Although breast cancer incidence and mortality in the United States have declined in recent years, the number of survivors continues to grow and identifying factors that may modify survival is thus increasingly important (Espey et al. 2007). The twenty-first century has brought a continued decrease in breast cancer mortality in developed countries. Specifically, in the United States the death rate is now 25.5 per 100,000 women and survival rates at 5 years (86%), 10 years (78%), 15 years (71%), and 20 years (65%) have all improved (SEER; Espey et al. 2007) (Brenner 2002). Improved survival presents new questions and considerations for patients, clinicians, and researchers.