After our article two weeks ago, we received a heart-rending letter from a mother whose daughter died from inflammatory breast cancer. She expressed frustration about the difficulty in diagnosing this rare form of breast cancer. According to the woman, her daughter had seen several physicians, had several biopsies, all of which were negative for cancer.

Although some sources refer to this as "a new type of breast cancer that doctors do not know about," IBC has been known about for decades - but it is difficult to diagnose.

IBC is a rare and aggressive type of breast cancer that accounts for 1 percent to 5 percent of all breast cancer cases in the United States.

IBC typically blocks the lymph vessels in the skin of the breast. This makes the skin appear pitted like the skin of an orange, called "peau d'orange." IBC rarely causes a lump and may not show up on a mammogram. The breast can also be tender and heavy, and a normally everted (turning outward) nipple can become inverted (turning inward). One may also note tender or swollen lymph nodes under the arm or above the collarbone.

Symptoms of IBC can develop very quickly, and include a breast that suddenly enlarges and becomes very red and warm, and may itch. It is important to note that these symptoms can be the same for an infection or an injury. The first step is to visit with your health care provider, who may prescribe a course of antibiotics. If the symptoms do not resolve, further testing is indicated.

Testing will include a mammogram or ultrasound, magnetic resonance imaging and a biopsy of breast tissue or the skin of the breast. After diagnosis, the patient should be sent to a medical oncologist, who will head up a multidisciplinary team.

IBC may involve a different sequence of therapies. Treatment may consist of aggressive chemotherapy, followed by mastectomy and then radiation. Further treatment may consist of targeted therapy and hormonal therapy.

IBC may affect younger women and is aggressive. Although prognosis has historically been poor, there are now cures. Early diagnosis remains the key factor in curing IBC.

While the outlook has improved for treating IBC, coping with the disease is not easy. Because of the rapid nature of IBC, treatment is started quickly and the patient usually has not had time to process what is happening. Women should not try to "go it alone." Seeking support from family and friends can make the journey easier for you and for them.

There is no "right" way to feel and act when you are dealing with cancer. You will have feelings of sadness, anxiousness and anger, and you need to know that these feelings are normal. Try not to "I should have," as this leads to negativity and frustration. Trying to keep a positive attitude makes a difficult journey easier to travel.

Char Houska is a registered nurse, oncology-certified nurse, certified breast care nurse, breast care coordinator and cervical cancer survivor at St. Patrick Hospital and Health Sciences Center.