I'm eternally grateful for the public relations machine that has grown into the annual retail marketer's dream known as Breast Cancer Awareness Month. If I had not been "aware" of the risks of breast cancer and how to examine my breasts, I may have been unphased when I felt a strange lump in my breast last year. I could have possibly dismissed it as "lumpy" breasts and gone on ingorantly while the evil cancer beast grew and spread within me. I am lucky. I found it early. I was aware.

There remains a part of me that wonders how much of the "awareness" in the retail world finds its way to fund mammograms and research or simply finds its way to the cash register. How much extra did I just pay for that product emblazoned with my little pink friend? And does that money support the cause or is the ribbon itself adding to the awareness factor? I find it difficult to conceive of the concept of little round choclatey candies promoting breast cancer awareness when a high fat diet is believed to contribute to cancer risk. I'll take the fifty cents though. Eventually it all adds up. And yes, each year I do fall victim to the annual commemorative bracelet. In fact I get one for myself and one for my sister. All of us bracelet wearers help a donation of $1,000,000 be made to support breast cancer research. It can't all be bad? Right? Especially not the little heart on the bracelet engraved with "You are a miracle," right?

I won't typically wear a pink ribbon (other than the bracelet), because there is a trail of "pink ribbons" all across my chest. I wear them all year, without fail, every moment of every day. My awareness starts in the middle of the night when I roll over only to be greeted by discomfort from the tissue expanders still below my skin. My awareness continues when I see my reflection as I step out of the shower. My awareness is magnified as I slip the prosthetics into my special bra. It continues as I slip on my suit jacket only to notice that the top puckers a little where my cups once runneth over. And as I try to style my too short hair, though grateful for its return, the awareness smacks me in the face yet again. And then as someone shares joyful news of a pregnancy or a new grandchild, the awareness punches me right in the gut and takes the air from my lungs. Breast cancer awareness is my waking (and sleepless) reality.

I will admit, there are many times during the day when I think about the business at hand, when my laughter fills the room rather than sadness, when I think of all things joyful rather than all things lost. Awareness isn't about the sadness and loss. Awareness is also about hope. When I hear that a friend's diagnosis is excellent because the cancer was caught at such an early stage, that breast conserving strategy coupled with radiation is all that is needed, then awareness makes me smile. When I meet a ten-year survivor who joyfully embraces life and does not live in constant fear of the cancer monster, awareness brings me joy. When I see a young woman emblazoned with a pink ribbon survivor tattoo, with her young children in tow, then awareness gives me hope. There are some who believe that promoting the hype about disease compromises the quality of life with unnecessary worry. I am here to dispute that. Knowledge is power. I can attest to that.

Let's look at the most recent statistics from the American Cancer Society:

• Incidents of death have come down every year since 1991.
• Five-year relative survival rate for localized stage is 98%.
• Nearly all breast cancers can be treated successfully if detected early.

That sure sounds like hope and the power of awareness to me. Don't you think? It doesn't mean we can relax about testing and exams. It is the awareness raised and funding provided to fund mammograms that have made this difference.

Let's look at the risk factors provided by the Susan G. Komen Foundation:

• Having a first menstrual period before age 12 or entering menopause at age 55 or later increases a woman's exposure to estrogen and may therefore increase risk.
• Not having children or having the first child after age 30, as well as not breast feeding, increases risk.
• HRT after menopause increases risk and the risk increases the longer the hormones are taken.
• Women with inherited BRCA genetic mutations have a much higher risk; however, only 5 - 10% of all breast cancer cases are in women with the BRCA mutation.
• A family history of breast, ovarian, and prostate cancer are also risk factors.
• Current or recent use of birth control pills, being tall, being overweight, lack of exercise, drinking alcohol, a higher socioeconomic background, and high density breast tissue on mammograms all increase risk.

Being a woman is the greatest risk factor. We can't control our genetic make-up or when we started our menstrual cycle. Many of the other factors are related to lifestyle. That we can control. This is where awareness helps. We have to weigh the pros and cons of our lifestyles and discuss it with our doctors.

• If there is a strong family presence of breast cancer, we need to evaluate the relative benefits of using birth control or HRT.
• If there is already a personal history of breast cancer, we need to evaluate our diets, exercise, and alcohol consumption.
• If multiple risk factors are present, we certainly can never miss our mammograms, breast self-exams, and clinical breast exams. Ever.

Early detection is the best defense. You are aware now. What are you waiting for? Go examine yourself already (or go examine the women in your life). Schedule your mammogram (or schedule one for the women you love).

Okay. I'm done being preachy and teachy. I challenge my fellow bloggers to post something related to breast cancer this month, even if it is only a link. Join me in making this month mean more than pink candy and accessories. Join me in spreading hope.