Breast Gland Inflammation (Mastitis) – Causes & Treatment
Breast gland inflammation, known medically as mastitis, is an inflammatory condition of breast tissue that most commonly affects breastfeeding women but can also occur outside of lactation.
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Breast gland inflammation, known medically as mastitis, is an inflammatory condition of breast tissue that most commonly affects breastfeeding women but can also occur outside of lactation.
What Is Breast Gland Inflammation?
Breast gland inflammation, medically known as mastitis, is an inflammation of the breast tissue. It most commonly occurs in breastfeeding women – referred to as lactational mastitis or puerperal mastitis. However, it can also develop independently of breastfeeding, in which case it is called non-puerperal mastitis. In rare cases, men may also be affected.
Causes
The causes of breast gland inflammation differ depending on the type:
Lactational Mastitis (Puerperal Mastitis)
- Milk stasis due to incomplete emptying of the breast
- Bacterial infection – most commonly Staphylococcus aureus – entering through cracks or wounds in the nipple
- Incorrect breastfeeding latch technique
- Oversupply of breast milk (hyperlactation)
Non-Puerperal Mastitis
- Hormonal changes
- Smoking (a known risk factor for periductal mastitis)
- Inverted nipples, which can promote bacterial accumulation
- Weakened immune system or chronic illness
- In rare cases: abscess formation or granulomatous mastitis
Symptoms
Typical signs and symptoms of breast gland inflammation include:
- Redness, swelling, and warmth of the affected breast
- Tenderness and a feeling of pressure in the breast tissue
- Hardness or lumps in the breast area
- General malaise, fever, and chills (especially with bacterial mastitis)
- Purulent discharge from the nipple (in advanced infections)
- Abscess formation (a collection of pus) if the condition is left untreated
Diagnosis
Diagnosis is typically made through a physical examination. Depending on the clinical presentation, the following investigations may be used:
- Breast ultrasound (sonography): to detect abscesses or tissue changes
- Laboratory tests: complete blood count, inflammatory markers (CRP, white blood cell count)
- Swab or milk culture: to identify the causative organism and guide antibiotic therapy
- Mammography or MRI: if inflammatory breast cancer or unclear findings are suspected
Important: In cases of persistent symptoms or lack of response to treatment, inflammatory breast cancer must be excluded, as its symptoms can closely resemble those of mastitis.
Treatment
General Measures
- Regular and complete emptying of the breast (breastfeeding or pumping)
- Cooling the affected breast to relieve pain and swelling
- Adequate fluid intake and rest
- Wearing a well-supporting, non-restrictive bra
Medication
- Antibiotics: Bacterial mastitis is typically treated with penicillinase-resistant penicillins (e.g., dicloxacillin) or cephalosporins. Breastfeeding mothers receive medications compatible with nursing.
- Pain relievers and anti-inflammatory drugs: Ibuprofen or paracetamol for pain relief and fever reduction
Abscess Treatment
If an abscess (an encapsulated collection of pus) has formed, surgical drainage (incision and drainage) or ultrasound-guided needle aspiration is necessary.
Breastfeeding During Mastitis
In most cases, breastfeeding can and should be continued during mastitis, as it helps to drain the breast and promotes healing. Continued breastfeeding is generally considered safe for the infant.
Prevention
- Learning correct breastfeeding latch technique
- Regularly and completely emptying the breast
- Caring for nipples to prevent wounds and cracks
- Seeking lactation counseling when needed
References
- Spencer J.P. - Management of mastitis in breastfeeding women. American Family Physician, 2008; 78(6): 727-731. PubMed.
- World Health Organization (WHO): Mastitis – Causes and Management. WHO/FCH/CAH/00.13. Geneva, 2000.
- Dixon J.M. - Breast infection. BMJ Clinical Evidence, 2011. BMJ Publishing Group.
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