Your best defense against breast cancer.

Breast cancer is the most common cancer affecting women. And while research and medical advances have created more and better ways to treat breast cancer, so far there's no known way to prevent it.

The American Cancer Society estimates that, in 2003 alone, more than 211,000 women were diagnosed with breast cancer--and almost 41,000 women died from the disease.

So what can you do about it? Your best line of defense is early detection. Generally, the earlier breast cancer is found and treated, the better the outcome.

Are you at risk?

Even if you do not have a family history of breast cancer, you can still develop the disease. In fact, the National Cancer Institute reports that most women with breast cancer have no family history of it. For many, the primary risk is one's age.

Typically, breast cancer doesn't develop before age 35, and women over age 60 are at the greatest risk. While the disease can strike any adult woman, it's more common among Caucasian women than among Latina, African-American, or Asian American women.

In addition, the following risk factors may increase your chance of getting breast cancer:

* Being a woman (while extremely rare, there are cases of breast cancer in men)

* Personal or "blood-relative" family history of breast cancer

* Certain genetic factors

* Hormone replacement therapy for more than five years, particularly estrogen plus progesterone therapy)

* Not having children or delivering one's first child after age 30

* Radiation therapy to the chest before age 30

* Menopause after age 50

* Starting menstruation before age 12

* Obesity

* Excessive drinking of alcohol

Screening for breast cancer

There are two main screenings for breast cancer: regular mammogram and clinical breast exam. Many women also do a monthly breast self-exam.

Following are descriptions and suggested time intervals for these screenings, but if you are in a higher risk group, discuss screening schedules with your doctor.

Mammogram. Having a mammogram offers you the best chance of finding breast cancer at an early stage. This low-dose X-ray of the breasts can detect lumps too small to feel. The National Cancer Institute recommends that women in their 40s and older get a mammogram every one to two years. Women who are at a higher than average risk should talk to their doctor about whether to have a mammogram before age 40.

Clinical breast exam. A mammogram is not foolproof and some lumps may not be detected by a mammogram. That's why it's important to have a clinical breast exam at your routine preventive care appointment. This exam is performed by a medical professional who is trained to look for clues that may be undetectable by self-examination. If something is found, your medical professional can arrange for the next step to ensure a timely diagnosis and treatment if needed. If you're between the ages of 20 and 49 without any significant risk factors, see your physician for a clinical breast exam at least every three years. Women ages 50 to 69, without risk factors, should have a clinical breast exam at least every two years.

Self-exam. It is important for all women to become familiar with the appearance and feel of their breasts so they may notice any possible changes. If you choose to do a monthly self-exam, your health care provider can show you a demonstration. If you notice something unusual, promptly contact your doctor.

Symptoms to look for

Breast cancer can cause specific changes in your breast. The following are some symptoms to watch out for:

* A change in the feeling of your breast or nipple. This includes nipple tenderness or a lump or thickening in or near the breast or underarm area.

* A change in the look of your breast or nipple. This may include the size or shape of your breast, an inwardly turned nipple, or red or scaly skin around the breast or nipple.

* Nipple discharge/fluid

It is recommended that you also see your medical professional immediately if you experience breast pain or any other symptom that does not disappear. Bear in mind that most of the time these breast changes are not cancerous.

Learn more to protect yourself

Not long ago, women diagnosed with breast cancer were limited to a few treatment options. Now, many more are available. Talk to your doctor and contact any of the following organizations fur additional information:

* American Cancer Society (www.cancer.ors)

* The National Cancer Institute (www.nci.nih.gov)

* National Breast Cancer Coalition (www.natlbcc.org)

* California Breast Cancer Organizations (www.cabco.org) (This site is currently under reconstruction.)

In summary

* Have regular mammograms.

* Have routine clinical exams.

* Be aware of changes in your breasts.

* Stay informed about breast cancer.

To learn more

For more information about breast cancer, visit Kaiser Permanente's web site at www.kaiserpermanente.org and search the online health encyclopedia, which has more than 30,000 pages, covering about 1,900 topics. To help you make informed decisions about your own health or that of a loved one, you can find articles on mammography, clinical breast examination, breast cancer screening, prevention, and treatment. If you are looking for information on early-stage breast cancer, search the topic "breast cancer."

You also can call The Kaiser Permanente Healthphone system at 1-800-33-ASK ME (1-800-332-7563) or (1-800-777-9059, TTY). The system answers your questions on more than 200 topics and includes messages on women's health. Listen to any of the following messages:

Title                               English   Spanish

Breast self-examination               128       420
Mammography                           420       213
Breast cancer susceptibility gene     202       702

These free, recorded health messages are available to the public 24 hours a day.

Information for this article was provided by Kaiser-Permanente.