Mastitis
Summary/Definition
Mastitis is an inflammatory process of the breast that occurs against the background of bacterial infection, which can be divided into acute purulent infection, chronic non—lactational mastitis and chronic lactation mastitis. Lactation mastitis is when bacteria enter through the milk ducts and cause inflammation in the nutrient–rich breast tissue. In most cases, bacteria enter the mammary glands through the milk ducts during breastfeeding. Non–lactational mastitis is a blockage of the milk ducts, especially in the enlarged area of the duct below the nipple, which causes inflammation. In the case of breast cancer during lactation, the causative agents are mainly Staphylococcus aureus, which is relatively easy to treat. Since pathogen bacteria are diverse, treatment is difficult, the frequency of relapses and complications is high, in most cases long-term treatment is required. Other inflammatory diseases include ductal papilloma, peripheral mastitis unrelated to lactation, breast inflammation due to skin injuries, breast tuberculosis, granulomatous lobular mastitis, artificial feeding mastitis, Mondor’s disease, diabetic mastopathy, etc. Non-lactational mastitis is divided into inflammation of peripheral tissues or near the areola of the nipple, which occurs due to the expansion of the ducts, and peripheral mastitis, abscesses and other inflammatory diseases that often occur in the mammary gland in diabetics or with a decrease in the body’s resistance. Mastitis during lactation is not a very frequent inflammation of the breast in non-lactating women, but in lactating women there is a blockage of the ducts of the breast with milk retention, which develops during breastfeeding, so if a bacterial infection occurs, it can easily develop into acute mastitis.
Types of non-lactational mastitis include inflammation of peripheral tissues around the areola, ductal papilloma, peripheral mastitis unrelated to lactation, breast inflammation associated with skin injury, contact dermatitis of the breast, tuberculosis of the breast, granulomatous lobular mastitis, mastitis with artificial feeding, Mondor’s disease, diabetic mastopathy, neonatal mastitis. Mastitis during breastfeeding occurs when a child bites the nipple while sucking milk or a wound forms on the nipple, which causes bacteria such as Staphylococcus aureus to enter the mammary gland.
Symptoms
Usually, with mastitis, your chest hurts and symptoms such as fever, chills and body aches appear at temperatures above 38.5 ° C. The whole body tingles and hurts, as if with a cold. The area of inflammation of the breast turns red, there is pain with a feeling of heat. A lump may form in the chest, causing pain, and the lymph nodes under the arm may increase. With non-lactational mastitis, in some cases, solid formations, multiple abscesses and characteristic accumulations of masses, etc. may appear. In the case of lactation mastitis, symptoms are most pronounced during the first 6 weeks of breastfeeding and during weaning and include pain, redness, swelling and soreness. In severe cases, mastitis is accompanied by systemic symptoms such as chills and fever, and with further progression, such symptoms as sepsis, fever, tachycardia and an increase in the number of white blood cells may appear.
Diagnostics
Breast imaging, breast ultrasound, mammography, etc. is performed. If necessary, a biopsy is also performed to identify the inflammatory process of the breast.
Treatment and course of the disease
Depending on the cause, non-lactational mastitis can be treated with medications such as antibiotics and anti-tuberculosis drugs, as well as surgically. In most cases, lactation mastitis can be treated with appropriate antibiotics before an abscess forms. Some antibiotics get into milk during breastfeeding, so it is important to check whether they are harmful to the baby, and if the condition does not improve within a few days with appropriate antibiotic treatment, it is necessary to identify an abscess or an inflammatory process of the breast. It is diagnosed by ultrasound or needle aspiration. Antibiotics are usually used for 10-14 days. With staphylococcus – dicloxacillin 250-500 mg 4 times a day, with streptococcus – penicillin, and if the child is older than 1 month, you can also use ampicillin or erythromycin. When treated with antibiotics, symptoms usually begin to improve within 1-2 days, and after about a week the swelling subsides, the reddened breast area gradually decreases. However, mastitis can recur if you do not take antibiotics for a sufficient period of time.
