A reader wrote in concerned that she might have inflammatory breast cancer (IBC).  Although she had three of the symptoms of IBC--redness, swelling, and warmth--her doctors were confident that she couldn't have IBC.  She did not have the characteristic skin dimpling of IBC, and only part of her breast was affected.  Yet five antibiotics had not diminished her symptoms.  Finally they decided to biopsy.

The results were astonishing!  Her doctors were right.  She did not have IBC.  She had an internal malignancy that had escaped detection from earlier imaging tests.  Cancer deep in the breast does not typically show itself with infection-like symptoms on the surface of the breast, but it did in her case.  Her body clearly had not read the textbook!

A friend of ours was diagnosed with a rare type of cancer in her knee that usually appears in the spinal cord.  Her diagnosis was delayed because her body hadn't read the textbook.

This kind of situation occurs more often than we might imagine.  Our bodies are complex, individual organisms.  Each of us has her own genetic code, her own medical history, her own combination of environmental factors.  How our bodies manifest disease varies widely.

My situation was similar to our reader's. Thirteen years ago, I had some of the symptoms of IBC, but not all.  My doctor assured me that my swelling was not nearly as severe as it would be if I had IBC.  Thank goodness he believed that if one course of antibiotics does not clear up an apparent breast infection, it is time to biopsy to rule out IBC.

He was ahead of his time.  The current guidelines of the National Comprehensive Cancer Network say that doctors need to rule out IBC first when women who are not breast feeding have apparent breast infections.  

The wide variation in how breast cancer reveals itself is why we at the HealthCentral Breast Cancer site always tell readers to see a doctor for any change in their breast that lasts longer than a month.  Breasts are constantly changing over the course of the menstrual cycle as hormones surge and wane.  But when a change remains constant despite hormonal highs and lows, it is time to see a doctor.  Post-menopausal women should call a doctor sooner because their breast changes are less likely to be related to hormones.

What should you do if you have symptoms that don't seem to fit any known category?

First, remember you are not a doctor.  Symptoms that can relate to breast cancer can also relate to other problems.  Swollen lymph nodes under the arm might be related to lymphoma.  Redness under the breast might be a fungal infection.   Googling "itchy breast" may lead you to articles on IBC, but an itchy breast is more likely to be dry skin or an allergy than a rare type of breast cancer.  It is important to have your doctor assess the entire situation.