1. Stand in front of a mirror, shoulders straight, hands on hips. Are your breasts evenly shaped, with no distortion or swelling? Do you see any redness or dimpling, or feel any soreness? Has your nipple changed position or been inverted? If so, tell your doctor.

2. Raise your arms, one at a time, and look for the same changes as in step 1.

3. Check for nipple discharge by gently squeezing each nipple between your thumb and index finger.

4. Now lie down and feel your breasts, using your right hand for your left breast and left hand for your right breast. With the first few fingers of each hand go over the entire surface area of your breast, feeling all of your breast tissue just underneath your skin and again deeper down with a firmer touch. If you locate any lumps or hard spots, notify your doctor.

5. Repeat step 4 while standing, perhaps while you are in the shower; it’s easier to feel what’s under the surface when your skin is wet and slippery.

Once breast cancer is suspected, whether it’s on a diagnostic mammogram or otherwise, other tests will follow—usually a biopsy, because this is probably the only way to make sure you have or don’t have cancer. Biopsies involve removing a small sample of the suspect tissue for further examination under a microscope by a pathologist. Not only do pathologists look for the cancer, they also seek to determine what kind of receptors—estrogen or progesterone—the cancer tissue has. The receptors help determine what type of therapy you will receive for the cancer; there are specific therapies directed at each type of receptor that improve the outcome.

The “stage” or location of the cancer is also determined during the diagnosis. If it’s located in a lobule or duct of the breast, the cancer is at Stage 0. If the tumor is less than 2 centimeters but has not spread beyond the breast itself, it’s Stage 1.

Stage 2 involves tumors that are less than 2 centimeters and have migrated beyond the breast to the lymphatic nodes, or are greater than 2 centimeters and haven’t spread outside the breast.

Stage 3 involves more advanced breast cancers, greater than 5 centimeters, that have spread to the lymphatic nodes under the arm.

Stage 4 is metastatic cancer, meaning that it has spread outside the breast to other organs.

Surgery plays a major role in the treatment by essentially removing as much of the cancer as possible. For the very early stages of breast cancer, the treatment is called a lumpectomy, which is the removal of the tumor and a little bit of normal tissue around the tumor. A lumpectomy is usually combined with radiation therapy.

Partial mastectomies involve removing a larger piece of the breast.

More advanced cancers are treated with modified radical mastectomies, meaning that the entire breast and the lymph nodes are removed. Most women who have total breast removal get reconstructive surgery in order to create a substitute breast mound. Those with high stages of cancer often also receive chemotherapy, with surgery or without surgery, in order to decrease the risk of the cancer’s recurrence, though the side effects of chemotherapy can be considerable.

Similarly, radiation therapy, which uses high-energy X-rays to kill cancer cells, is often used to reduce the risk of recurrence and to kill tumor cells that may be living in lymph nodes. Depending on whether the tumor expressed estrogen or progesterone receptors, patients may also receive hormonal therapy. Patients whose tumors expressed estrogen, for example, may receive an estrogen-blocking drug called tamoxifen for five years after their surgery.