One of the most frightening aspects of my breast cancer diagnosis in 1998 was that I never knew my symptoms might be breast cancer until the doctor told me I needed a biopsy for inflammatory breast cancer. I didn't know that breast cancer doesn't always start with a lump.

About eight weeks earlier at the beginning of February, I jumped when the water hit my breast in the shower. It hurt-really hurt. I turned down the water pressure and forgot about it until the same thing happened the next morning. What was going on? My first self-diagnosis was that my breasts must be tender from hormonal changes. But by the third morning, I realized that if only the right breast hurt, my hormonal theory wasn't likely.

I wasn't worried. I believed the myth that breast cancer doesn't hurt. I had just had a clean mammogram before I moved to Missouri in December, so I knew I didn't have a lump. But I was starting to feel more frequent pain and an itching deep in my breast. On Valentine's Day, a new acquaintance invited my husband and me to a dinner party, and I could hardly pay attention to the conversation because the pain and itching were so intense.

By now, I knew that something was seriously wrong, but I didn't want my first visit to a doctor to be about an itchy breast. I would sound like a hypochondriac. Fortunately, I had developed a cyst in my left breast. That was a symptom worth bothering a new doctor about. My doctors had always taken cysts seriously.

My new doctor sent me off for a mammogram and ultrasound of both breasts, but didn't seem concerned about the right side. By the time I saw the radiologist, the right breast was pink as if I had a light sunburn or had just stepped out of a hot shower. My breast was also a little puffy and swollen, but the radiologist didn't appear worried.

Sure enough, I did have a cyst on the left and no problems on the right. No one seemed to consider my pain and itching to be a medical problem. Back at my doctor's office, I suggested that maybe the swelling and pinkness on the right indicated infection, but he dismissed my concern. He did want the surgeon to evaluate the left side to see if the cyst needed draining.

No one seemed in any rush about my symptoms, so I scheduled appointments around my work schedule even when that meant a delay. Six weeks after I first jumped back in the shower, I woke up to see the upper outer quadrant of my right breast covered in a dark red/purple circle of streaked, dimpled skin. I was sure now that I had an infection, and because of the overnight change from light pink to angry red, I was very worried.

The surgeon didn't look worried when I showed him what had happened, but finally someone seemed to be agreeing with my infection self-diagnosis. He prescribed an antibiotic. I wasn't alarmed when the antibiotic didn't work. The red place wasn't getting any worse. I thought the doctor would just try a different antibiotic.