Kylie Minogue's battle with breast cancer has made headlines around the world. But it is an experience shared by thousands of women in Australia every year.

Rita Marigliani sat numb and alone as her surgeon delivered the shattering news. She went home to her boyfriend and they cried together, then she phoned her two brothers and sister, knowing she had to tell them something they would struggle to digest.

Days later she was lying on a hospital bed recovering from breast cancer surgery. It was Christmas Day 2002. She was 36 years old, the baby of her family, and she had just had her lymph nodes removed.

Instead of a festive lunch at home, her relatives and friends took it in turns to keep her company in a hospital ward. Still, Marigliani decided to look on the bright side - the hospital put on a good spread and she didn't have to wash the dishes.

Despite losing her mother to breast cancer 10 years earlier, and later her father to lung cancer, it did not occur to her that the two lumps she had carried on her left breast for 18 months might one day kill her. She was young and active. She certainly did not feel ill.

The seemingly innocuous lumps lay beside each other, nestled beneath her armpit. Numerous tests and mammograms over several months had given inconclusive results. But with the lumps showing no sign of simply going away, a surgeon decided it was best she have them removed - just in case.

"At this time I thought we were being thorough about something I felt pretty confident was nothing," she recalls.

"Despite all the tests I'd gone through, I was convinced that this wasn't going to be cancer. I was fit and young and that wasn't going to be an outcome.

"But when it was the outcome I was completely shocked and floored and scared. I thought I was going to die."

Apart from the mere act of surviving, she was plagued by other issues - would she still feel desirable?

How would it affect her sexuality? Would she ever be able to have a baby? And would she still want to have sex with her boyfriend?
The good news was the cancer had not spread to her lymph nodes, so statistics were heavily on her side.

"As a young person I thought I was going to die and I wasn't ready," she says. "This wasn't something I was expecting and I didn't know how I could possibly cope with it. I started to then learn more about the disease and what my prognosis would be and started to feel a bit more confident about getting involved with treatment and making decisions about it."

Uncertain and scared, but silently optimistic, she began treatment. First came four lots of chemotherapy, one dose every four weeks over several months. And then she began to lose her hair, an experience that brought home the degree to which her plight would drastically affect her life.

"It was really confronting when I heard I was going to have chemotherapy," she says. "I was very concerned about losing my hair. I wanted to look normal. I didn't want to look or feel different."

The chemotherapy left her with nausea that sometimes lasted for days, and an aversion to food.

Talking to other women in her situation helped to make her feel more normal, and an understanding employer meant she was able to continue working, despite the fatigue and nausea - the inevitable symptoms of chemotherapy. She also completed six weeks of radiotherapy.

While some women's libidos are affected by cancer treatment, Marigliani found herself seeking intimacy. "For me I probably felt the need for intimacy more because it's a time when you need comfort and the idea of trying to keep things normal was important for me as well," she says. "After the surgery you can be sore where you've had surgery and we spoke about physical issues like that, but otherwise things were pretty normal."

Like most of her girlfriends, she had intended to delay having children until she was in her mid to late 30s. She went to see a fertility specialist but decided against freezing her ovarian tissue because it would have meant another operation. Given she was young, she decided to take her chances. She has no reason now to think she can't have a baby.

"At a time when all my friends were putting off having children until mid to late 30s, I was in that category as well - and then to have that decision possibly taken away from me made me angry," she says."

For a young woman to be diagnosed with breast cancer, that's shock enough, and then to have the extra burden of having to make decisions about fertility and sexuality is a lot to have to digest and process at one time."

By late 2003, Marigliani was told that the cancer had been removed and there was no evidence the disease remained. But she will never be declared "cancer-free" and the uncertainty of her situation means even now, having recovered, there is still a thought in the back of her mind that it might come back.

"It's one of those things that can come back even many years after initial diagnosis," she says.

"There's no measure of cancer-freeness. At no stage will I ever hear that news."

As for the scars from her surgery, she considers them "medals" - "almost something to be proud of - that I got through it and I'm here and doing really well".

But she says the experience from the time she was diagnosed made her quickly reorganise her life's priorities. "You realise your family and friends are the most important things in your life and the people you want to spend the most time with," she says.

"There is support and you're not alone."

BREAST CANCER . . . AND HOW THE SURGERY IS PERFORMED

First the bad news: breast cancer is the most common cancer among Australian women, with an average 32 new cases diagnosed each day. It is also the biggest cancer killer, claiming seven women's lives a day.

The good news: survival rates are improving through earlier detection, better treatment and new drugs. And when it comes to "early breast cancer" - cancer contained in the breast that may, or may not, have spread to lymph nodes in the armpit - treatment is generally effective, with 90 per cent of women having no further problem from the cancer in the next decade. Most women diagnosed and treated for early breast cancer do not die from the disease, according to the National Breast Cancer Centre.

WHAT CAUSES BREAST CANCER?
It is not known what causes the disease, although there are factors that increase the risk. Most women with breast cancer, however, have no obvious risk factors. As there is currently no means of preventing breast cancer, the focus in reducing deaths from the disease has been on finding breast cancer as early as possible. The Federal Government offers free mammograms for women aged 50 to 69.

WHAT INCREASES RISK OF CANCER?
Breast cancer is more likely in older women, those with a family history of breast cancer or those previously diagnosed with breast cancer. Among those things to show a slight increase in risk are early menstruation (before 12), late menopause (after 55), being childless or having children after 35, and not breast feeding.

HOW IS IT FOUND?
Breast cancers can be found in several ways, including mammogram screening, discharge or a lump in the breast. If a lump found, those over 35 usually have a mammogram (low-dose X-ray) and those under 35 an ultrasound, or both. If abnormal tissue is found, a sample is taken with a needle, or sometimes under general anaesthetic. The sample is tested by a pathologist. Results can take a few days.

HOW DOES IT DEVELOP?
- Ductal carcinoma in situ is a cancer that is contained in a milk duct in the breast, and has not spread into the breast. It is thought invasive breast cancer starts with DCIS. This type of cancer is usually found by mammograms in older women and cannot be felt as a lump.

Removal with surgery is the usual treatment. As there is no spread, the cancer is effectively cured (although other cancers can be found). About 1200 women are diagnosed with DCIS each year in Australia, most aged 55-59.

- Invasive breast cancer is regarded as a cancer that has spread from the milk duct into the breast. It can be found as a lump. In some cases it is contained in the breast, in other cases the cancer has spread to the lymph nodes in the armpit.

Treatment aims to remove the cancer, destroy cancer cells that may be left in the breast and destroy any cancer cells that may have spread outside the breast and armpit area, but cannot be detected.

WHAT ARE THE TREATMENT OPTIONS?
Each woman's situation is different, and likewise treatment differs. Typically, if a lump is less than three centimetres in diameter, surgeons usually remove the lump and one lymph gland in the armpit.

This is located by injecting a dye into the breast.

The operation is done under general anaesthetic and patients typically stay overnight. If the removed gland - typically the size of a fingertip - is clear of cancer, no further surgery is required. If it is affected, more lymph glands can be removed. Radiotherapy is usually recommended after a lump is removed.

A typical course is every weekday for six weeks. In most cases of early breast cancer, surgery and radiotherapy is regarded as being as effective as a mastectomy, or removal of the breast.

A mastectomy is considered an option if the cancer is large compared with breast size, the cancer is in more than one area in the breast, or previous surgery has failed to remove all the cancer.

In some cases women are given hormone treatment, such as the drug tamoxifen. This depends on the type of cancer found. If the cancer is thought to have spread from the breast and armpit area, chemotherapy can be given. - Tom Noble