Navratilova and Breast Cancer: Why Do Women Blame Themselves for Diagnosis?

Martina Navratilova wrongly blames her early breast cancer diagnosis on not getting annual mammograms.

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Tennis great Martina Navratilova announced Tuesday that she was being treated for breast cancer and—as happens all too often with breast cancer patients—she's placing some of the blame on herself. Diagnosed with a tiny self-contained growth, called ductal carcinoma in situ (DCIS), she says she could have caught the cancer earlier if she hadn't let four years pass between mammograms. "I let it slip by," the nine-time Wimbledon singles champion told USA Today. "I was a bad girl."

Okay, maybe the 53-year-old should have had annual mammograms, but her cancer was caught so early that it's considered a pre-cancer, meaning that once it's removed it has little chance of spreading or posing a threat to her life. The mammogram that did detect Navratilova's breast cancer back in January served its purpose: It caught the malignancy in its earliest possible stage, a DCIS, which means abnormal cells are lodged in one or more of the breast ducts but they haven't yet invaded into surrounding tissues. [More details on what to do about DCIS.] And it's hard to believe that her having a mammogram a year or two earlier would have made any difference in her prognosis. In fact, the tiny growth may not have even formed during that time.

I've written several blog posts on what women can do to lower their risk of dying from breast cancer (like preventing inflammation) or to keep from getting it in the first place (like these four steps to lower your breast cancer risk). But the danger in telling women to, say, exercise or lose excess body fat to lower their breast cancer risk is in making the implication that if we do all the right things, we won't get breast cancer. That's simply not true, according to breast surgeon Susan Love, author of Dr. Susan Love's Breast Book, who has told me in previous interviews that the vast majority of breast cancers—the ones not triggered by an inherited gene mutation—have no known cause. In fact, she's currently trying to recruit more than a million women to participate in various research studies in an effort to determine the real causes of breast cancer. Navratilova told USA Today that her diagnosis was a "total shock" because she'd been so healthy. She eats nutritiously and is in peak physical condition without an ounce of excess body fat.

Certainly, exercising most days of the week, avoiding alcohol, and losing excess weight (which all lower levels of estrogen, which fuels some breast tumors) can help reduce your breast cancer risk, but not as much as, say, avoiding smoking to lower your chances of lung cancer. The role that diet plays in breast cancer is far murkier. Many studies have shown that dietary fat doesn't play a role in breast cancer, and some have suggested that our intake of fruits and vegetables doesn't either. A recent study from the European Prospective Investigation into Cancer and Nutrition found that eating five servings a day of fruits and vegetables lowered the risk of getting any cancer by about 9 percent—not bad, but not a huge reduction. In fact, the researchers calculated that if everyone ate two extra servings a day of fruits and vegetables, only about 2.3 percent of cancers in women could be avoided and about 2.6 percent of cancers in men.

The benefits of breast cancer screening have also been overstated to the point that women, like Navratilova, blame themselves if they fail to have annual mammograms. While mammograms certainly have the potential to save lives , they don't guarantee that every breast cancer will be caught early enough to cure. In fact, they often miss life-threatening tumors or detect tiny malignancies that would have disappeared on their own without any treatment. Certainly, I applaud the tennis star for stepping forward to reveal her diagnosis and discuss her treatment publicly—never easy in any circumstance. I just wish she hadn't used it as a way to lay the blame on herself. No woman dealing with a devastating breast cancer diagnosis should get the message that she's somehow to blame.