What is breast cancer? Cancer refers to a group of related diseases that involve out-of-control growth of cells in the body. Normally, healthy cells grow and divide in a regular, set rhythm as they move through their life cycles. With cancer, the growth and division of cells go haywire, with erratic change and proliferation. When these abnormal, cancerous cells group together, they form what's known as a tumor, which penetrates and destroys healthy tissue.

Who gets breast cancer? There are many myths about who gets breast cancer, and what causes it. The fact is, anyone can get breast cancer. And despite the many myths about what raises risk, about 80 percent of women who get breast cancer have no identifiable risk factor whatsoever. And while many people believe that having a family history of breast cancer is the biggest risk factor of all, the truth is that 90 percent of those who get breast cancer have no family member with the disease.

Is breast cancer being caught earlier these days? Yes--cancers are being caught earlier, when they are smaller; and also, women diagnosed with early breast cancer are less likely to be "lymph node positive"--meaning that these days, when the cancer is found, it's less likely than in days past to have spread to the lymph nodes under that armpit. Between 1990 and 1995, the most recent available data, breast cancer mortality rates have dropped 1.7 percent per year. During this time, in Afro-American women, the death rate increased 3%, so clearly there remains much to do in the fight against breast cancer.

Can breast pain indicate cancer? Yes. I am troubled by the widespread myth that "if there's pain, there can't be cancer." It's always important to notify your doctor of any breast pain you may be having, so that he or she can do a complete workup and rule out the more common benign problems, as well as a potential cancer. Up to 15-20 percent of breast cancers may be associated with some degree of pain or discomfort.Cyclical pain is less likely related to a serious problem than is constant pain; but there's no way to know just by guessing.

What are the trouble signs to watch for in my own breast? The more you know about your overall anatomy and the anatomy of your breasts, the greater your chance of catching a problem early--and of alerting your doctor to that problem. So consider yourself your doctor's best ally.

Here are some key trouble signs to watch for in your breasts. They certainly do not guarantee that there is a cancer or other serious problem, but they should catch your attention so you, in turn, can bring them to the immediate attention of your doctor:

1. RECENT ASYMMETRY OF YOUR BREASTS: Many women have asymmetrical (different-sized) breasts, and this is perfectly normal. And there are other normal causes of breast asymmetry, including having surgery on one breast and not the other, or long-term breast-feeding on one side and not the other. But when your breasts are normally close in size, and then become asymmetrical without some obvious explanation, this can be a trouble sign. Be sure to discuss any such change with your doctor, as a breast can become smaller if a cancer is pulling the skin in and shortening the ducts. This can also create puckering on the skin of the breast.

2. PUCKERING, INDENTATIONS, OR RETRACTION OF SKIN: Puckering of the breast can indicate the existence of a cancer--perhaps one growing in or involving the connective tissue surrounding the breast ducts. Cancers close to the surface of the skin can cause puckering as well.

3. DIMPLING OF BREAST SKIN: This condition, known as peau d'orange or orange peel, may indicate the presence of a tumor that is blocking the lymph system and causing fluid accumulation under the skin. Be sure to bring it to your doctor's attention.

4. REDNESS OF THE BREAST SKIN: Redness does not necessarily indicate cancer--for instance, a woman who is breast-feeding and has redness, swelling, or warmth in a breast may have an infection or abscess. But if antibiotics fail to clear the problem, it's important to have your doctor confirm that no cancer or other underlying problem is present. A relatively rare form of breast cancer is called inflammatory breast cancer, and does involve redness and heat in the breast. When dimpling and redness appear together, this is more worrisome. Again, don't diagnose yourself--see your doctor.

5. ULCERATION OR ERODED SKIN ON THE BREAST: This is something I don't like to see on the surface of the breast, as it can indicate a cancer which is eroding the breast skin. Tell your doctor as soon as this sign appears.

6. RETRACTION OF THE NIPPLE: This must be differentiated from long-standing inverted nipples, which can be perfectly normal.  But a sudden, pronounced retraction of the nipple can indicate a cancer pulling the nipple inward. So show it to your doctor.

Breastdoc is an educational web site where the latest information on new techniques in the diagnosis and treatment of breast cancer, as well updates on risk-reduction may be found.

Signs and Symptoms of Serious  Breast Diseases are brought to you as an informative clinical presentation. Examples of mammography which lead to biopsies are shown and the types of biopsies, ranging from needle biopsies to surgical biopsies are discussed. Treatment including indications for lumpectomy and mastectomy and different types of reconstruction are outlined and clinical examples of these are given.  The sentinel node biopsy is explained step by step.

A listing of consumer resources, is available to download. Pen-Pal buddies is a support system that will enable newly-diagnosed women to "buddy-up" with a woman, who has received similar treatments.

Women who are undergoing treatment for cancer will have access to boutiques and programs across the United States where they can learn to improve their appearance during treatment.  Linda Secher, founder of Appearance Center Consultants, Inc. will interact via e-mail with those women who have questions about postsurgical garments, prosthesis and products related to hair loss, etc..