The evening of the day my hair started to fall out, Christie, Barbara and I were having dinner at one of our favorite restaurants. Naturally, I had to tell them how it all happened.

“Guess what happened this morning?”

“What happened, Deb?” Christie asked, leaning forward in anticipation.

“I reached up to pull some fuzz out of my hair and the whole clump of hair came out. I’m losing my hair!”

“Wow! What did you do?”

“I kept pulling pieces from different places on my head - then I showered and washed my hair to see how much more would come out.”

Christie was fascinated. Barbara was unnaturally quiet.

“You know what would be fun?” I said, “Let’s go back to my house after dinner, sit on the deck, and see if we can make a checkerboard pattern on my head!”

“How can you talk like that!!?” Barbara shouted at us. Our heads whipped around as we looked at her with astonishment.

“She’s losing her hair! That’s terrible!” Barbara was near tears.

“It’s her hair, Barbara,” Christie murmured soothingly. But Barbara was not to be comforted. Barbara was one of those people for whom hair is a very important thing.

I didn’t realize right away that many people would be distraught about losing their hair. I had to learn about it from others.

When I spoke at a conference not long ago about my experiences, for example, one of the women from the audience told me how it was for her. She just shook her head, “I couldn’t bear to lose my hair - it’s who I am - my whole image of me is wrapped up in how I look with my hair!”

I was lucky that way. My image isn’t tied to the way my hair looks. For me, one of the hardest adjustments was not being able to do all the things I was used to doing.

I hated the “nap attacks” and not being able to just get up and go do the things I love to do. I found that my identity was tied up in being a doer. Not doing was hard and having to ask for help was harder, much harder for me than worrying about how my hair looks.

Even so, losing my hair meant something else that many of us with cancer have to deal with. Until we lose our hair, most of us look fairly normal. Losing our hair is the step that firmly sets us apart from the rest of the population.

We’ll always be apart from them. Once you’ve had breast cancer, even if you’re free of symptoms for years, you know that it can always recur. As a friend said to me, “Once you’ve had breast cancer you can’t be sure it won’t come back until you die of something else.”

That’s the shadow that’s always lurking around the corner. It’s also the reality that puts other things, like being bothered by asking for help, or losing your hair, into perspective.

For me the hair issue was easily solved. A few days after that dinner with Christie and Barbara, I decided to shave my head.

First, I went to the beauty parlor and got “buzzed.” Then I went home and borrowed my husband’s shaving cream and razor and shaved the stubble off to be truly “bald.”

I didn’t stay bald, but I did find that I liked short hair. You can see how I looked before and after chemo by visiting one of the photo galleries. And you can see how I look today by checking out the picture on the main page of this site.

Everyone who gets breast cancer has lots of hard things they have to deal with. But for me, checkerboard hair was one of the easy ones.

Deb Haggerty is a breast cancer survivor who helps women with breast cancer and their loved ones by providing information, inspiration, and links to resources through her web site Positive Hope (http://www.positivehope.com).

The Checkerboard Hair experience was part of Deb’s Breast Cancer Journey (http://www.positivehope.com/email_diary).

It was early February, 2000 and while everybody else was getting ready for Valentine’s Day, I was getting ready for a full battery of tests, including my first MRI. I was in a bit of a funk.

Earlier in the week, I got the reports from the pelvic ultrasound. The “lesions” they’d seen on the CT scan seemed to be cysts, but they weren’t sure. One ovary was greatly enlarged by this “mass.”

I had done a lot of research on the net and talked to my doctor and I knew this might be more cancer. Breast cancer and ovarian cancer often go hand in hand.

I was devastated. I had been feeling really good about making a great recovery from breast surgery, but now it looked like a hysterectomy might be in my future.

I moped around the house on Tuesday night, all of Wednesday and Wednesday night thinking about maybe having a whole new kind of cancer. I didn’t even get dressed. Finally I found the strength to call the doctor and schedule more tests.

Thursday I was in a much better mood. I’d taken some action and scheduled the tests for Friday. Plus, I was thinking about all my friends who were there for me and praying for me. Life might not be good, but with friends and faith it usually doesn’t stay too bad for too long.

By now I was used to tests so I wasn’t nervous about most of them. They started Friday morning at 7:30, way before I usually even get up. The first test was the MRI. The prospect made me nervous.

I’m just a little bit claustrophobic, and the idea of being stuck inside a really small space was scary. But the staff did everything they could to make me comfortable.

They covered me with a blanket for warmth and gave me ear plugs for the noise they said I would hear. Then they gently pushed me into a narrow tube. The quick look I took showed about 5-6 inches of space between my face and the tube.

I kept my eyes shut most of the time!! One time though, I opened my eyes and found that it was light inside the tube. That helped. Don’t ask me why, but I didn’t really feel closed in.

Then the MRI started: Tap, tap, tap - like a drummer counting cadence on the rim of a snare drum. Then loud discordant sounds: sort of a doo-wop, doo-wop, doo-wop coupled with a low pitched busy signal.

This went on for what seemed like about 10 minutes. Slight pause, tap, tap, tap and different pitches of static like you get on a TV station after it goes off the air. I kept myself amused trying to imagine what tones would be next.

Then I was wheeled out, given a dye injection, and wheeled back in for “three more sets!” By then I was used to it and I got to see some of the pictures. They looked pretty to me, but I would have to wait until the following week for results.

So I set off for the rest of the day’s tests, with one more thing I could check off life’s list. I had my first MRI and survived by listening to the strange music of the tube.

Deb Haggerty is a breast cancer survivor who helps women with breast cancer and their loved ones by providing information, inspiration, and links to resources through her web site Positive Hope (http://www.positivehope.com). If you’d like to know the results of the tests, you’ll find them in her email of February 17, 2000 (http://www.positivehope.com/email_diary/20000217bcemail.htm).

Breast cancer continues to affect millions of people worldwide - plunging newly diagnosed sufferers and their families into the bewildering world of treatment plans and statistics on a daily basis.

This year alone, over one-million people worldwide will be unwillingly inducted into this club of warriors. And strong in numbers, these sufferers and their families will continue to affect change in the landscape of awareness and treatment; part of the way in which they raise awareness is through the wearing of merchandise, including the breast cancer bracelet.

The breast cancer bracelet can attribute its beginnings to the awareness campaign, where the pink ribbon first became the symbol in the united fight. The Susan B. Komen Breast Cancer Foundation - which began in the early 1980s as a way to funnel comprehensive information to victims and raise money for research - began using the pink ribbon in the early years of its Race for the Cure, the annual run/walk fundraising event that is the signature event of this foundation.

The early beginnings of the pink ribbon were brought to the forefront as Self magazine planned their second annual Breast Cancer Awareness Month issue in the early 1990s. In this effort, the magazine partnered with Estee Lauder to create the looped pink ribbon we have now come to recognize; over a million of which were distributed at makeup counters around the country to coincide with the distribution of the magazine. The ribbon included instructions on self examination and information on how to petition Washington to increase funds for research. The color pink was chosen because of its strong association with femininity.

With the growing popularity of the pink ribbon, came the further development of other pink items to signify awareness. The items have since come fast and furious - from t-shirts and pins, to umbrellas and mugs. The breast cancer bracelet, especially, has achieved enormous popularity as the message of awareness is encapsulated in a beautifully designed - and very wearable - bracelet.

The bracelet is just like any other bracelet that you would think nothing of buying and wearing; but you have the added benefit of knowing that in wearing the bracelet you are promoting awareness and, in so doing, are part of a community that is saving lives.

The bracelet comes in a variety of styles and prices - everything from pearls and crystal to silver and gold. No matter what your style or taste in jewelry, there will surely be a bracelet that draws your attention and furthers the message of awareness. In today’s online world especially, there is a growing number of websites dedicated to the sale of pink awareness merchandise.

This awareness encompasses many different things when it comes to the battle against breast cancer. Raising awareness means increasing people’s understanding of research, prevention, detection, and treatment. But more importantly, raising awareness - through the wearing of insignia such as the bracelet - means alerting those who are affected to a larger community; a community of enormous support and infinite understanding.

For more information on breast cancer try visiting http://www.breastcanceranalysis.com - a website that specializes in providing breast cancer related information and resources including information on the breast cancer bracelet

No matter who you are, what you do, or where you live, chances are you have been personally affected by breast cancer. The statistics are clear and overwhelming; but statistics mean little when faced with the diagnosis of yourself or a loved one.

For those who fight the battle against this cancer on a daily basis, the support of family and friends is just as important as the treatment received - necessary support that widens still the circle of people affected by this disease. This family of patients and supporters
“strong in numbers” often find the wearing of a breast cancer ribbon to be a sign of their connectivity and a larger call for awareness and aggressive strides in research.

We’ve all seen them - the pink breast cancer ribbon that adorns any manner of clothing and is meant to draw attention to the staggering statistics - affecting one in eight women during their lifetime; over a million people throughout the world this year alone; and claiming the lives of 43,000 people a year in the United States.

The wearing or displaying of a ribbon has long been identified with the plight of charitable causes; from the yellow ribbons tied around trees in honor of soldiers far from home, to the looped red ribbon worn in symbol of AIDS activism. The pink ribbon, that is now so inseparable from its cause, had its origins with the Susan G. Komen Breast Cancer Foundation.

The foundation, which began in 1982 as a way to unite women who were suffering with breast cancer in a unified call for better funded research, began holding Race for the Cure in 1990, an annual walk/run event to help raise funds for education, screening, treatment, and research. Participants of the race who were cancer survivors were initially given pink visors to commemorate their fight; but all participants began receiving pink ribbons in 1991.

However, the ribbon really stepped into the limelight in 1992 when Self magazine featured it in its second annual Breast Cancer Awareness Month issue. The magazine partnered with Estee Lauder who handed out over a million pink ribbons at its makeup counters across the country. Attached to each were instructions on proper breast self-examination and information on how to petition the White House for increased funding for better research.

Legend tells us that the pink ribbon was chosen because of its close association with femininity. Meant to empower and inspire women to enact change in their own medical care, the pink ribbon began as a wake-up call for all women; without fully engaging in the network of healthcare, researchers, and government that wield influence in cancer prevention, detection, and treatment, women were at the mercy of those in power. It was time to take an active role and affect change at the highest level.

Today, the power of the ribbon holds fast to its fundamental values with which it was originally introduced. And it continues its work of uniting generations of women and families in the fight against cancer. As research continues and new medical and technological advancements are brought to the table, the ribbon will surely continue in its role as a sign of awareness and an infinite commitment by its wearers.

For more information on breast cancer try visiting http://www.breastcanceranalysis.com - a website that specializes in providing breast cancer related information and resources including information on the breast cancer ribbon.

Talk about breast cancer and naturally, people think of the disease that is the number one cancer among women. But the truth is that breast cancer is on the rise among both women and men, and researchers think the national obesity crisis may be to blame.

With two-thirds of Americans now overweight, we can probably expect more obesity-related cancers. But on the brighter side, weight problems are extremely treatable, even preventable. So to the extent overweight is contributing to cancer, this is one risk factor we may actually have some real control over.

Just how we go about getting that control appears to be critical, though. Even among the most motivated of people, we see that very few are successful in independent efforts to lose weight, even if their life depends on it. And among cancer patients, it clearly does.

Consider some of the numbers: breast cancer in women increased by 52 percent from 1973 to 1998. Part of that increase can be accounted for by better detection, because mammography is much more available than it was 30 years ago. But use of post-menopausal estrogen supplements has also become routine, and these have been clearly linked to cancer in women.

But in that same period, incidence of breast cancer among men increased by 26 percent, and that’s without the ingested estrogen and without the extra detection offered by mammography, since men typically don’t pursue that procedure.

So what else is going on? Experts say the increase in breast cancer in both sexes seems to closely track the increase in American obesity, giving rise to the theory that the obesity crisis may actually be to blame for the boom in breast cancer.

Obesity has been shown to have a clear relationship with some cancers, but not with others. For instance, there does not appear to be any correlation between overweight and prostate cancer in men. Or sometimes, the relation is clear, but the reasons aren’t. Hence, researchers are looking at whether acid reflux in overweight people might account for their greater incidence of esophogeal cancer.

But with breast cancer, there is at least one known culprit: all that excess estrogen. Fatty tissue produces estrogen, in both men and women.

Studies of menopausal women make the case most clearly. Before menopause, the ovaries are the primary source of estrogen. But after menopause, when the ovaries have retired from that duty, fatty tissues are the main estrogen source.

Among postmenopausal women, estrogen levels are 50 to 100 percent higher in heavy women, compared to those of healthy weight. Similar ratios are found among men.

And when estrogen-sensitive tissues get more estrogen exposure, that leads to more growth of estrogen-responsive breast tumors.

Researchers figure that between 11,000 and 18,000 breast cancer deaths per year could be avoided in American women over age 50, if they could maintain a healthy body weight throughout their adult lives. There are no similar guesstimates for men, because while breast cancer is a growing problem for men, there is little research on mortality rates among males, and it is still less of a concern than heart disease or prostate and colon cancer.

But obesity puts men at higher risk for these diseases, as well, so the imperative is to drop that excess weight, or at least some of it. There’s abundant evidence that even a minor weight loss reaps huge rewards for health. So how do you do it?

It’s tough, especially if you’re an older person, and the average age of diagnosis for breast cancer is 62 among women, and 67 among men.

Motivation counts, but the research shows that it’s not enough. People need help. For instance, who would be more motivated to lose weight than a heavy person who had already survived cancer?

An overweight survivor has a double whammy when it comes to risk of recurrence, but a study published earlier this year in Obesity Research said that even among that motivated group, people left to their own devices, or those who only had a group program did not achieve much weight loss.

This is no surprise to those of us who have treated obesity for years. We see people who have tried diet after diet, joined gym and club and fellowship alike, all to no avail. But when they are treated with a comprehensive diet and lifestyle modification program that has been designed specifically for them, things change.

In this latest study, the researchers were pretty unequivocal, concluding that “for breast cancer survivors to lose weight to reduce risk factors, intervention is necessary. Of the different intervention regimens, individualized counseling combined with attending weekly … meetings was most effective….”

When you’re facing a chocolate éclair, death is perhaps too abstract an idea, even if you’ve only narrowly escaped it. Without some real retraining, it’s hard to equate even the greasiest burger with a lethal tumor. But professional support makes all the difference.

For instance, I’ve been tracking insulin levels in weight management patients for years, because we know that high insulin levels indicate a metabolic abnormality that leads to diabetes and weight gain. Now recent research shows that elevated insulin levels are also a risk factor for breast cancer recurrence.

Yet very specific changes in lifestyle and diet can significantly reduce insulin levels in days to weeks, immediately reducing those disease risks. The disembodied threat of disease is sometimes hard for people to get their arms around, but when patients can look at their lab results and see how their behavioral changes directly affect their blood chemistry, it hits home.

What happens to patients’ bodies on the inside as they lose weight is more important than the changes they get on the outside, but even at the best health clubs or peer support groups, they won’t have an opportunity to see that.

It’s inspiring to see how people embrace a fitness and weight-loss program when they have more than just a bathroom scale to tell them that it’s working. Consistent and reliable guidance is essential because nobody goes from obese to healthy overnight. It takes time.

But cancer takes time, too, so the race is on. With the proper help, this is a race both men and women have great odds of winning.

THROUGH THICK & THIN

Breast cancer is a growing risk for both men and women, and it’s a cancer for which the obesity link has been clearly established. Fat produces excess estrogen; excess estrogen produces breast cancer. And in the reverse, weight loss reduces cancer risk. The data are clear, but it doesn’t make the task any easier. What does make it easier, and more successful, is professional help - and the sooner the better.

Caroline J. Cederquist, M.D. is a board certified Family Physician and a board certified Bariatric Physicians (the medical specialty of weight management). Dr. Cederquist is the founder of Bistro MD formerly Diet To Your Door, a home diet delivery program that specializes in low calorie gourmet food that is delivered to your home or office. Bistro MD serves as culmination of Dr. Cederquist’s expertise and experience in the world of medical weight loss.

Breast cancer is one of the dreaded women illnesses that has affected millions of women all over the world. All women should be concerned with breast cancer because it is a risk they have to live with. The greater they know about the risk, the more they will be able to fight back.

Most women discover breast cancer too late because of the lack of regular breast check ups or mammography. Some women think they could not get breast cancer while most would rather ignore the thought thinking it would all go away and they would not get it if they do not think of the illness.

The right attitude to take is to go for mammography or breast examinations regularly to be able be secure in the knowledge that one is free from the illness or to be able to detect the illness the soonest possible time.

A woman is expected to do self breast examinations and then see a doctor when an abnormality is discovered. Once the abnormality is confirmed, the doctor would then recommend more tests including biopsy. Biopsy will confirm whether the lump of abnormality is related to breast cancer.

Unlike most illnesses, breast cancer is not easily detected because it does not have painful symptoms. Most women who found out they have breast cancer did not even experience any symptoms at all. However, every woman should watch out for bodily changes that may indicate the presence of breast cancer.

The best time to check for lumps near the breast and underarm area is when a woman is taking a bath. A lump in those areas coupled with some form of nipple discharge as well as changing breast size should be a warning that something is not right. When such conditions are observed, she should immediately go to her doctor and report the changes.

The said changes do not necessarily mean breast cancer is present but it should be reason enough for concern. It is better to have them checked and be given a clean bill of health than suffer the consequences of detecting breast cancer too late.

There are several ways by which a doctor will be able to determine the existence of breast cancer and one of the simplest ways is to carefully feel for lumps in the breast, or in areas near the breast and the underarm. A more technical manner of detecting breast cancer is mammography or breast x-rays. The doctor can also opt for ultrasonography to determine the type of lump felt near or in the breast area.

The part most women dread during serious breast examinations is when the doctor tells them that he needs to get some fluid samples from the lump in the breast to determine whether it is cancerous or not. The examination will determine whether the lump is fluid or solid which may or may not be cancerous at all.

A woman who is detected with breast cancer should not lose hope because it can be treated. Several treatments can be had which will either eliminate the cancer or to minimize its spread to other parts of the body.

Accepting breast cancer is a struggle for every woman and she will need all the Support she can have from family and friends. Therefore an early breast cancer diagnosis is highly important.

Learn more helpful Information About Breast Cancer, and how Breast Cancer Awareness can help with the struggle, all this and more at http://breastcancer.healthandcosmetics.com

I was first diagnosed with breast cancer in October of 1992, at the age of 37. My life changed that day, in ways that I wouldn’t fully understand until many years later.

I was living in Miami at the time, a city I had lived in during my teenage years. I have many friend there and thought it would be nice to live and work there for a year before returning to California, where I am originally from. I took a job with the Department of Transportation and moved to a house in an area called Cutler Ridge in January of 1992.

On the weekends I saw all of the people that I had known since I was twelve years old and first living in south Florida. We would go to the beach and spend time catching up after all those years. Although I had regularly visited I had not spent much time in Miami since I had returned to California in 1974.

On August 17, 1992, Hurricane Andrew struck Miami. The house I was renting was torn apart and I spent six hours in a closet with my little dog and my insurance policy. When I was finally able to come out of the closet my world had forever changed. I lost everything, except for my life. I thanked God every minute for sparing me after such an ordeal.

I was ready to return to California when I became quite ill. After seeing three different doctors I was told that I had breast cancer and would have to undergo a radical mastectomy. I was finally able to return to California in time for Thanksgiving, but the doctors were sure that I would not see Christmas. Again I asked God to spare my life. I told Him that I had important work to do for Him, and promised to spend the rest of my life making Him proud.

Here I am, 14 years, 6 months, and 8 days later. I have kept my promise. I have also kept a positive attitude. I believe that my outlook on life is what keeps me going. I do have important work to do and I remember that each and every day. Each moment is a gift from God and I don’t forget that. Gratitude is another part of each of my days. My most important letter of gratitude was one I wrote to my first oncologist last year. I thanked him for what he had done to save my life and told him a little about how I live my life. I hope and believe that God is proud of me.

Connie Ragen Green is a motivational speaker and writer living in southern California. Visit her at http://www.ReinventYourLifeWithPassion.com/

The insidiousness of breast cancer is without parallel - affecting over a million people a year worldwide and claiming the lives of women at a rate second only to lung cancer. As women battle for their lives on a daily basis, a grassroots movement to educate the women of the world continues to surge.

Those who are affected by breast cancer know that recovery stems from early detection and proper treatment; and in order to detect symptoms and find effective treatment, women need to have access to up-to-date information; thus evolved the promotion of breast cancer awareness.

Breast cancer awareness encompasses the education and empowerment of women and men worldwide and encourages them to act as advocates for their own care; it includes a comprehensive plan for focusing on the whole person and the many ways in which breast cancer and prevention can be approached.

One of the first components of raising breast cancer awareness includes awareness of education, literacy, and research. There is so much research being done on a daily basis to further the cause of treatment and to one day find a permanent cure. In order for patients and families to feel connected to the process, they must be kept informed as to what advancements have been made.

The breast cancer awareness campaign works to make sufferers and families aware of the places in which to find comprehensive information. In today’s age of technology, most people find their information via the Internet; there are a host of reputable and valuable websites that provide a wealth of continually updated information.

Prevention is a large part of awareness and part of the work of the campaign is to make people aware of the ways in which they can prevent breast cancer. This includes making people aware of up-to-date information regarding diet and exercise, as well as the effects of other lifestyle and environmental stressors on the possibility of getting this cancer.

Most importantly, awareness focuses on the importance of screening for early detection so that treatment options are immediately available to increase the chance of survival and ongoing health. Doctors recommend screenings from 35 years of age and up; more than 50% of diagnosed cases of breast cancer are found in women over the age of fifty. Such screenings include routine gynecological examinations, mammograms, breast ultrasound and, most importantly, breast self-examination. Spreading the message of screenings is especially important in low-income areas where women tend to avoid medical care because of the cost.

Of course, breast cancer awareness also includes knowing where to turn for treatment and what that treatment may entail. In the spirit of providing people with accurate and up-to-date information, many of the websites and other informational centers that feature educational resources, will also include comprehensive information regarding treatment options. This is vitally important for people struggling to make choices regarding their health.

But one of the most important aspects of awareness is reminding the people that are engrossed in the fight that they are a part of a larger community where they can find support and camaraderie.

Breast cancer awareness saves people’s lives. It can be the bridge from people - to information. And for those who are faced with a frightening diagnosis and unsure of where to turn, the information imparted through the awareness campaign can be a beacon of hope.

For more information on breast cancer try visting http://www.breastcanceranalysis.com - a website that specializes in providing breast cancer related information and resources including information on breast cancer awareness.

Cancer accounts to a death of 6 million human lives per year. Modern medicine is aging with breath taking advances in cancer care with increasing awareness, preventing, detection, therapy, research and symptom management. Last 15 years has been a revolution. It is likely to fight Cancer out by getting an early detection especially at a pre cancer stage thus yielding best cure with much shorter treatment time, lesser cost, lesser body insult.

Am I at risk for breast cancer? Breast cancer is the most common malignancy-affecting woman in North America and Europe. Every woman is at risk for breast cancer. Close to 200,000 cases of breast cancer were diagnosed in the United States in 2001. Breast cancer is the second leading cause of cancer death in American women behind lung cancer. The lifetime risk of any particular woman getting breast cancer is about 1 in 8 although the lifetime risk of dying from breast cancer is much lower at 1 in 28. The diagnosis once confirmed by Doctor shocks in such a way that not only the patient suffers but entire family suffers the shock. Thus the patient and family both suffer differently and that adds to the total burden of cancer related illness.

Know your breast: The breast is a collection of glands and fatty tissue that lies between the skin and the chest wall. The glands inside the breast produce milk after a woman has a baby. Each gland is called as lobule and many such lobules make up a lobe. There are 15 to 20 lobes in each breast. The milk gets to the nipple from the glands by way of tubes called ducts. The glands and ducts get bigger when a breast is filled with milk, but the tissue that is most responsible for the size and shape the breast is the fatty tissue. There are also blood vessels and lymph vessels in the breast. Lymph is a clear liquid waste product that gets drained out of the breast into lymph nodes. Lymph nodes are small, pea-sized pieces of tissue that filter and clean the lymph. Most lymph nodes that drain the breast are under the arm in what is called the axilla.

Risk factors for breast cancer: They can be divided into those that you cannot change and those that you can change. Some factors that increase your risk of breast cancer that you cannot alter include being a woman, getting older, having a family history (having a mother, sister, or daughter with breast cancer doubles your risk), having a previous history of breast cancer, having had radiation therapy to the chest region, being Caucasian, getting your periods young (before 12 years old), having your menopause late (after 50 years old), never having children or having them when you are older than 30, and having a genetic mutation that increases your risk. Genetic mutations for breast cancer have become a hot topic of research lately. Between 3-10% of breast cancers may be related to changes in either the gene BRCA1 or the gene BRCA2.

Women can inherit these mutations from their parents and it may be worth testing for either mutation if a woman has a particularly strong family history of breast cancer (meaning multiple relatives affected, especially if they are under 50 years old when they get the disease). If a woman is found to carry either mutation, she has a 50% chance of getting breast cancer before she is 70. Family members may elect to get tested to see if they carry the mutation as well. If a woman does have the mutation, she can get more rigorous screening or even undergo preventive (prophylactic) mastectomies to decrease her chances of contracting cancer. The decision to get tested is a highly personal one that should be discussed with a doctor who is trained in counseling patients about genetic testing.

Certain factors which increase a woman’s risk of breast cancer can be altered including taking hormone replacement therapy (long term use of estrogens with progesterone for menopause symptoms slightly increases your risk), taking birth control pills (a very slight increased risk that disappears in women who have stopped them for over 10 years), not breastfeeding, drinking 2 to 5 alcoholic drinks a day, being overweight (especially after menopause), and not exercising. All of these modifiable risk factors are not nearly as important as gender, age, and family history, but they are things that a woman can control that may reduce her chances of developing a breast malignancy. Remember that all risk factors are based on probabilities, and even someone without any risk factors can still get breast cancer. Proper screening and early detection are our best weapons in reducing the mortality associated with this disease.

What are the signs of breast cancer? Unfortunately, the early stages of breast cancer may not have any symptoms. This is why it is important to follow screening recommendations. As a tumor grows in size, it can produce a variety of symptoms including: lump or thickening in the breast or underarm, change in size or shape of the breast, nipple discharge or nipple turning inward, redness or scaling of the skin or nipple, ridges or pitting of the breast skin

Can you prevent breast cancer? The individual cannot control the most important risk factors for the development of breast cancer. There are some risk factors that are associated with an increased risk, but there is not a clear cause and effect relationship. In no way can strong recommendations be made like the cause and effect relationship seen with tobacco and lung cancer. There are a few risk factors that may be modified by a woman that potentially could influence the development of breast cancer. If possible, a woman should avoid long-term hormone replacement therapy, have children before age 30, breastfeed, avoid weight gain through exercise and proper diet, and limit alcohol consumption to 1 drink a day or less. For women already at a high risk, their risk of developing breast cancer can be reduced by about 50% by taking a drug called Tamoxifen for five years. Tamoxifen has some common side effects (like hot flashes and vaginal discharge), which are not serious and some uncommon side effects (like blood clots, pulmonary embolus, stroke, and uterine cancer) which are life threatening. Tamoxifen isn’t widely used for prevention, but may be useful in some cases.

There are limited data suggesting that vitamin A may protect against breast cancer but further research is needed before it can be recommended for prevention. Other things being investigated include phyto estrogens (naturally occurring estrogens that are in high numbers in soy), vitamin E, vitamin C, and other drugs. Further testing of these substances is also needed before they can be recommended for breast cancer prevention. Right now, the most important thing any woman can do to decrease her risk of dying from breast cancer is to have regular mammogram screening, perform breast self-exams once a month. Follow a few, easy steps, you will soon know what is normal for you and will quickly be aware of any changes. If you find a lump or other change, note down where it is and make an appointment to see your doctor as soon as possible.

Question for young women’s are how to look? Well it is medically suggested that you stand up straight in front of a mirror with your arms loosely by your sides. Raise your arms above your head and move from side to side so you can see your breasts in the mirror, from different angles. What should you look for? A change in the size of either breast, change in the shape or position of nipple, bleeding or discharge from the nipples, unusual dimpling or puckering.
How do you feel for changes? Lie flat on your back with your head on a pillow. Put a folded towel under the shoulder on the side of the breast you are checking. This helps to spread the tissue so that it is easier to feel. Examine one breast at a time. Put the hand on the same side of the breast that you are going to examine under your head. With your other hand flat and fingers together, use the flats of your fingers to feel around the breast in small, circular movements, in an anticlockwise direction. Cover the whole of the breast including the nipple. Check your armpit for lumps in the same way, starting in the hollow and moving down towards the breast.

Now examine the other breast in the same way. If you think you have found something, feel the same area on the opposite breast. If they are the same it’s probably just your shape, but if you are at all worried, do visit your doctor. Breast cancer happens when cells in the breast begin to grow out of control and can then invade nearby tissues or spread throughout the body. Large collections of this out of control tissue are called tumors. However, some tumors are not really cancer because they cannot spread or threaten someone’s life. These are called benign tumors. The tumors that can spread throughout the body or invade nearby tissues are considered cancer and are called malignant tumors. Theoretically, any of the types of tissue in the breast can form a cancer, but usually it comes from either the ducts or the glands. Because it may take months to years for a tumor to get large enough to feel in the breast, we screen for tumors with mammograms, which can sometimes see disease before we can feel it.

The earlier that a breast cancer is found, the more likely it is that treatment can be curable. Screening mammograms are simply x-rays of each breast. The breast is placed between two plates for a few seconds while the x-rays are taken. If something appears abnormal, or better views are needed, magnified views or specially angled films are taken during the mammogram. Mammograms often detect tumors before they can be felt and they can also identify tiny specks of calcium that could be an early sign of cancer. Regular screening mammograms can decrease the mortality of breast cancer by 30%. Woman should get a yearly mammogram starting at age 40 (although some groups recommend starting at 50), and women with a genetic mutation that increases their risk or a strong family history may want to begin even earlier. Between the ages of 20 and 39, every woman should have a clinical breast exam every 3 years and after age 40 every woman should have a clinical breast exam done each year.

There are some experimental screening modalities that are currently being studied. These include MRI, ductal lavage, ultrasound, optical tomography, PET scan, and digital mammograms. Depending on the results of the mammograms and/or ultrasounds, your doctors may recommend that you get a biopsy. A biopsy is the only way to know for sure if you have cancer, because it allows your doctors to get cells that can be examined under a microscope. There are different types of biopsies; they differ on how much tissue is removed. Some biopsies use a very fine needle, while others use thicker needles or even require a small surgical procedure to remove more tissue. Your team of doctors will decide which type of biopsy you need depending on your particular breast mass. Once the tissue is removed, a pathologist will review the specimen. The pathologist can tell if it is cancer or not; and if it is cancerous, then the pathologist will characterize it by what type of tissue it arose from, how abnormal it looks (known as the grade), whether or not it is invading surrounding tissues, and if the entire lump was excised, the pathologist can tell if there are any cancer cells left at the borders (also known as the margins). The pathologist will also test the cancer cells for the presence of estrogen and progesterone receptors as well as a receptor known as HER-2/neu. Basic 4 stages of breast cancer are called as

Stage 0 (called carcinoma in situ) Lobular carcinoma in situ (LCIS) refers to abnormal cells lining a gland in the breast. Ductal carcinoma in situ (DCIS) refers to abnormal cells lining a duct.

Stage I - early stage breast cancer where the tumor is less that 2 cm across and hasn’t spread beyond the breast

Stage II - early stage breast cancer where the tumor is either less than 2 cm across and has spread to the lymph nodes under the arm; or the tumor is between 2 and 5 cm (with or without spread to the lymph nodes under the arm); or the tumor is greater than 5 cm and hasn’t spread outside the breast

Stage III - locally advanced breast cancer where the tumor is greater than 5 cm across and has spread to the lymph nodes under the arm; or the cancer is extensive in the underarm lymph nodes; or the cancer has spread to lymph nodes near the breastbone or to other tissues near the breast

Stage IV - metastatic breast cancer where the cancer has spread outside the breast to other organs in the body

Depending on the stage of your cancer, your doctor may want additional tests to see if you have metastatic disease. If you have a stage III cancer, you will probably get a chest x-ray, CT scan and bone scan to look for metastases. Each patient is an individual and your doctors will decide what is necessary to adequately stage your cancer.
What are the treatments for breast cancer?

Surgery: Almost all women with breast cancer will have some type of surgery in the course of their treatment while some women will be candidates for what is called breast conservation therapy (BCT) where surgeons perform a lumpectomy which means they remove the tumor with a little bit of breast tissue around it but do not remove the entire breast. Some patients will have a sentinel lymph node biopsy procedure first to determine if a formal lymph node dissection is required. Sometimes, the surgeon will remove a larger part (but not the whole breast), and this is called a segmental or partial mastectomy. Most patients with DCIS that have a lumpectomy are treated with radiation therapy to prevent the local recurrence of DCIS.More advanced breast cancers are usually treated with a modified radical mastectomy. Modified radical mastectomy means removing the entire breast and dissecting the lymph nodes under the arm.

Chemotherapy: is the use of anti-cancer drugs that go throughout the entire body. The higher the stage of cancer you have, the more important it is that you receive chemotherapy; however, even stage I patients may benefit from chemotherapy in certain cases. In early stage patients, the risk of recurrence may be small, and thus the benefits of the chemotherapy are even smaller. There are many different chemotherapy drugs, and they are usually given in combinations for 3 to 6 months after you receive your surgery. Depending on the type of chemotherapy regimen you receive, you may get medication every 3 or 4 weeks; and you may have to go to a clinic to get the chemotherapy because many of the drugs have to be given through a vein. Two of the most common regimens are AC (doxorubicin and cycolphosphamide) for 3 months or CMF (cycolphosphamide, methotrexate, and fluorouracil) for 6 months. There are advantages and disadvantages to each of the different regimens that your medical oncologist will discuss with you. Based on your own health, your personal values and wishes, and side effects you may wish to avoid, you can work with your doctors to come up with the best regimen for your lifestyle.

Radiotherapy: uses high-energy rays (similar to x-rays) to kill cancer cells. It comes from an external source, and it requires patients to come in 5 days a week for up to 6 weeks to a radiation therapy treatment center. The treatment takes just a few minutes, and it is painless. Radiation therapy is used in all patients who receive breast conservation therapy (BCT). It is also recommended for patients after a mastectomy that had large tumors, lymph node involvement, or close/positive margins after the surgery. Radiation is important in reducing the risk of local recurrence and is often offered in more advanced cases to kill tumor cells that may be living in lymph nodes.

Hormonal Therapy: When the pathologist examines your tumor specimen, he or she finds out if the tumor is expressing estrogen and progesterone receptors. Patients whose tumors express estrogen receptors are candidates for therapy with an estrogen-blocking drug called Tamoxifen. Tamoxifen is taken by pill form for 5 years after your surgery. This drug has been shown to drastically reduce your risk of recurrence if your tumor expresses estrogen receptors. However, there are side effects commonly associated with Tamoxifen including weight gain, hot flashes and vaginal discharge that patients may be bothered by. There are also very uncommon side effects like blood clots, strokes, or uterine cancer that may scare patients from choosing to take it. You need to remember that your chances of having a recurrence of your cancer are usually higher than your chances of having a serious problem with Tamoxifen, but the decision to undergo hormonal therapy is a personal one that you should make with your doctor. There are also newer drugs, called aromatase inhibitors that act by decreasing your body’s supply of estrogen; these drugs are reserved for patients who have already gone through menopause. Talk to your doctors about these new therapies.

Biologic Therapy: The pathologist also examines your tumor for the presence of HER-2/neu over expression. A compound called Herceptin (or Trastuzumab) is a substance that blocks this receptor and helps stop the breast cancer from growing.

Follow-up testing: Once a patient has been treated for breast cancer, they need to be closely followed for a recurrence. At first, you will have follow-up visits every 3-4 months. The longer you are free of disease, the less often you will have to go for checkups. After 5 years, you could see your doctor once a year. You should have a mammogram of the treated and untreated breasts every year. Because having had breast cancer is a risk factor for getting it again, having your mammograms done every year is extremely important. If you are taking Tamoxifen, it is important that you get a pelvic exam each year and report any abnormal vaginal bleeding to your doctor.

Drink Green Tea: Generations of families in India and Asia have been turning to tea to cure what ails them. Green tea could benefit at least five vital organs, including the heart. Earlier, green tea was thought to improve urinary and brain function, combat beriberi disease, and alleviate indigestion. In other words, green tea was considered to be a multi-purpose elixir, able to treat a wide variety of health problems. But this ancient remedy has now found a place in modern scientific literature, thanks to a new wave of studies on the medicinal properties of green tea. While studies on human subjects have been inconclusive, initial evidence from the laboratory looks incredibly promising.

While green tea can be beneficial in attacking everything from high cholesterol to depression, it has perhaps gotten the most attention for its impact on cancer.
Antioxidants are important because they can stop the enzyme activities that give rise to cancer. In essence, they repair DNA problems that have been caused by oxidants or free radicals. Green tea has been considered a godsend for good health because it contains antioxidants known as catechins. These substances have been called impressive inhibitors of cancer growth. Here’s how they do it: lab tests show that they combat oxidants prior to cell injuries, stop the growth of tumor cells, and reduce the occurrence of tumors.

This article is meant to give you a better understanding of breast cancer. Use this knowledge when meeting with your physician, making treatment decisions, and continuing your search for information.

Stay Healthy, as Health is Wealth!