What are the symptoms of breast infection? What causes breast infection? How is breast infection treated? Get comprehensive information on breast infection and its management.

The Anatomy of the Breast

The breast is composed of several glands and ducts that lead to the nipple and the surrounding colored area called the areola. The milk-carrying ducts extend from the nipple into the underlying breast tissue like the spokes of a wheel. Under the areola are lactiferous ducts, which fill with milk during lactation after a woman has a baby. When a girl reaches puberty, changing hormones cause the ducts to grow and fat deposits in the breast tissue to increase. The glands that produce milk (mammary glands) are connected to the surface of the breast by the lactiferous ducts and may extend to the armpit area.

What is Mastitis?

Mastitis is an infection of the tissue of the breast that occurs most frequently during the time of breastfeeding. It can occur when bacteria, often from the baby’s mouth, enter a milk duct through a crack in the nipple. Breast infections most commonly occur one to three months after the delivery of a baby, but they can occur in women who have not recently delivered and in women after menopause. Other causes of infection include chronic mastitis and a rare form of cancer called inflammatory carcinoma.

Who is at Risk of Developing Breast Infection?

In healthy women, mastitis is rare. However, women with diabetes, chronic illness, AIDS, or an impaired immune system may be more susceptible. About 1%-3% of breastfeeding mothers develop mastitis. Engorgement and incomplete breast emptying can contribute to the problem and make the symptoms worse. Chronic mastitis occurs in women who are not breastfeeding. In postmenopausal women, breast infections may be associated with chronic inflammation of the ducts below the nipple. Hormonal changes in the body can cause the milk ducts to become clogged with dead skin cells and debris, making the breast more open to bacterial infection.

Symptoms of Breast Infection

Breast infections may cause pain, redness, and warmth of the breast along with the following symptoms:

• Tenderness and swelling
• Body aches
• Fatigue
• Breast engorgement
• Fever and chills

Breast Abscess: A Complication of Mastitis

A breast abscess can be a complication of mastitis. Noncancerous masses such as abscesses are more often tender and frequently feel mobile beneath the skin. The edge of the mass is usually regular and well defined. Indications that this more serious infection has occurred include a tender lump in the breast that does not get smaller after breastfeeding, pus draining from the nipple, and persistent fever with no improvement of symptoms within 48-72 hours of treatment.

When to Seek Medical Attention

Call your health care provider as soon as you feel any suspicious lump, whether you are breastfeeding or not. Call for an appointment if you have any abnormal discharge from your nipples, breast pain that is making it difficult for you to function each day, prolonged, unexplained breast pain, or any other associated symptoms such as redness, swelling, pain that interferes with breastfeeding, or a mass or tender lump in the breast that does not disappear after breastfeeding.

If you are breastfeeding, call your doctor if you develop any symptoms of breast infection so that treatment may be started promptly. You may need to be evaluated in a hospital’s emergency department if the breast pain is associated with other signs of an infection and if your health care provider cannot see you promptly.

Diagnosis and Treatment of Breast Infection

The diagnosis of mastitis and a breast abscess can usually be made based on a physical exam. If it is unclear whether a mass is due to a fluid-filled abscess or to a solid mass such as a tumor, a test such as an ultrasound may be done. An ultrasound may also be helpful in distinguishing between simple mastitis and abscess or in diagnosing an abscess deep in the breast.

If an abscess is confirmed, aspiration or surgical drainage, and IV antibiotics, are often required. Cultures may be taken, either of breast milk or of material taken out of an abscess.

Managing Breast Infection

Breast infections can be effectively managed with prompt treatment. Antibiotics are the mainstay of treatment, but home remedies like applying warm compresses and maintaining good breastfeeding practices can also help alleviate symptoms. In some cases, surgery may be necessary to drain an abscess. With proper care, most breast infections resolve without any long-term complications.