Mastitis, which is inflammation of the breast tissue, is often associated with complications that hinder breastfeeding due to blocked milk ducts. While this is certainly a common cause of inflammation, you don’t have to be breastfeeding to develop inflammation of your breast tissue. And if you suffer from inflammation for a long period of time without treating the underlying cause, that inflammation can lead to further complications.
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Internist Lakshmi Khatri, MD, explains the causes of non-lactational mastitis, how its treatment differs from that of lactational mastitis, and why you should always see a doctor if you experience symptoms.
How did the mastitis come about?
Mastitis is an inflammatory disease of the breast that is often caused by or leads to an infection. In non-lactation-related mastitis, the inflammation is often caused by compression or blockage of the milk ducts and swelling of the surrounding breast tissue. This can be due to several reasons:
- Periductal mastitis is the most common cause of non-lactational mastitis. It often occurs because areas of your breast under your areola become inflamed, causing the milk ducts to become blocked or pus-filled abscesses to form. “Periductal mastitis is most common in women who smoke because smoking can cause changes in the cells of your milk ducts,” says Dr. Khatri. “When younger people come to us with recurrent abscesses — that is, they keep coming back even after they’ve cleared up — they often need to see a surgeon to have a milk duct cut out or removed.”
- Duct ectasia is a non-cancerous breast condition that can cause inflammation and thickening of the milk ducts. It may be accompanied by discharge from the nipple. This occurs most often in premenopausal women.
- Idiopathic granulomatous mastitis (IGN) is a rare inflammatory breast disease of unknown cause that often resembles or resembles inflammatory breast cancer.
- Bacterial infections Like tuberculosis, staphylococci (staphylococci) and streptococci (angina pectoris) can also lead to the development of inflammation of the breast and non-lactational mastitis.
“Your skin is a barrier against infection, so if the skin is damaged for any other reason, bacteria living on the skin can very easily enter and cause an infection,” explains Dr. Khatri. “This would cause local redness, heat, warmth and pain.”
Symptoms of mastitis when not breastfeeding
Lactational and non-lactational mastitis can cause similar symptoms such as pain, redness and swelling. However, non-lactational mastitis often shows other symptoms such as:
- Pain on one side of your body, usually the same side as the affected breast.
- Firm and/or painful lumps in the breast, usually located around the areola.
- Breast abscesses that can rupture, causing discharge from the nipple.
- Swollen lymph nodes in the neck or armpits.
“In particular, idiopathic granulomatous mastitis usually occurs at the edge of the breast, away from the areola and the central part of the breast,” explains Dr. Khatri.
What can be confused with mastitis?
The redness and pain associated with non-lactational mastitis can also occur with inflammatory breast cancer. Although rare, inflammatory breast cancer occurs when cancer cells block lymph vessels – small hollow tubes that drain lymph fluid from your breasts. These blockages can then lead to inflammation, which can sometimes be confused with mastitis.
“Inflammation can occur whenever lymphatic drainage is blocked,” says Dr. Khatri. “Inflammatory breast cancer can cause redness, pain, and a kind of orange peel skin condition where the pores are clearly visible and the skin becomes very thick.”
Another condition that can be confused with mastitis is cellulitis, as it is a skin infection that can occur anywhere on the body, including the breasts.
“Cellulite often occurs because bacteria can enter the skin when the barrier breaks down,” she continues. “This often occurs with an underlying skin condition such as eczema or inflammation under the breasts caused by moisture.”
Treatment options
There are some things you can do at home to help reduce the severity of your mastitis symptoms, such as:
- Use a warm compress to promote drainage if an abscess is present.
- Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to reduce inflammation.
But treating symptoms is only a small part of the solution if you have breast inflammation.
“Unlike lactation-related mastitis, where there are ways to relieve and cure it without antibiotics, non-lactation-related mastitis requires some kind of treatment in most cases,” explains Dr. Khatri.
If you have periductal mastitis or breast abscesses, these abscesses will need to be drained and you will likely need antibiotics to clear the infection. If you have IGN, you may need a biopsy to determine if the inflammation is caused by mastitis or breast cancer.
In some cases, surgery may be necessary if you have a very large abscess that needs to be drained.
“Surgery is only used as a last resort,” notes Dr. Khatri. “If it is severe and painful enough, surgeons will take patients to the operating room for these procedures, but often it is an outpatient procedure. Radiologists can use a needle to drain the fluid from the pus pocket or abscess, if there is one. Surgeons can also do this in the office by numbing the area and making a very small incision to release all the pressure of the fluid.”
Is this an emergency?
If left untreated, mastitis can lead to systemic problems with worsening symptoms, such as:
“If you are experiencing these systemic symptoms, these are signs that your mastitis may be severe enough to require intravenous antibiotics,” says Dr. Khatri.
Can mastitis go away on its own?
Non-lactational mastitis does not heal on its own. In addition, it is often confused with more serious conditions such as breast cancer. If you are experiencing any of the symptoms of mastitis, it is important to get checked out by a trusted doctor as soon as possible to make sure you are receiving the right treatment and that your symptoms are actually caused by mastitis.
“I wish there were really simple home remedies for this, but that is not the case with non-lactational mastitis,” says Dr. Khatri. “It is an inflammatory disease and treatment must be tailored to the cause.”
