DESCRIPTION
Breast cancer is the development of abnormal cells within the breast tissue. These cells grow and replace normal healthy tissue. Breast cancer is a treatable disease. Early detection is the key to surviving breast cancer.

At first the cancer is a small, firm, usually painless lump, not noticeable unless you are looking for it. With time it grows and spreads to nearby areas, such as muscle, skin or the lymph nodes under the arm. Ultimately the tumor can spread to vital organs such as the liver, brain and lungs.

INCIDENCE

A report from the National Cancer Institute (NCI) estimates that one in eight women in the United States will develop breast cancer during her lifetime. Currently, breast cancer is the third leading cause of death for women in the United States.

RISK FACTORS
Any woman can get breast cancer and though much less common, males can have breast cancer too. Some women are more likely to develop breast cancer than others are. Factors that increase a woman's chance of developing breast cancer include:

• Having a mother or sister with breast cancer
• Never having children
• Having a first child after age 30
• A history of radiation exposure

Two factors that are being evaluated for possible links to breast cancer are obesity and regular alcohol intake. There is no evidence that prolonged use of oral contraceptives causes breast cancer, but this possibility also continues to be investigated.

DETECTION
To detect breast cancer at the earliest possible time, every woman, from the time she is old enough to have pelvic exams, should do all of the following:

• Perform a breast self-exam every month
• Have a breast exam by her doctor annually
• Have a baseline mammogram and follow-up
• Have mammograms according to the schedule recommended by her physician

The first sign of breast cancer is usually a lump in the breast. Nipple discharge and skin changes on the breast are also symptoms that should not be ignored. In the early stages of the disease there are generally no other symptoms.

DIAGNOSIS
Most breast lumps are not cancer, but every lump must be evaluated. Often the lumps are fluid-filled cysts within the breast tissue that change with the menstrual cycle. Evaluation of the lump usually involves an exam by a health care provider, a mammogram (a special X-ray of the breast) and either a needle aspiration or a biopsy.

• Needle aspiration is a method for diagnosing breast cysts. After you are given a local anesthetic to numb the area, the physician inserts a needle into the breast lump. If the doctor is able to remove fluid, the lump is a fluid-filled cyst and not cancer. Removing the fluid also makes the lump go away.
• If fluid cannot be removed from the lump, a breast biopsy may be done. The physician will numb the area, make a cut in the breast and remove the tissue forming the lump. The breast tissue is then examined for possible cancer cells

TREATMENT
If a breast lump is cancerous, the woman, her surgeon and her oncologist (cancer specialist) will make the decisions for treatment. These decisions will be based on the type and size of the cancer and whether it has spread to lymph nodes or other parts of the body.

Possible surgical treatments are lumpectomy (removing the cancerous tissue only) or mastectomy (removing the entire breast). Other possible treatments are radiation and chemotherapy. These different treatments may be used alone or in combination.

A woman who is considering a mastectomy should discuss the options and timetable for reconstructive surgery with her surgeon.

TAKING CARE OF YOURSELF
Women with breast cancer need a range of supportive services that are available in or near most communities. Groups and agencies may be located through physicians' offices or the local American Cancer Society office.

Breast cancer survival continues to improve. As more women do regular breast self-exams, more cancers are found early. As screening mammography and other technology improve, more cancers are being detected before they can be felt or suspected. Early detection and treatment of breast cancer greatly increase your chances of survival.