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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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Things worth knowing about "Breast Gland Inflammation"

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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