breast cancer,
about the different types of surgery.
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So it's always important for
us to clear up these myths so
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that patients know
the correct information.
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[MUSIC]
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It's a myth that breast cancer surgery or
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even breast cancer biopsies
will make the cancer spread.
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We do know from multiple studies
that once we do a biopsy,
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we're not seeding or
making the cancer move within the breast.
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I think people are concerned that once
we take the cancer out because it's
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microscopic, you might be sort
of leaving behind cancer,
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maybe moving the cancer
around in the breast.
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And one of the things that we do know
is that when we take the cancer out,
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especially if we give treatment after and
including radiation,
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we usually will sort of take care
of anything that's microscopic.
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It's a myth that if you
have a high risk or
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if you have a family
history of breast cancer,
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that the only surgery that you need is
a mastectomy, and that is not true.
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Patients with high risk for breast cancer,
high risk of developing cancer in
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the future can safely
undergo lumpectomies as well.
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If you are tested for the BRCA genes,
we do know that there is a high risk of
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you developing cancer in
either breast at any point.
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Which is why we usually will recommend
a mastectomy for those patients.
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And it's another type of myth that
the titanium clips that are used for
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marking the areas after breast biopsies
will cause problems in the future.
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When you do work on minimally
invasive breast biopsies,
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which are biopsies done with a needle,
usually we will mark the area with a clip.
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If you do need surgery, that will mark
the area so that area will come out,
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including that clip.
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But if you don't need
to go back to surgery,
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if the area is benign,
then we can just follow you.
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And it's a myth that everybody who gets
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lymph node surgery will have swelling
of the arm or arm lymphedema.
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We do know that obviously lymphedema is
a complication of lymph node surgery, but
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the majority of people will not get it.
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So before, we used to do a surgery which
was called axillary lymph node dissection,
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in which we would take out all of
the axillary lymph nodes, right?
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Many years ago, we developed a surgery
called sentinel lymph node biopsy,
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in which we only take out the first couple
lymph nodes in which we think the cancer
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will have spread to, and we test them.
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If those are negative,
then we feel confident enough to say,
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there is no need for
us to do any additional surgery.
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And also it's a myth that
if you do get a mastectomy,
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you don't have to think about
the cancer coming back.
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We do know that the rates of recurrence
after mastectomy are lower when you
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compare them to a lumpectomy,
but there's still not zero.
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And so it's important for them to know
that they will have to continue to follow
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up with their medical providers.
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Oncoplastic Techniques in Breast Conserving Surgery. UpToDate. (Accessed on July 18, 2018 at https://www.uptodate.com/contents/oncoplastic-techniques-in-breast-conserving-surgery)
Mastectomy: Indications, types, and concurrent axillary lymph node management. UpToDate. (Accessed on July 18, 2018 at https://www.uptodate.com/contents/mastectomy-indications-types-and-concurrent-axillary-lymph-node-management)
Surgery for Breast Cancer. American Cancer Society. UpToDate. (Accessed on July 18, 2018 at https://www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer.htm)
Overview of sentinel lymph node biopsy in breast cancer. UpToDate. (Accessed on July 18, 2018 at https://www.uptodate.com/contents/overview-of-sentinel-lymph-node-biopsy-in-breast-cancer)