Reality check: How much do you really know about breast cancer?

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Fact or fiction?: Some chain e-mails and websites have suggested that chemicals in underarm antiperspirants cause toxins to build up in the breast, and eventually lead to breast cancer. According to the American Cancer Society, there is very little scientific evidence to support this claim. | FILE PHOTO

Sometimes, the truth hurts. Other times it can save your life.

See how much you really know about breast cancer by answering these five true/false questions from the American Cancer Society.

1. Most breast cancer is hereditary. You don’t need to worry if you don’t have a family history of breast cancer.

Answer: False. Only about 5 percent to 10 percent of breast cancer cases are thought to be the result of gene defects (called mutations) inherited from a parent. The lifetime risk for breast cancer can be as high as 80 percent for members of some families who inherit certain mutations of BRCA genes.

The risk is not nearly as high for most women with a family history of breast cancer. On average, having one first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman’s risk, and having two first-degree relatives triples her risk. About 20 to 30 percent of women with breast cancer have a family member with this disease (although most of these families do not have abnormal BRCA genes). This means that most women (70 to 80 percent) who get breast cancer do not have a family history of this disease.

2. If you have a family history of breast cancer, there is nothing you can do to protect yourself from this disease.

Answer: False. If one or more of your relatives have had breast cancer, be sure to tell your doctor. Careful discussion of which and how many relatives were affected can determine whether you may benefit from genetic counseling or even genetic testing. It is estimated that only a few percent of women who should consider breast cancer genetic testing actually get tested, and the main reason is that doctors and patients do not discuss this topic enough.

If genetic tests show that you are at very high risk, doctors will recommend starting screening earlier, and using MRI scans as well as mammograms. Screening can find breast cancer earlier, when treatments are more likely to be successful. Additional options include medications and even surgery to help reduce your risk of developing breast cancer.

3. There is nothing a woman with average risk can do to reduce her risk of developing breast cancer.

Answer: False. Many breast cancer risk factors are things you cannot change, like your age, your family history, and how old you were when you started and stopped having menstrual periods. But there are other important breast cancer risk factors that you do have some control over, and which can help reduce your risk of developing breast cancer: your weight, your physical activity level, and how much alcohol you drink.

Although medicines and even surgery are options to consider for women at increased risk, they are not recommended for women at average risk.

4. Monthly self examination is the best way to find breast cancer early.

Answer: False. The American Cancer Society no longer recommends that all women routinely perform monthly breast self-exams (BSE). Instead the Society emphasizes breast awareness, which means knowing how your breasts look and feel and being alert to any changes in your breasts that you may notice while showering, dressing, etc.

Research has shown that breast awareness seems to be more effective for detecting breast cancer than a formal monthly BSE. When women find their own breast cancer it is usually while bathing, showering or dressing, and less often during a specific BSE. Women who still want to do monthly BSE in addition to being aware of breast changes throughout the month should ask their health care providers for instruction on how to do this exam most effectively.

5. Lumps are the only sign of breast cancer.

Answer: False. Skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk can also be important warning signs for breast cancer. In one uncommon but aggressive form of breast cancer called inflammatory breast cancer, or IBC, women usually do not notice a lump, and the only symptoms may be redness and thickening of the skin covering the breast, sometimes together with swelling of the breast. It is important not to ignore these changes or assume they are the result of an infection. If you have breast changes like these, get checked by a doctor.

The American Cancer Society