Total Breast Care And Maintenance

Your Ultimate Breast Health Companion

Total Breast Care And Maintenance

Contents A Note for all Readers Introduction Part 1: About Your Breast Learn About Your Breast 8 Fun Facts about Your Breast

Part 2: Breast Self Check About Breast Self Check (BSE) When is the best time to do Breast Self Check (BSC) Breast Self Check Procedure

Part 3: How to Choose the Right Bra & Wear It the Right Way? Importance of Wearing the Right Bra Determining Your bra size and cup Does Your Current Bra Fit You? Are you wearing your bra the right way? Different types of bra for different clothing

Part 4: About Mammogram What is mammogram? Different types of mammograms Are mammograms safe How is a mammogram done How is a mammogram done in a woman with breast implants How often should I get a mammogram? How can I get ready for my mammograms Are there any problems with mammograms

Part 5: Breast Cancer Information About Breast Cancer Understanding of Breast Cancer Are you at risk? Detection of Breast Cancer Screening and Examination of Breast Cancer Diagnosis of Breast Cancer

A Note for all Readers

This manual contains materials protected under international and federal copyright laws and treaties. Any unauthorized re-print or use of these materials is prohibited. This breast care information is distributed by http://www.anbes.com. The information and materials provided on this information kit are to be used for informational purposes only. It should not be construed as personal medical advice or instruction. No action should be taken based solely on the contents of this information kit. Always consult your physician or other health care professional before making any decision based upon something that you have read here. EPublishingVault.com or its distributors assume no responsibility for the use or application of any posted material. For more information on Total Wellness and Breast Enhancement you should visit http://www.anbes.com/newsletter.htm to subscribe to ... "Free Breast Enhancement And Wellness Newsletter." A Glimpse Of What You Will Be Receiving ...
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Introduction
Just as important as applying moisturizers onto our face religiously day and night, our breast needs to be given extra attention and tender care to maintain their appearance, keeping them firm and perky. Performing breast care is not a tedious task, however, you will be surprised by the number of women who seemingly taken their current breast health for granted. Woman today do not give sufficient attention to their breast thus causing them to regret, which could have been too late. Premature sagging of breast, late diagnosis of Breast cancer, unnecessary discomfort concerning your breast health are results of poor breast maintenance. The aim of this information kit is to provide all the essential information on breast care. You will learn more about your breast, how to select and wear bra the correct way, breast self check, mammogram information, and breast cancer prevention and treatment options are covered too.

News Article From "The Nation" Deputy Public Health Minister of Thailand said he had learnt that Pueraria Mirifica (kwao kreu) could be used as a supplemental hormone for menopausal women, could enhance breasts, and could even create new brain cells to treat Alzheimer's disease. He said research done at King Mongkut Hospital had also found that the herbs could be useful in preventing breast cancer. News Article From Ohio, USA There's new information that suggests an herbal plant will enhance your breast. News Channel 5 reports new finding show if women take an herb called Pueraria Mirifica, it will increase their breast size. "The root is presumed to contain substances that might have an effect on glands," say medicinal plant expert Varro Tyler, Ph.D. The herb is so popular that demand is outweighing supply." News Article From Thailand Miracle Jungle Root Of Thailand A jungle root that grows in the north of Thailand is believed to enlarge the breasts of women who take it. Firms from Japan, Germany and the United States have been conducting research into the Pueraria Mirifica root, a source in Thailand's Agriculture Department told the Bangkok Post. As reported on NEWS NET 5 Cleveland, Ohio USA

Unpublished Story Of ANBES Pueraria Mirifica Breast Serum. Many years even before the first Pueraria Mirifica is grown, the founder of ANBES Breast Serum began a long and tedious research to determine the best species that holds the most amounts of miroestrol and deoxymiroestrol inside the root of Pueraria Mirifica plant. Studies from independent laboratory shows that ANBES Pueraria Mirifica contains 42.44% of active phytoestrogen out of every 100g 30% more than most brand name found in the market. After he found the right type of Pueraria Mirifica, he proceed to create an organic growing environment, to grow their own Pueraria Mirifica. As he believe this is the best way to ensure the safety and consistency of the roots. All Pueraria Mirifica are harvest only at their maturity. He took great pain to ensure and maintain a high quality manufacturing environment to turn the Premium Pueraria Mirifica roots into their respective products, which include skincare and breast enhancement. All products that failed his personally manage Quality Management Task Force will be destroyed immediately. All roots need to first run through the washing and peeling machine before they are grinded into powder by a high speed slicing machine. All the powder are then dried by passing through special UV light and air sprayed to jet out all possible moisture. All this process is done in GMP certified factories where sanitation comes first. As far as I know, there is no other manufacturer that come close to their tightly monitor manufacturing system. Thats not all Breakthrough Technology It Makes All The Usual Breast Enhancement Creams and Serums Like Applying Moisturizer On Your Breast. Introducing Nanotechnology let me give you some background information. As part of the FY 2004 Budget, President Bush requested $849 million for nanotechnology R&D across all of the agencies that participate in the NNI. This represents an increase of approximately 10% over the amount appropriated by Congress for FY 2003. The 2005 budget request that President Bush has sent to Congress calls for a total NNI budget of $982 million, which represents a 2% increase over estimated expenditures for FY 2004. Government Agencies involved, include, NSF DOD DOE HHS(NIH) DOC(NIST) NASA USDA EPA DHS

To put it simply, Nanotechnology is the invention of small particles in Nano-size that does amazing things where normal size particles are unable to. It has the capacity to penetrate deep down into the skin layer while the core of the particle is being protected while carrying variety of substances to pass into the inner skin layer. This effective mechanism will target directly to the skin organ which will result in gaining the most benefit from the composition.

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Part 1: About Your Breast

Learn About Your Breast The surface of a human breast has a circular, pigmented area in the center called the areola. The nipple, a rounded protruding structure, lies in the center of the areola. In mature women the breast contains a collection of 10 to 15 tubes, called ducts, that connect to the nipple. These ducts branch out from the nipple into the interior of the breast, ending in clusters of rounded cells, called lobules, that produce the milk. In addition to the structures directly connected with the production and outflow of milk, the breast is composed of fatty tissue and ligaments that provide support and shape. In humans, a womans breast size and shape vary widely, depending on her age and whether she is pregnant or going through a menstrual cycle. Breast development begins in girls about 10 to 12 years old, when the ovaries start to produce the hormone estrogen. Completion of breast development, which occurs around 16 to 18 years old, requires the interaction of other hormones such as progesterone, prolactin, and corticosteroids. After breast growth is completed, the breasts typically undergo monthly cyclic changes in response to fluctuating hormone levels in the blood that occur during the menstrual cycle. Just before the onset of menstruation, the breasts are often swollen and tender because the ductal

system expands in preparation for pregnancy. If pregnancy does not occur, the estrogen level falls and the breasts return to normal. During pregnancy there is a remarkable growth of ducts and lobules in the breast along with a thickening of the nipples. After a baby is born, the hormone prolactin stimulates milk production in the breast. Initially, the breast produces a thick yellow liquid called colostrum, which is particularly rich in the disease-fighting substances called antibodies. Within three to five days, the breast produces milk as the suckling infant stimulates the release of another hormone called oxytocin. This hormone causes contractions in the network of cells that surround the ducts and lobules, so that milk readily flows from the breast and into the mouth of the hungry infant. As a woman passes the childbearing age and enters menopause, the ovaries stop producing estrogen. The decreased stimulation from this hormone causes the milk-producing ducts and lobules in the breast to be replaced with extra fatty tissue. Female Breast

The female breast is either of two mammary glands (organs of milk secretion) on the chest.

8 Fun Facts about your Breasts There's more to taking care of your twins than doing self-exams and wearing a good bra. Read on as we reveal important info -- and a few downright bizarre details -- about your precious pair. For all the attention breasts get from men (and the media), you probably know surprisingly little about yours. Maybe it's because you've had your set for years now, and you view them simply as a bodacious accessory. Or your twin peaks seem so low-maintenance, you've never had a reason to give them much thought. Well, hold on to your bra straps -- truth is, your boobs are a hell of a lot more than just two bumps that keep your bikini top in place. To give you a better understanding, we've put together 8 of the most fascinating facts about your bosom buddies. 1. Breasts get fat as you age. In your 20s, your boobs are made up of fat, milk glands and collagen -- the connective tissue that keeps them firm. But as you age, the glands and collagen shrink and are replaced by more and more fat. The added flab can send breasts down, instead of

increasing your bra size. Wearing an underwire bra (whether you're an A-cup or a D) can help fight sagging over time. 2. You have gained weight, but it is not your set fault. That surge in the scale isn't your set's fault: An A-cup clocks in at only a quarter pound; a B, about half a pound; a C, three-quarters of a pound; and a D, around one pound. 3. Thin-skinned and need extra care. Because they were stretched as you developed, breasts have thinner skin than the rest of your body, leaving them susceptible to dryness. Use firming cream that stimulates collagen and elastin growth and has UV protection and retinol to prevent wrinkling. Don't forget your nipples either; they too need moisturiser as they are also prone to dryness. 4. Stray strands, are they normal? Almost all women have some degree of nipple hair. It is common if you have 4 to 15 dark, straight strands growing at one time. Generally, the darker your skin and the hair on your head, the more nipple hair you'll have. It's easier to tweeze if you only have a few bothersome nipple hair. Otherwise, waxing it away is also fine. Wipe down the affected skin with an antibacterial lotion to prevent infection after plucking them off. 5. They may point in different directions. Not only do nipples come in varying sizes, they also point in different directions. Some areolae rest a little higher, which can angle the nipples upward. Others rest lower or are closer to the edges of the breasts. Some women even sport a pair that aim in opposing directions. 6. They have their own monthly cycle. Fluctuating hormones cause your breast tissue to change and feel differently. The week before and during your period, extra progesterone may leave your breasts swollen, bumpy and tender. After your period, breast tissue usually feels smoothest. During midcycle, your nipples may become more sexually sensitive, due to increased estrogen levels. 7. About 2 million of women have fake breasts. About two million women in the United States have breast implants, with 250,000 going under the knife each year. The average age of a woman who gets implants is 34, and 90 percent do it after they have had kids. Most women increase by 2 cup sizes after the implants. But not every women who underwent implants are always happy with the results: about 6% of women with breast implants return for a size adjustment or to have them taken out altogether. 8. Watch out, Breast Implants Have its Risks Side effects like implant breasts deflating, leaking or becoming wrinkled can happen for breast implants. This usually will require another operation to replacement the faulty ones. The breast may feel hard if after surgery complication called capsular contracture occurs. This happens when the scar tissue that naturally forms around implants tightens. A surgery is required to fix the problem. In addition, as with any operation, there's the small but dangerous risk of infection and excessive bleeding.

Part 2: Breast Self Check

About Breast Self Check (BSE) What is breast self check, and why is it so important? Lets find out in this section. Breast self check is a procedure that takes no more then 10 min yet contributes much more in the long run. BSE is considered a preventive measure for breast cancer. Although it doesn't prevent breast cancer from occuring, it helps early detection which aides recovery process tremendously. Physicians encourage regular breast self-examinations in which a woman uses her fingers to feel for changes in breast shape and fluid discharge from the nipple. Breast lumps are usually discovered by the woman herself or by her sex partner. These lump are mostly non cancerous, However, if anything unusual is observed immediate report to your family doctor is needed. When is the best time to do Breast Self Check (BSC) It is important to do a Breast Self Exam around the same day in your cycle every month. The most suitable time for a BSE will be one week after your period, as your breasts are not swollen or tender from PMS etc.

Breast Self Check Procedure:

Stand up and place one hand behind your head. Hold the fingers of the other hand flat. Gently touch every part of the breast below the raised arm. Feel for lumps, bumps or thickening. Now do the other breast.

 Stand in front of a mirror. Place your hands on your hips. Inspect each breast for changes in size, shape and form. Do it again with your arms raised above your head

Lie back with a pillow or folded towel under your right shoulder. Place your right hand behind your head. Examine every part of your breast with the fingers of the left hand held flat. Feel for lumps, bumps or thickening. Now do the other breast. Be sure to follow a consistent pattern. You may want to use one of the following patterns:

Wedges : Starting at the outer edge of the breast, move your fingers toward the nipple and back to the edge. Check your whole breast, covering one small wedge-shaped section at a time. Be sure to check the underarm area and the upper chest

Lines : Start in the underarm area and move your fingers downward little by little until they are below the breast. Then move your fingers slightly toward the middle and slowly move back up. Go up and down until you cover the whole area.

Circles : Beginning at the outer edge of your breast, move your fingers slowly around the whole breast in a circle. Move around the breast in smaller circles gradually working toward the nipple. Don't forget to check the underarm and upper chest areas.

Rest your arm on a firm surface like the top of a bookshelf. Examine the underarm. Feel for lumps, bumps or thickening in the same way. Now do the other underarm.

In time, These steps will become familiar to you and you will begin to get use to the "feel" of your breasr. As you become more familiar with the "feel", the easier it is for you tol recognize any breast abnormalities. Ask your your family doctor for more information and guidance.

Part 3: How to Choose the Right Bra & Wear It the Right Way?
Importance of Wearing the Right Bra Do you know a good bra of the correct fit is essential to a womans breast? Most women are still unaware that they are not wearing the right bra. Women today should be aware that wearing the wrong bra size could cause all sorts of medical problems. Imagine some of these symptoms you may recognize them: backache, shoulder pain, neck ache, tender, aching bust, soreness under bust, grooves in shoulders, and bad posture

because you either have too much bust or not enough. We are never happy with our lot. These are just a few of the very real problems that can be put right with a good bra. There are so many women out there buying their bras assuming that their size is the same or some guesses their bra size and without trying them on or seeking expert advise. The result is usually more discomfort. The most common complaints are straps slipping off the shoulders, the back riding up, wrinkled cups, not to mention uncomfortable chafing and unsightly bumps and ridges.

Better fitting bras not only feel comfortable but also help your clothes to look better. A wellfitted bra is similar to a pair of well-fitting shoes. Women should re-measured regularly especially during pregnancy, following childbirth, weight loss or weight gain - as the breast size can change dramatically. The advantages of a correct fit bra: no more soreness under the bust, pulling the back down, lifting the shoulder swaps and popping back in what has flowed out, making four boobs. Most women have these problems. Having the correct fit can make larger women look smaller and small-busted women bigger; that has to be a bonus.

Determining your bra size and cup It takes an expert eye to find the size and style that will make the very best of each womans figure. It also required in-depth knowledge of the wide variety of bras now available. Although manufacturers use what appears to be standard sizing on their labels, every bra is in fact slightly different. This means that a particular cup size in one style may not give you the right fit with another style or manufacturer. Measuring your bra size and bra cup of exact fit is not difficult, however most women find it unnecessary and a nuisance. This is the major mistake as a good fitted bra brings about many benefits and eliminates unnecessary aliments. Most major department stores and lingerie shops offer this measuring service to their customers. The following is some information for you while taking the measurement for yourself. Your bra size consist of two figures; your back size and your cup. You will need to take two measurements using a tape measure: Back Size: The measurement is taken around the body directly under the bust or your breasts (over your present bra). Especially when buying a strapless bra, the bra has to fit slightly tighter but not too tight otherwise unsightly bulges would be formed. Use the following table to find your exact bra size.

Back Measurement (cms) 63 68 73 78 83 88 67 72 77 82 87 92

Bra back size 30 32 34 36 38 40

Cup size: this is determined the difference between bra back size and the measurement around the fullest part of the bust. Calculate the difference of the 2 measurements, rounding it off to the nearest inch. Use the value to find out its corresponding cup size in the table below.
Difference 1" 2" 3" 4" 5" 6" Cup size A B C D E F

After you have obtained both values, combine the two to get your exact fit size. Does your current bra fit you? Try doing your own measurement for bra and cup size and check if it matches your current bra size. If the size differ it might mean that your bra size have changed. Also, if the bra fits tightly or is uncomfortable even though it is the same size as what you have measured, it might mean that the bra's design have a slightly different cutting or is more suitable for a different breast shape from yours. Bras are like clothes, with different designs and cutting to accentuate different shapes of the breast. No one bra fits all shape. Take your time the next time you shop for undergarments. Ask the shop's staff for help as they can help you do a more accurate measurement and give a good recommendation on which bra they carry is suitable for you. Are you wearing your bra the right way? Wearing your bra the right way is very important. The following technique may sound confusing and complicated, but it isnt as it is simply a break down of the steps. After a few tries, the process will eventually become a habit when you wear your bra. Step 1: You start by slipping your hands through the shoulder straps Step 2: While holding the under-bust bands of your bra, lean your upper body forward and bend downwards allowing your breasts to fall into the cups of the bra. Step 3: Return to normal standing position and fasten the hooks of the under-bust band. Step 4: Now, adjust the shoulder straps to comfortable length, so that they do not cut into the flesh or keep falling off. Step 5: The next step is what I call the 'scooping' action. With one hand holding the side of the bra, insert the other hand in between the breast and the bra cup and gently pull the excess flesh from the underarm area into the breast cup. Step 6: Repeat for the other side. Step 7: Make sure the breasts fit snugly into the bra cups. Adjust bra to ensure that the nipples are in the centre seams of the bra cups. Step 8: Stand up straight to see if the front under bust band and the back band is at the same level. Lift your arms up and a well-fitted bra should not move up. When you wear the right bra, you should feel comfortable. An ill-fitting bra can cause red imprints on your skin, ride up the back, dig into the back, result in flesh bulging from the sides and back and also cause pain.

A cup size that is too small can pinch and be uncomfortable. Well-endowed women should wear bras with full cups and the breasts should not be overflowing from their bra cups. Different types of bra for different clothing The right bra is essential to achieve the desired effect of looking good. Not only can it enhance what you already have, it can also make you look your best in your favorite dress. V-Neck Bra A plunge neckline dress or low neckline top will need a bra that dips low at the front middle band which give support at the side. Convertible Bra A bra which is suitable for all occasions. It can be worn under a strapless dress or under a Tshirt. All you need to do is to adjust the strap to suit your clothes. Sport Bra While performing sports, the correct type of bra is none other then the sports bras. The main reason why a sport bra is worn instead of the daily bra is that while exercising, the breast needs more support comparing to when we are performing our normal activities. On top of that the support , it will also help minimize the bouncing of the breast, which can cause the connective tissue in the breast to be strained. Sports bras are also a good alternative for women who are pregnant as breast fullness and tenderness is a often experienced. The extra support provided by the sports bra help to minimize discomfort. Nursing Bra For mothers who are breast feeding, nursing bra designed with cups that open and close with minimum effort, a nursing bra helps you respond quickly when your baby is hungry. Comfort and support are key, soft fabrics, stretch straps and adjustability will be ideal

Part 4: About Mammogram

What is mammogram? A mammogram is a test that is done to look for any abnormalities, or problems, with a woman's breasts. The test uses a special x-ray machine to take pictures of both breasts. The results are recorded on film that your health care provider can examine. Mammograms look for breast lumps and changes in breast tissue that may develop into problems over time. They can find small lumps or growths that a health care provider or woman can't feel when doing a physical breast exam. Breast lumps or growths can be benign (not cancer) or malignant (cancer). If a lump is found, a health care provider will order a biopsy, a test where a small amount of tissue is taken from the lump and area around the lump. The tissue is sent to a lab to look for cancer or changes that may mean cancer is likely to develop. Detecting breast cancer early means that a woman has a better chance of surviving the disease. There are also more choices for treatment when breast cancer is found early. Different types of mammograms? There are two reasons mammograms are taken. Screening mammograms are done for women who have no symptoms of breast cancer. Diagnostic mammograms are done when a woman has symptoms of breast cancer or a breast lump. Diagnostic mammograms take longer than screening mammograms because more pictures of the breast are taken. In January 2000, the FDA approved a new way of doing mammograms, called digital mammography. This technique records x-ray images on a computer, rather than film. It can reduce exposure to radiation, allow the person taking the x-ray to make adjustments without having to take another mammogram, and takes pictures of the entire breast even if the denseness of the breast tissue varies. Are mammograms safe?? A mammogram is a safe, low-dose x-ray of the breast. A high-quality mammogram, along with clinical breast exam (exam done by a professional health care provider) are the most effective tools for detecting breast cancer early. How is a mammogram done? You stand in front of a special x-ray machine. The person who takes the x-rays (always a woman) places your breasts (one at a time) between two plastic plates. The plates press your breast and make it flat. You will feel pressure on your breast for a few seconds. It may cause you some discomfort, feeling like squeezing or pinching. But, the flatter your breasts, the better the picture. Most often, two pictures are taken of each breast - one from the side and one from above. The whole thing takes only a few minutes. How is a mammogram done in a woman with breast implants?

If you have breast implants, be sure to tell your mammography facility that you have them. You will need an x-ray technician who is trained in x-raying patients with implants. This is important because breast implants can hide some breast tissue, which could make if difficult for the radiologist to see breast cancer when looking at your mammograms. For this reason, to take a mammogram of a breast with an implant, the x-ray technician might gently lift the breast tissue slightly away from the implant. How often should I get a mammogram? Women over 40 should get a mammogram every 1 to 2 years. This guideline was just re-issued by the federal government's U.S. Preventive Services Task Force. And, it is also the position of the Secretary of the U.S. Department of Health and Human Services. Women who have had breast cancer or breast problems, or with a family history of breast cancer may need to start having mammograms at a younger age or more often. Talk to your health care provider about how often you should get a mammogram. Be aware that mammograms don't take the place of getting breast exams from a health care provider and examining your own breasts. If you find a lump or see changes in your breast, talk to your health care provider right away no matter what your age. Your health care provider may order a mammogram for you to get a better look at your breast changes. How can I get ready for my mammograms? First, check with the place you are having the mammogram for any special things you may need to do before you go. Here are some general guidelines to follow: Make your mammogram appointment for one week after your period. Your breasts hurt less after your period. Wear a shirt with shorts, pants, or a skirt. That way you can undress from the waist up and leave your shorts, pants, or skirt on when you get your mammogram. Don't wear any deodorant, perfume, lotion, or powder under your arms or on your breasts on the day of your mammogram appointment. These things can make shadows show up on your mammogram. Are there any problems with mammograms? As with any medical test, mammograms can have limits. These limits include: Mammograms are only part of a complete breast exam. If they show abnormalities your health care provider will follow-up with other tests. False negatives can happen. This means everything may look normal, but cancer is actually present. False negatives don't happen often. Younger women are more likely to have a false negative mammogram than are older women. This is because the breast tissue is denser, making cancer harder to spot.

 False positives can happen. This is when the mammogram results look like cancer is present, even though it is not. False positives are more common in younger women than older women.

Part 5: Breast Cancer Information

About Breast Cancer Breast cancer is the most common type of cancer among women in United States(other than skin cancer). The number of new cases of breast cancer in women was estimated to be about 212,600 in 2003. In the past 50 years, the lifetime risk of breast cancer has nearly tripled in the United States. In the 1940's, a woman's lifetime risk of breast cancer was 1 in 22. In the year 2003, the risk is 1 in 8. Since 1986, female breast cancer rates have increased by 0.6 percent each year in the U.S. In situ breast cancer incidence rates have also continued to increase by 6.1 percent per year over the same period. Breast cancer occurs in men and is increasing at an alarming rate. In 2003 it is estimated that 1,300 men in the U.S. will be diagnosed with breast cancer, a 30 percent increase over the 1,000 diagnosed in 1998. All women are at risk for breast cancer, regardless of hereditary factors. In fact, 85 to 90 percent of breast cancer incidences cannot be explained by hereditary factors. Other known risk factors include: 1. earlier onset of menstruation (12 years or younger), 2. later menopause (55 years or older), 3. late first-term pregnancy (30 years or older), 4. no children or no breast-feeding, 5. early use of oral contraceptives, 6. more than four years use of hormone replacement therapy, 7. postmenopausal obesity, 8. alcohol consumption, 9. exposures to second-hand cigarette smoke, 10. low physical activity and 11. exposure to radiation.

Understanding of Breast Cancer Breast cancer like any other cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body. Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place Sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor. Not all tumors are cancer. Tumors can be benign or malignant: Benign tumors are not cancer:

Benign tumors are rarely life-threatening. Usually, benign tumors can be removed, and they seldom grow back. Cells from benign tumors do not spread to tissues around them or to other parts of the body. Malignant tumors are cancer:

Malignant tumors generally are more serious than benign tumors. They may be lifethreatening. Malignant tumors often can be removed, but they can grow back. Cells from malignant tumors can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the bloodstream or lymphatic system. That is how cancer cells spread from the original cancer (primary tumor) to form new tumors in other organs. The spread of cancer is called metastasis.

When breast cancer cells enter the lymphatic system, they may be found in lymph nodes near the breast. The cancer cells also may travel to other organs through the lymphatic system or bloodstream. When cancer spreads (metastasizes), the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if breast cancer spreads to the bone, the cancer cells in the bone are breast cancer cells. The disease is metastatic breast cancer, not bone cancer. It is treated as breast cancer, not as bone cancer. Doctors sometimes call the new tumor "distant" or metastatic disease. Are you at risk? No one knows the exact causes of breast cancer. Doctors can seldom explain why one woman gets breast cancer and another does not. Doctors do know that bumping, bruising, or touching the breast does not cause breast cancer. And breast cancer is not contagious. No one can "catch" this disease from another person.

However, research has shown that women with certain risk factors are more likely than others to develop breast cancer. A risk factor is anything that increases a person's chance of developing a disease. Studies have found the following risk factors for breast cancer: Age: The chance of getting breast cancer goes up as a woman gets older. A woman over age 60 is at greatest risk. This disease is very uncommon before menopause. Personal history of breast cancer: A woman who has had breast cancer in one breast has an increased risk of getting this disease in her other breast. Family history: A woman's risk of breast cancer is higher if her mother, sister, or daughter had breast cancer, especially at a young age (before age 40). Having other relatives with breast cancer on either her mother's or her father's side of the family may also increase a woman's risk. Certain breast changes: Some women have cells in the breast that look abnormal under a microscope. Having certain types of abnormal cells (atypical hyperplasia or lobular carcinoma in situ [LCIS]) increases the risk of breast cancer. Genetic alterations: Changes in certain genes (BRCA1, BRCA2, and others) increase the risk of breast cancer. In families in which many women have had the disease, genetic testing can sometimes show the presence of specific genetic changes. Health care providers may suggest ways to try to reduce the risk of breast cancer, or to improve the detection of this disease in women who have these changes in their genes. The Cancer Information Service can provide printed material about genetic testing. Reproductive and menstrual history: The older a woman is when she has her first child, the greater her chance of breast cancer. Women who began menstruation (had their first menstrual period) at an early age (before age 12), went through menopause late (after age 55), or never had children also are at an increased risk. Women who take menopausal hormone therapy (either estrogen alone or estrogen plus progestin) for 5 or more years after menopause also appear to have an increased chance of developing breast cancer. Much research has been done to learn whether having an abortion or a miscarriage affects a woman's chance of developing breast cancer later on. Large, well-designed studies have consistently shown no link between abortion or miscarriage and the development of breast cancer. Race: Breast cancer occurs more often in white women than Latina, Asian, or African American women. Radiation therapy to the chest: Women who had radiation therapy to the chest (including breasts) before age 30 are at an increased risk of breast cancer. This includes women treated with radiation for Hodgkin's lymphoma.

Studies show that the younger a woman was when she received radiation treatment, the higher her risk of breast cancer later in life. Breast density: Older women who have mostly dense (not fatty) tissue on a mammogram (x-ray of the breast) are at increased risk of breast cancer. Taking DES (diethylstilbestrol): DES is a synthetic form of estrogen that was given to some pregnant women in the United States between about 1940 and 1971. (DES is no longer given to pregnant women.) Women who took DES during pregnancy have a slightly increased risk of breast cancer. This does not yet appear to be the case for their daughters who were exposed to DES before birth. However, as these daughters grow older, more studies of their breast cancer risk are needed. Being obese after menopause: After menopause, women who are obese have an increased risk of developing breast cancer. Being obese means that the woman has an abnormally high proportion of body fat. Because the body makes some of its estrogen (a hormone) in fatty tissue, obese women are more likely than thin women to have higher levels of estrogen in their bodies. High levels of estrogen may be the reason that obese women have an increased risk of breast cancer. Also, some studies show that gaining weight after menopause increases the risk of breast cancer. Physical inactivity: Women who are physically inactive throughout life appear to have an increased risk of breast cancer. Being physically active may help to reduce risk by preventing weight gain and obesity. Alcoholic beverages: Some studies suggest that the more alcoholic beverages a woman drinks, the greater her risk of breast cancer.

Other Possible Risk Factors Are Under Study. Many risk factors can be avoided and breast cancer can be prevented . Others, such as family history, can't be avoided. It is helpful to be aware of risk factors. But it's also important to keep in mind that most of the women who have these risk factors do not get breast cancer. Also, most women who develop breast cancer have no history of the disease in their family. In fact, except for growing older, most women with breast cancer have no strong risk factors. Still, a woman who thinks she may be at risk of breast cancer should discuss this concern with her health care provider. The health care provider may suggest ways to reduce the risk and can plan an appropriate schedule for checkups. Detection of Breast Cancer Early detection is crucial to the treatment for breast cancer as treatment is more efficient on patients of early stages How? Screening for cancer before there are symptoms can be important. It can help doctors find and treat cancer early. Treatment is more likely to be effective when cancer is found early.

The health care provider may also suggested the following examination and screening tests which is used to check for breast cancer before any of the symptoms develop: 1. Screening mammogram 2. Clinical breast exam 3. Breast self-exam Symptoms Breast cancer can cause changes that women should watch for:

A change in how the breast or nipple feels

o o

A lump or thickening in or near the breast or in the underarm area Nipple tenderness

A change in how the breast or nipple looks

o o o

A change in the size or shape of the breast The nipple is turned inward into the breast The skin of the breast, areola, or nipple may be scaly, red, or swollen. It may have ridges or pitting so that it looks like the skin of an orange.

Nipple discharge (fluid)

Although early breast cancer usually does not cause pain, a woman should see her health care provider about breast pain or any other symptom that does not go away. Most often, these symptoms are not cancer, but it is important to check with the health care provider so that any problems can be diagnosed and treated as early as possible. Screening and Examination of Breast Cancer Screening and examination for cancer should be done annually before the symptoms develops instead of after. The health care provider advises women to take the following types of screening and examinations annually. 1. Screening mammogram 2. Clinical breast exam 3. Breast self-exam 1. Screening mammogram Who should take? Women in their 40s and older should have mammograms (pictures of the breast made with x-rays) every one to two years. Women who are at higher than average risk of breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.

Screening mammograms can often show a breast lump before it can be felt. They also can show a cluster of very tiny specks of calcium. These specks are called microcalcifications. Lumps or specks can be signs of cancer. If the doctor sees an abnormal area on the mammogram, the woman may need more pictures taken. Also, the woman may need to have a biopsy. A biopsy is the only way to tell for sure if cancer is present. (More information on biopsy is in the section on Detection and Diagnosis.) Mammograms are the best tool doctors have to find breast cancer early. However, it is good for a woman to keep in mind that: A mammogram may miss some cancers that are present. (This is called a "false negative.") A mammogram may show things that turn out not to be cancer. (This is called a "false positive.") Some fast-growing tumors may already have spread to other parts of the body before a mammogram detects them. Mammograms (as well as dental x-rays, and other routine x-rays) use very small doses of radiation.Although the benefits nearly always outweigh the risks, repeated exposure to x-rays could be harmful. It is a good idea for a woman to talk with her health care providers about the need for each x-ray and to ask about the use of shields during the x-ray to protect other parts of the body. 2. Clinical Breast Exam During a clinical breast exam, the health care provider feels the breasts while the woman is standing or sitting up and lying down. The woman may be asked to raise her arms over her head, let them hang by her sides, or press her hands against her hips. The health care provider looks for differences between the breasts, including unusual differences in size or shape. The skin of each breast is checked for a rash, dimpling, or other abnormal signs. The nipples may be squeezed to see if fluid is present. Using the pads of the fingers to feel for lumps, the health care provider checks the entire breast, the underarm, and the collarbone area, first on one side, then on the other. A lump is generally the size of a pea before anyone can feel it. The lymph nodes near the breast may be checked to see if they are swollen. A thorough clinical breast exam may take 10 minutes. 2. Breast Self-Exam Some women perform monthly breast self-exams to check for any changes in their breasts. When a woman does this exam, it is important for her to remember that each woman's breasts are different, and that changes can occur because of aging, the menstrual cycle, pregnancy, menopause, or taking birth control pills or other hormones. It is normal for the breasts to feel a little lumpy and uneven. Also, it is common for a woman's breasts to be swollen and tender right before or during her menstrual period.

Women who notice anything unusual during a breast self-exam or at any other time should contact their health care provider. Also, it is important to remember that breast self-exams cannot replace regular screening mammograms and clinical breast exams. Although breast self-exams lead to more breast biopsies, studies so far have not shown that breast self-exams reduce the number of deaths from breast cancer. Diagnosis of Breast Cancer Diagnosis: If a woman has a breast change, her doctor must determine whether it is due to breast cancer or some other cause. The woman has a physical exam. The doctor asks about her personal and family medical history. She may have a mammogram or other imaging procedure that makes pictures of tissues inside the breast. After the tests, the doctor may decide that no further tests are needed and no treatment is necessary. Or the woman may need a biopsy to examine the suspicious area for cancer cells. Clinical Breast Exam The health care provider feels each breast for lumps and looks for other problems. If a woman has a breast lump, the health care provider can tell a lot about it by feeling it and the tissue around it. Benign lumps often feel different from cancerous ones. The health care provider can check the size, shape, and texture of the lump and feel whether it moves easily. Lumps that are soft, smooth, round, and movable are likely to be benign. A hard, oddly shaped lump that feels firmly attached within the breast is more likely to be cancer. Diagnostic Mammography Diagnostic mammograms involve x-ray pictures of the breast to get clearer, more detailed pictures of any area that looks abnormal on a screening mammogram. They also are used to help the doctor learn more about unusual breast changes, such as a lump, pain, thickening, nipple discharge, or change in breast size or shape. Diagnostic mammograms may focus on a specific area of the breast. They may involve special techniques and more views than screening mammograms. Ultrasonography Using high-frequency sound waves, ultrasonography (ultrasound) can often show whether a lump is a fluid-filled cyst (not cancer) or a solid mass (which may or may not be cancer). The doctor can view these pictures on a monitor. After the test, the pictures can be stored on video and printed out. This exam may be used along with a mammogram. Magnetic Resonance Imaging For magnetic resonance imaging (MRI), a powerful magnet linked to a computer is sometimes used to make detailed pictures of tissue inside the breast. The doctor can view these pictures on a monitor and can print them on film. MRI may be used along with a mammogram.

Biopsy Often, fluid or tissue must be removed from the breast to help the doctor learn whether cancer is present. This is called a biopsy. For the biopsy, the doctor may refer the woman to a surgeon or breast disease specialist.

Sometimes a suspicious area that can be seen on a mammogram cannot be felt during a clinical breast exam. The doctor can use imaging devices to help see the area to then obtain tissue. Such procedures include ultrasound-guided, needlelocalized, or stereotactic biopsy. Doctors can remove tissue from the breast in different ways: Fine-needle aspiration: The doctor uses a thin needle to remove fluid and/or cells from a breast lump. If the fluid appears to contain cells, it goes to a lab where a pathologist uses a microscope to check for cancer cells. If the fluid is clear, it may not need to be checked by a lab. Core biopsy: The doctor uses a thick needle to remove breast tissue. A pathologist checks for cancer cells. This procedure is also called a needle biopsy. Surgical biopsy: In an incisional biopsy, the surgeon removes a sample of a lump or abnormal area. In an excisional biopsy, the surgeon removes the entire lump or abnormal area. A pathologist examines the tissue for cancer cells.

If cancer cells are found, the pathologist can tell what kind of cancer it is. The most common type of breast cancer is ductal carcinoma. It begins in the lining of the ducts. Another type, called lobular carcinoma, begins in the lobules. A woman who needs a biopsy may want to ask her doctor the following questions: What kind of biopsy will I have? Why? How long will it take? Will I be awake? Will it hurt? Will I have anesthesia? What kind? How soon will I know the results? Are there any risks? What are the chances of infection or bleeding after the biopsy? If I do have cancer, who will talk with me about treatment? When? Additional Tests If the diagnosis is cancer, the doctor may order special lab tests on the tissue that was removed. The results of these tests help the doctor learn more about the cancer and plan appropriate treatment. Many women with breast cancer will have the hormone receptor test. It shows whether the cancer needs hormones (estrogen or progesterone) to grow. The result helps the doctor plan treatment.

Sometimes a sample of breast tissue is checked for the human epidermal growth factor receptor2 (HER2) or the HER2/neu gene. The presence of the HER2 receptor or gene may increase the chance that the breast cancer will come back.

Treatments for Breast Cancer Many women with breast cancer want to learn all they can about their disease and their treatment choices. They want to take an active part in making decisions about their medical care. Learning more about the disease helps many women cope. But how much information to seek and how to deal with it are personal choices. Each woman can make her own decision about how much she wants to know. The shock and stress after a diagnosis of cancer can make it hard to think of everything to ask the doctor. Often it helps to make a list of questions before an appointment. To help remember what the doctor says, a woman can take notes or ask whether she may use a tape recorder. Some also want to have a family member or friend with them when they talk to the doctor--to take part in the discussion, to take notes, or just to listen. The doctor may refer a woman with breast cancer to a specialist, or the woman may ask for a referral. Specialists who treat breast cancer include surgeons, medical oncologists, radiation oncologists, and plastic surgeons. A woman may have a different specialist for each type of treatment. Treatment generally begins within a few weeks after the diagnosis. Usually, there is time for a woman to talk with her doctor about treatment options, get a second opinion, and learn more about breast cancer before making a treatment decision. Getting a Second Opinion Before starting treatment, a woman with breast cancer may want to get a second opinion about her diagnosis and treatment options. Some insurance companies require a second opinion; others may cover a second opinion if the woman or doctor requests it. It may take time and effort to gather medical records (mammogram films, biopsy slides, pathology report, and proposed treatment plan) and arrange to see another doctor. In general, taking several weeks to get a second opinion does not make treatment less effective. There are a number of ways to find a doctor for a second opinion: The woman's doctor may refer her to one or more specialists. At cancer centers, several specialists often work together as a team. A local or state medical society, a nearby hospital, or a medical school can usually provide the names of specialists. Internet provides much information on specialist in breast cancers available and the medical group available in your country.

Treatment Methods Women with breast cancer have many treatment options. These include surgery, chemotherapy, radiation therapy, hormonal therapy, and biological therapy. These options are described below. In most cases, the most important factor in treatment choices is the stage of the disease. See the section called Treatment Choices by Stage. Many women receive more than one type of treatment. In addition, at any stage of disease, women with breast cancer may have treatment to control pain and other symptoms of the cancer, to relieve the side effects of treatment, and to ease emotional problems. This kind of treatment is called supportive care, symptom management, or palliative care. Information about supportive care is available on NCI's Web site at http://cancer.gov and from NCI's Cancer Information Service at 1-800-4-CANCER. Treatment for cancer is either local therapy or systemic therapy: Local therapy: Surgery and radiation therapy are local treatments. They remove or destroy cancer in the breast. When breast cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas but not elsewhere. Systemic therapy: Chemotherapy, hormonal therapy, and biological therapy are systemic treatments. They enter the bloodstream and destroy or control cancer throughout the body. Some women with breast cancer have systemic therapy to shrink the tumor before surgery or radiation. Others have systemic therapy after surgery and/or radiation to prevent the cancer from coming back. Systemic treatments also are used for cancer that has spread.

Most women want to know how treatment may change their normal activities. They want to know how they will look during and after treatment. The doctor is the best person to describe treatment choices, side effects, and the expected results of treatment. Each woman can work with her doctor to develop a treatment plan that meets her needs and personal values. Surgery: Surgery is the most common treatment for breast cancer. There are several types of surgery. (See the pictures below.) The doctor can explain each type, discuss and compare the benefits and risks, and describe how each will affect the woman's appearance: Breast-sparing surgery: An operation to remove the cancer but not the breast is called breast-sparing surgery, breast-conserving surgery, lumpectomy, segmental mastectomy, or partial mastectomy. Through a separate incision, the surgeon often removes the underarm lymph nodes to learn whether cancer cells have entered the lymphatic system. The procedure to remove the underarm lymph nodes is called an axillary lymph node dissection. After breast-sparing surgery, most women receive radiation therapy to the breast to destroy cancer cells that may remain in the breast.

Mastectomy: An operation to remove the breast (or as much of the breast tissue as possible) is a mastectomy. In most cases, the surgeon also removes lymph nodes under the arm. After surgery, the woman may receive radiation therapy. Studies have found equal survival rates for breast-sparing surgery (with radiation therapy) and mastectomy for Stage I and Stage II breast cancer. A new method of checking for cancer cells in the lymph nodes is called sentinel lymph node biopsy. In this operation, a specially trained surgeon removes only one or a few lymph nodes (the sentinel nodes) instead of removing a much larger number of underarm lymph nodes.

In breast-sparing surgery, the surgeon removes the tumor in the breast and some tissue around it. (Sometimes an excisional biopsy--which removes all of the tumor--serves as a lumpectomy. Biopsy is described in the Diagnosis section.) Occasionally, some of the lining over the chest muscles below the tumor is removed as well. Some lymph nodes under the arm may also be removed.

In total mastectomy, the surgeon removes the whole breast. Some lymph nodes under the arm may also be removed.

In modified radical mastectomy, the surgeon removes the whole breast, most or all of the lymph nodes under the arm, and, often, the lining over the chest muscles. The smaller of the two chest muscles also may be taken out to make it easier to remove the lymph nodes.

Women may choose to have breast reconstruction (plastic surgery to rebuild the shape of the breast). It may be done at the same time as a mastectomy or later. Women considering reconstruction may wish to talk about it with a plastic surgeon before having a mastectomy.

Radiation therapy Radiation therapy (also called radiotherapy) is the use of high-energy rays to kill cancer cells. It generally follows breast-sparing surgery. Sometimes, depending on the size of the tumor and other factors, radiation therapy also is used after mastectomy. The radiation destroys breast cancer cells that may remain in the area. Some women have radiation therapy (alone or with chemotherapy or hormonal therapy) before surgery to destroy cancer cells and shrink tumors. This approach is most often used when the breast tumor is large or cannot easily be removed by surgery. Doctors use two types of radiation therapy to treat breast cancer: External radiation: The radiation comes from a machine. For external radiation therapy, a woman with breast cancer goes to the hospital or clinic. Generally, treatments are scheduled 5 days a week for several weeks. Internal radiation (implant radiation): The radiation comes from radioactive material placed in thin plastic tubes put directly in the breast. For implant radiation, the woman stays in the hospital. The implants remain in place for several days. They are removed before the woman goes home. Some women with breast cancer have both kinds of radiation therapy.

Chemotherapy Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for breast cancer is usually a combination of drugs. The drugs may be given as a pill or by injection into a vein (IV). Either way, the drugs enter the bloodstream and travel throughout the body. Most women with breast cancer have chemotherapy in an outpatient part of the hospital, at the doctor's office, or at home. But some women may need to stay in the hospital during chemotherapy. Hormonal therapy Hormonal therapy keeps cancer cells from getting the natural hormones (estrogen and progesterone) they need to grow. If lab tests show that the breast tumor has hormone receptors, the woman may have hormonal therapy. Like chemotherapy, hormonal therapy can affect cells throughout the body. This treatment may be a medicine or surgery:

Medicine: The doctor may suggest a drug that can block the natural hormone. One example is tamoxifen, which blocks estrogen. Another type (aromatase inhibitor) prevents the body from making the female hormone estradiol, a form of estrogen. Surgery: If a woman has not gone through menopause, she may have surgery to remove her ovaries. The ovaries are the main source of the body's estrogen. (After menopause, hormone production by the ovaries naturally declines so surgery would not be needed.) Biological therapy Biological therapy uses the body's natural ability (immune system) to fight cancer. Some women with metastatic breast cancer receive a biological therapy called Herceptin (trastuzumab). It is a monoclonal antibody, a substance made in the laboratory that can bind to cancer cells. Herceptin is given to women whose lab tests show that a breast tumor has too much of a specific protein known as HER2. By blocking HER2, Herceptin can slow or stop the growth of the cancer cells. Herceptin is injected into a vein. It may be given by itself or along with chemotherapy. Like chemotherapy and hormonal therapy, it can affect cancer cells throughout the body. A woman may want to ask her doctor these questions before having systemic therapy (chemotherapy, hormonal therapy, or biological therapy):

Side Effects of Cancer Treatment Because cancer treatment is likely to damage healthy cells and tissues, unwanted side effects are common. Specific side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each woman, or even for women having the same treatments. And a woman's side effects may change from one treatment session to the next. The health care provider will explain the possible side effects of treatment and how to manage them. Surgery - causes short-term pain and tenderness in the area of the operation. Before surgery, women may want to talk with their health care provider about pain management. Any kind of surgery also carries a risk of infection, bleeding, or other problems. Women who develop any problems should tell their health care provider right away. Removal of one or both breasts can cause a woman to feel off balance--especially if she has large breasts. This imbalance can cause discomfort in her neck and back. Also, the skin in the area where the breast was removed may feel tight. The muscles of the arm and shoulder may feel stiff and weak, but these problems usually are temporary. The doctor, nurse, or physical therapist can recommend exercises to help a woman regain movement and strength in her arm and shoulder. Because nerves may be injured or cut during surgery, a woman may have numbness and tingling in her chest, underarm, shoulder, and upper arm. These

feelings usually go away within a few weeks or months, but for some women, numbness does not go away.

Lymphedema - Removing the lymph nodes under the arm slows the flow of lymph fluid. The fluid may build up in the arm and hand and cause swelling (lymphedema). This problem can develop right after surgery or months to years later. A woman needs to protect her arm and hand on the treated side for the rest of her life. If lymphedema occurs, the doctor may suggest exercises and other ways to deal with this problem. For example, some women with lymphedema wear an elastic sleeve to improve lymph circulation. The doctor also may suggest other approaches, such as medication, manual lymph drainage (massage), or use of a machine that gently compresses the arm. The woman may be referred to a physical therapist or another specialist.

Radiation Therapy -`During radiation therapy, women with breast cancer may become tired, especially toward the end of treatment. This feeling may continue for a while after treatment is over. Resting is important, but doctors usually advise patients to try to stay as active as they can. It is also common for the skin in the treated area to become red, dry, tender, and itchy. The breast may feel heavy and tight. These problems will go away over time. Toward the end of treatment, the skin may become moist and "weepy." Exposing this area to air as much as possible can help the skin heal. Because bras and some other types of clothing may rub the skin and cause irritation, women may want to wear loose-fitting cotton clothes during this time. Gentle skin care also is important, and women should check with their doctor before using any deodorants, lotions, or creams on the treated area. These effects of radiation therapy on the skin are temporary, and the area gradually heals once treatment is over. However, there may be a lasting change in the color of the skin.

Chemotherapy - As with radiation, chemotherapy affects normal cells as well as cancer cells. The side effects of chemotherapy depend mainly on the specific drugs and the dose. In general, anticancer drugs affect cells that divide rapidly, especially: Blood cells: These cells fight infection, help the blood to clot, and carry oxygen to all parts of the body. When blood cells are affected, patients are more likely to get infections, may bruise or bleed easily, and may feel very weak and tired. Cells in hair roots: Chemotherapy can lead to hair loss. The hair grows back, but the new hair may be somewhat different in color and texture.

Cells that line the digestive tract: Chemotherapy can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Many of these side effects can be controlled with drugs. Some anticancer drugs can damage the ovaries. If the damaged ovaries stop making hormones, the woman may have symptoms of menopause, such as hot flashes and vaginal dryness. Her menstrual periods may become irregular or may stop, and she may become infertile (unable to become pregnant). For women over the age of 35, infertility is likely to be permanent. On the other hand, if a woman remains fertile during chemotherapy, she may be able to become pregnant. Because the effects of chemotherapy on an unborn child are not known, a woman may wish to talk with her doctor about birth control before treatment begins. Although long-term side effects are quite rare, there have been cases in which the heart becomes weakened. Also, second cancers, such as leukemia (cancer of the blood cells), have occurred in people who have had chemotherapy.

Hormonal Therapy - The side effects of hormonal therapy depend largely on the specific drug or type of treatment. Tamoxifen is the most common hormonal treatment. It blocks the effects of estrogen on cells. Not all women who take tamoxifen have side effects. In general, the side effects of tamoxifen are similar to some of the symptoms of menopause. The most common side effects are hot flashes and vaginal discharge. Some women experience irregular menstrual periods, headaches, fatigue, nausea and/or vomiting, vaginal dryness or itching, irritation of the skin around the vagina, and skin rash. Women who are still menstruating may become pregnant when taking tamoxifen. Tamoxifen may harm the unborn baby. Women should discuss birth control methods with their doctor before taking tamoxifen. Serious side effects of tamoxifen are rare. However, it can cause blood clots in the veins, especially in the legs and in the lungs. In a small number of women, tamoxifen can slightly increase the risk of stroke. Also, it can cause cancer that arises in the lining or the muscular wall of the uterus. Any unusual vaginal bleeding should be reported to the doctor. The doctor may do a pelvic exam, as well as a biopsy of the lining of the uterus, or other tests. If the hormonal therapy is surgery to remove the ovaries, a woman will go through menopause immediately. The side effects are likely to be more severe than problems associated with natural menopause. The health care provider can suggest ways to cope with these side effects.

Biological Therapy - Herceptin is the biological therapy used to treat some women with breast cancer that has spread. Side effects that most commonly occur during the first treatment with Herceptin are fever and chills. Other possible side

effects include pain, weakness, nausea, vomiting, diarrhea, headaches, difficulty breathing, and rashes. These side effects generally become less severe after the first treatment. Herceptin also may cause heart damage, which may lead to heart failure. It can also affect the lungs, causing breathing problems that require immediate medical attention. Before a woman receives Herceptin, the health care provider checks the woman for heart and lung problems. During treatment, the health care provider watches for signs of heart and lung problems.

Complementary and Alternative Medicine Some women with breast cancer use complementary and alternative medicine healing approaches to reduce stress or to reduce side effects and symptoms: An approach is generally called complementary medicine when it is used in addition to treatments prescribed by a doctor. An approach is called alternative medicine when it is used instead of a standard treatment. Some common types of complementary and alternative medicine are acupressure, acupuncture, massage therapy, herbal products, vitamins or special diets, visualization, meditation, and spiritual healing. Many women report that such approaches help them feel better. However, some types of complementary and alternative medicine may interfere with or may be harmful when used with treatments prescribed by a doctor. Before trying any of these therapies, a woman should discuss their possible benefits and risks with her doctor. Some types of complementary and alternative medicine may be expensive. Health insurance may not cover the cost.

Prevention of Breast Cancer Breast cancer cannot be prevented but we can reduce the risk of getting breast cancer through the following methods. Monitor your diet

Introduce more whole grain bagels, breads, cereals, crackers, tortillas, and pasta into your diet. This maximizes intake of fiber, which may fight breast cancer by lowering levels of estrogen in the body. Take more nuts as they are a great source of fiber and another breast cancer foe-monounsaturated fats. Increases your intake of fruits and vegetables as they are packed with promising cancer-fighting phytochemicals.

Soybeans contain potentially anticarcinogenic compounds (weak estrogen compounds), including saponins, phytates, protease inhibitors, and isoflavones. The omega-3 fats in fish such as salmon, mackerel, white tuna, sardines, and herring may help fight breast cancer. Herb and spice increases your intake of phytochemicals Green tea is known for the promising anticancer activity of a compound it contains called epigallocatechin gallate (EGCG). Olive oil and canola oil are high in monounsaturated fats, which may protect against breast cancer. Eliminate highly processed food which has high amount of trans fats and saturated fats which increases cancer risk. Taking in of alcohol will also increase the risk of cancer. However occassional glasses or red wine and white white might be beneficial to the health as it contains high level of antioxident which will also help help prevent cancer.

Increase your fitness level Exercising helps to keep the body rejuvenated while help to maintain a healthy weight and to strengthen the immune system at the same time. Not forgetting that exercising keeps the spirit up within you, which will contribute to a healthier you in terms of mind, body and soul. A good fitness activity will be quick paced-walking which is easy and helps built stronger heart muscles. Start at normal speed initially and building up the pace over time to achieve a stronger you. Lower your risk through medications

On average, women who have a late first period and early first pregnancy have a lower risk. But those are things you can't control. Thinner women who exercise more and maybe eat a lower-fat diet may have a lower risk, but those effects are modest. The number one risk factor for breast cancer is age. There is also one drug, tamoxifen, that has been shown to lower the risk of breast cancer for women with high risk. The studies of this drug have been limited to women over age 35. Younger women would be unlikely to take it. Tamoxifen (Nolvadex) is a synthetic substance that is an anti-estrogen in the breast. It has been used for about 20 years as chemotherapy (drug treatment) for advanced breast cancer and more recently to prevent recurrence of earlystage breast cancer treated by lumpectomy. The Breast Cancer Prevention Trial recently examined tamoxifen's usefulness in preventing first breast

cancers in women who are at high risk; this study found a 45 percent reduction in the development of breast cancer in the group on tamoxifen, and tamoxifen has been approved for this use as well. However, tamoxifen has potentially serious side effects. There is a small increase in blood clots, especially in women who are undergoing other forms of chemotherapy. It may increase the chance of developing cataracts, but as with blood clots, this risk is small. Tamoxifen, while acting as an antiestrogen in breast tissue, acts like estrogen on the uterine lining; this increases the risk of developing cancer of the uterine lining by two to three times. This is the same increase in uterine cancer that is seen in women with a uterus who take estrogen replacement without a progestin. Any woman on tamoxifen who has any abnormal vaginal bleeding or pelvic pain must be evaluated by her gynecologist! Other side effects are less serious, but may be annoying: hot flashes, irregular periods, vaginal dryness. Tamoxifen was approved by the FDA a long time ago to treat breast cancer, and only recently was that approval expanded to include decreasing the risk of developing breast cancer in a very select group of women at very high risk. As a treatment for advanced breast cancer, or to prevent recurrence of a treated early-stage cancer, tamoxifen has time and time again been proven to save lives. With this drug, many more women are able to survive their breast cancer than will develop blood clots, cataracts or uterine cancer. As far as using tamoxifen to potentially prevent breast cancer that is a highly individual decision that must be carefully considered by each women and her doctor, after complete discussion of her risk factors and all possible drawbacks to tamoxifen therapy. Regular Examination

Do regular self breast examination and annual breast health check for yourself will not to prevent, however it allows the detection of abnormalities of your breast early so that you can be treated at preliminary stages where the chances of recovery will be much higher. There is no hard and fast rule to reduce your risk of getting cancer. However, rather then aiming to prevent breast cancer, aim to live a healthy and happy lifestyle. Create a balance in the mind, body and soul. Listen to your body's needs and increase your immune system slowly. This way, you not only prevent yourself from breast cancer but all other health ailments. Preventing breast cancer is a long-term commitment. Self-discipline is the key to success. Living well and maintaining a healthy body and a joyous attitude is all you need to reduce the risk of cancer.