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SAN FRANCISCO -- Fear of breast cancer starts early, as girls see it affect those close to them and hear reports in the media, researchers found.

Nearly a third of teens and 'tweens reported they've already worried about whether the disease will strike them personally, Marisa Weiss, MD, founder and president of Breastcancer.org, and colleagues reported here at the ASCO Breast Cancer Symposium.

These girls "had misinterpreted a normal breast finding as a sign of breast cancer or thought they had breast cancer because someone close to them had been diagnosed and they thought automatically they would have it," Weiss said.

Misinformation appeared common as well, according to their survey of more than 3,000 girls from urban areas across the country.

Among the girls ages 8 to 18 surveyed before an assembly at 13 schools in Philadelphia, Atlanta, Washington D.C., and Los Angeles, more than 23% believed that infection, drug use, stress, and tanning cause breast cancer.

From 10% to 20% said they thought caffeine, antiperspirants, or getting bumped or bruised in the breast were causes. According to 7%, breastfeeding increased the risk of breast cancer. None of these are known to increase the risk of a developing a breast tumor.

An important trigger of personal fear, as reported by 31% of the girls, appeared to be having someone close to them diagnosed with breast cancer.

Overall, 67% had a relative or close acquaintance who had breast cancer. Five percent reported it was their own mother.

"When breast cancer hits so close to home, fears about breast cancer get very magnified," Weiss said.

Notably, 72% of the teens and 'tweens thought breast cancer was most common in mothers, "and they were most fearful of it affecting their mothers."

Another problem may be misinterpretation of reports in the media designed to warn adult women about their breast cancer risk, Weiss said.

"When the girls hear them, they think it applies directly to the girls, which is not the case," she said.

Researchers don't know how these unrealistic fears affect lifestyle behaviors and breastfeeding decisions through the teen years and into adulthood, Weiss said, but she worries that a fatalistic impression of risk would make girls more likely to give up on prevention strategies.

Getting parents to talk with their daughters when a family member, teacher, or acquaintance develops cancer may help ease the youngsters' worries, Weiss suggested.

"They're too young to know how to talk about what's on their mind, ask their questions, air their concerns. They just don't have those dialogue skills developed," Weiss noted.

Only about 45% of the surveyed girls reported having talked with a parent about breast development or cancer, and only 40% had talked about them with a doctor.

Physicians too have a role to play, Weiss said.

"Oncologists need to address women's concerns about their daughters," she recommended. "Say, 'Look, your diagnosis may create concerns and need for more information in your daughters.'"