The first sign of breast cancer is usually a lump or a spot seen on a mammogram. Like all cancers, the disease is the result of unrestrained multiplication of cells. Normal cells divide in a planned way, creating more cells only when needed. Cancerous cells grow and divide without control or order, often making excess tissue that becomes a tumor. Cancer cells may grow into nearby healthy tissue, or they may break away from the tumor and travel through the blood stream or lymphatic system to other parts of the body. For this reason, breast cancer often spreads into the lymph nodes in the armpit, chest, and collarbone area.

Causes

There is no known cause, but certain factors increase the odds of the disease. A woman is more susceptible if:

• She is more than 45 years old and has not gone through menopause.
• She did not become pregnant before age 30.
• Her mother, sister, or daughter had breast cancer, especially before menopause and especially in both breasts.

Signs/Symptoms

There are usually no symptoms during the early stages of breast cancer; only a mammogram can detect it. Later, however, you may notice:

• Swelling or a lump in the breast
• An achy or uncomfortable breast
• One breast that looks different from the other
• Breast skin that is dimpled or pitted like an orange peel
• A nipple that looks as though it had been pushed in
• Bleeding from the nipple

In advanced breast cancer you may also experience:

• Swollen lymph nodes under your arm
• Bone or back pain
• Difficulty breathing

If the cancer has spread to other parts of the body, you may have other problems as well.

Care

To find out what stage the cancer is in, your doctor will measure the lump, check to see if the cancer has spread, and perform tests such as another mammogram, a biopsy, and body scans. The results of the tests will help you and your doctor decide on a treatment plan.
   There are many different ways to treat cancer. Often doctors use two or more types of treatment together. Treatments may be given in a clinic, doctor's office, or hospital. The major options include:

• Chemotherapy: Often called "chemo," this type of therapy uses drugs to kill new tumor cells or shrink lymph nodes that contain cancer cells. Once the tumor is smaller, you may have surgery to remove the rest of the cancer. Some forms of cancer can be completely cured with drugs alone.
     Many different chemo medicines are available. They may be taken as a pill, as a shot, or in an IV. You will probably need frequent blood tests to determine how your body is doing and how much chemo you need. The drugs can produce many side effects, and may leave you susceptible to infection for a while.
• Hormone Therapy: Natural hormones such as estrogen sometimes promote the growth of cancer cells. Special drugs are available to block the estrogen and slow the cancerous growth. In most cases, you can take this medicine by mouth. In some cases, it may also be necessary to surgically remove sources of estrogen such as the ovaries or adrenal glands.
• Radiation: X-rays or gamma rays can kill cancer and help prevent it from spreading. They can also be effective in reducing pain, controlling bleeding, and shrinking cancerous tumors. Doctors also use this type of therapy on cancerous lymph nodes. Radiation and chemotherapy are often used together. Radiation is also used after surgery to kill any cancer cells that may have been missed.
• Bone Marrow Transplant: In this form of therapy, diseased or damaged bone marrow is replaced with healthy marrow, usually from a donor. (Your own marrow may be used if it can be collected while your cancer is in remission.) The transplant is given in the hospital through an IV. Although the treatment can cure cancer, it may lead to other very serious health problems, including severe infections. You may have to stay in the hospital for a month after the procedure.
• Surgery: Depending on the stage of your breast cancer, you may need surgery to remove the lump, a part of the breast, or the entire breast. You may also need to have some lymph nodes taken out to help prevent the cancer from spreading to other parts of your body.

Risks

Left untreated, cancer eventually will spread. Almost all forms of cancer therapy have unpleasant side effects, and may fail to halt the spread. However, treatment---especially when performed early enough---usually improves your chances.