Following the announcement that Kylie Minogue has breast cancer, STEPHEN LEWIS and Jo Haywood look at what she faces in her battle against the disease.

Kylie Minogue's courage in facing up to breast cancer will have won the tiny pop star much admiration. Her first public act after being diagnosed was to apologise to fans for having to cancel her latest tour.

"I was so looking forward to bringing the Showgirl tour to Australian audiences and am sorry to have to disappoint my fans," she said in a statement.

"Nevertheless, hopefully, all will work out fine and I'll be back with you all again soon."

That simple statement speaks of unusual dignity and bravery, yet in many ways Kylie's reaction is typical of a woman who has been diagnosed with the disease, says Jackie Frazer, a Macmillan nurse at York Hospital who specialises in breast cancer.

Such women may experience a spectrum of emotions, Jackie says.

"They may be angry, they may be totally devastated, often they just cannot think clearly." Often they feel they have to apologise to friends, family, their children and to anyone close to them.

"They don't want to cause upset for others," Jackie says.

Different women cope in different ways. Having cancer is a personal thing, and many women may want to deal with it in private, with the support of close family and friends.

"For somebody like Kylie, who has a very high profile, finding that privacy may well be difficult," says Jackie. It may be that she wants to talk openly about it. But if she does want time to herself, away from the public eye, it is very important that she is given that time.

For a woman as young as Kylie to develop breast cancer is unusual. Most breast cancers are found in women of 50 or over. Fewer than 20 in every 100,000 women under 40 develop the condition.

Fortunately, the outlook for women with the condition has never been brighter.

Survival rates from breast cancer are steadily improving thanks to new drugs, better diagnosis and constantly improving surgical techniques, says York consultant breast surgeon Stewart Nicholson.

More than 70 per cent of women diagnosed with breast cancer can now expect to survive for at least five years after treatment, the standard measure used by doctors. This rises to more than 90 per cent among those diagnosed early.

"There are still tragic cases, women who present with very aggressive cancer that does not respond to medication and we cannot control it," Mr Nicholson said. "But breast cancer is now by no means a death sentence."

Nevertheless, the singer faces a gruelling combination of surgery and, possibly, radiotherapy, chemotherapy or hormone treatment during the coming months.

It is likely she will require some form of surgery - whether a 'lumpectomy' in which only the cancerous lump is removed, or a complete mastectomy in which the entire breast is removed.

Exactly which procedure is adopted will depend on the nature and extent of the cancer - and on what Kylie wants.

Lymph nodes under the arm may also need to be removed.

If the singer has a lumpectomy, that will be followed up by radiotherapy. She may also require hormonal treatment such as tamoxifen to reduce the risk of the disease returning or, if her cancer is more aggressive or not sensitive to hormonal treatment, possibly chemotherapy.

Liz Carroll, head of clinical services at charity Breast Cancer Care, says for a woman of Kylie's age, 36, doctors would almost always recommend chemotherapy as a precaution.

This, however, can affect fertility - possibly an issue for the singer, who has no children.

It is now possible for a woman's eggs to be harvested, fertilised and the embryos stored for the future.

Eggs alone can also be frozen, although this remains a relatively new procedure.

Radio presenter offers her own message to star

WHEN Radio York presenter Julia Booth heard Kylie Minogue had been diagnosed with cancer, it brought memories of her mother's battle with the disease flooding back.

"The news has particularly hit home because my mum was the same age as Kylie when she was diagnosed," she said. "Things were obviously very different then. Nobody talked about 'the big C' in the 70s and treatments were nowhere near as advanced.

"Hopefully, Kylie should have a much easier time of it."

Julia herself had a double mastectomy in 1997 after tests revealed she carried a gene that gave her a 85 to 90 per cent chance of contracting cancer without the radical preventative operation.

Her sister had the same operation in March this year and her three daughters have a 50-50 chance of carrying the same gene.

"My girls are very well aware of the set up," she said. "It will be up to them what they do when they reach the risky age, but that is not for a very long time yet."

Julia took radical action to rule out breast cancer because she witnessed how much her mother suffered.

"Breast cancer is awful at any age, but when you are only in your 30s with four young children to look after it is beyond cruel," she said.

"Perhaps the only positive aspect of this is that Kylie will be able to further de-stigmatise breast cancer.

"She's a sexy, glamorous young woman, and she will still be a sexy, glamorous young woman when this is all over."

In the 70s cancer was widely regarded as a virtual death penalty and women such as Julia's mum, who died at 43, were embarrassed by their condition.

"When someone as rich and fit and popular as Kylie gets cancer it makes people feel powerless," she said. "The fact is that we are powerless in the face of cancer, but it is no longer a death penalty.

"Most women survive, as I'm sure Kylie shall."

:: The facts

Breast cancer is the most common cancer among women worldwide. It accounts for almost one in three of all cancer cases in women but is more common among older women

Breast cancer detected early can be treated successfully, and most women diagnosed and treated early do not die.

According to the charity Cancer Research UK, breast cancer death rates have fallen by a fifth in the last ten years, mainly thanks to early detection and diagnosis.

In the UK there are more than 41,000 new cases every year.

The cancer develops in the milk-producing glands in the breast, or in the passages or ducts which deliver milk to the nipples. Some breast cancers may spread into the surrounding tissue, and can spread to other parts of the body.

Men can also get breast cancer but it is rare, with only around 300 cases diagnosed each year.

Treatment for early breast cancer usually involves "breast conserving surgery" or a mastectomy. Both are usually combined with radiotherapy treatment.

The aim of treatment for early breast cancer is to remove the cancer from the breast and armpit area, and to destroy any cancer cells that may have spread to other parts of the body, but cannot be detected.

Breast screening, offered every three years to all women in the UK aged between 50-70, can help detect breast cancer at its earliest stages. Older women can also request screening. It could save your life

Women are recommended to examine their own breast regularly. If you notice any changes - a painless lump, a change in the size or shape of the breast, a lump in the armpit, or a bloodstained discharge from the nipple (which is rare), contact your GP

The breast cancer support group at York hospital offers support and information, and holds regular monthly meetings. To find out more contact one of the Macmillan breast cancer nurses on 01904 726775.

The CancerBACUP helpline is 0808 800 1234.

:: Other celebrities who have had cancer

American singer Anastacia was diagnosed with breast cancer at 29. During a routine check-up in 2003, her doctor discovered a cancerous lump. After surgery and a course of chemotherapy, she bounced back into the charts with more energy than ever... and a number one album.

Olivia Newton John, the one that John Travolta wanted in Grease, lost her father and godchild to cancer. She was diagnosed with a malignant tumour in her breast in 1992 and has since gone on to be a vociferous campaigner on breast cancer issues.

Melanie Appleby, one half of the 80s pop duo Mel & Kim, was diagnosed with cancer in 1987 at the age of 21. She had enjoyed success in the charts with her sister, selling three million copies of their debut album FLM (Fun, Love & Money). Mel died in 1990.

EastEnders stalwart Wendy Richard, who has played grumpy matriarch Pauline Fowler since the BBC1 soap began, has twice beaten cancer. She fought breast cancer in 1997 and had a lump removed from her neck seven years later.

Model-turned-photographer Koo Stark, who hit the headlines when she had a fling with Prince Andrew, was diagnosed with stage two breast cancer in 2002. She had a radical mastectomy and chemotherapy, and lost all her hair. She now campaigns on behalf of the Haven Trust, which supports people affected by breast cancer.

Updated: 10:49 Wednesday, May 18, 2005