October is National Breast Cancer Awareness Month. In fact, 2005 is the 20th anniversary of National Breast Cancer Awareness Month. I am not a physician, oncology nurse, or other cancer expert, so I am not providing educational material. What I am providing is hope and advice. My mother is a 25-year survivor of breast cancer. She was 36 years old (I was 10) in November of 1980 when she had to have a total hysterectomy because of advanced endometriosis. After surgery, she had a routine mammogram that showed an abnormality. In December, a biopsy came back as cancerous. January of 1981 my mother had a mastectomy. For 11 years she was disease-free. All of her routine scans and tests showed her to be disease-free. This time span was amazing because she was a pre-menopausal, 36-year-old with estrogen-receptor positive breast cancer. I could have been motherless at 12 years old, but the endometriosis required a total hysterectomy, which we are told is the only thing that saved my mother’s life. In 1992, a routine mammogram identified a lump in her second breast. I think something intuitive in her mind told her it was there. She had mastectomy number two. Then, a bone scan revealed a metastasis on her left leg bone. Nearly four years of three surgeries, metal plates, titanium rods, physical therapy, braces and an internal electrical stimulation device, and my mother’s leg finally healed and she recuperated. In 1997, a spot was found on her skull. She had a three-inch diameter section of her skull removed behind her right ear and replaced with titanium mesh. In April of 2003, the skin of her scalp blistered. A biopsy showed that it was cancerous. She had radiation therapy on her scalp. The destroyed skin actually let the screws in the titanium mesh show through. In July of that year, she went to Pittsburgh for simple surgery to remove the diseased scalp and have a skin graft done. At that time, doctors found that behind the titanium mesh was a tumor growing on the covering of her brain, which grew through the covering into her brain. Her simple “cosmetic” surgery turned into 14 and a half hours of neurosurgery. And to this day, she has no skull on the back right side of her head, because surgeons had to replace it with abdominal muscle and other tissue. Both the scalp and brain metastases were the result of disturbing the diseased skull in 1997. My mother has been through so much it is impossible to describe in this short article. I wanted to provide an abbreviated version to point out a few things. First, that you can survive with breast cancer. In my mother’s case, the surviving comes at a high price, but if she would not have paid this price, she would not have seen her children graduate, get married, have successful careers and have children of their own. My mother has gotten to experience all of these wonderful things. My second point is that you cannot survive with this disease if you do not know it is there. Breast cancer’s best weapons are denial and ignorance. So please inform yourself, do self- exams, see your doctors regularly, and have yearly mammograms. Without proactive, aggressive medical care, my mother would be dead. My third point is that fear can be conquered. In the last 25 years, I have had so many times when I thought I was not going to have a mother. Now, I have learned to accept that my mother will have to fight breast cancer until her dying breath. I have also learned that if that dying breath is tomorrow or 20 years from now, everything will be okay, because here or hereafter I will always have a mother. Michael Archer is a clinical laboratory science educator for Mount Nittany Medical Center and Penn State University.