BREAST INFECTIONS

The incidence of breast infections is relatively rare. It is most commonly encountered in women who are breast feeding .

Rarely these occur in women who are not breast feeding. Chronic and recurring abscesses are sometimes seen in ladies in their younger years and is very commonly associated with cellular changes (metaplasia ) of the ducts. This can also happen in women with low immunity like those with diabetes

The two common types of breast infections are

MASTITIS

Cause of mastitis is breast feeding, cracked nipples and poor hygiene. The most common bacteria causing mastitis and abscess is Staphylococcus aureus. This bacteria is commonly found on the skin

Lactational (puperal) mastitis typically involves the connective tissue of the lactating breast. The main reason is milk stasis and because of this bacteria finds milk a good culture media it starts multiplying in the breast .the bacteria may be in the blood of the lady/ on the skin or may enter from the mouth of the baby while suckling. The woman complains of sudden onset swelling hardness/ lumpiness and pain.

BREAST ABSCESS

When mastitis is ignored or the antibiotics do not work pus starts forming in the infected area and this condition is called breast abscess.

Symptoms of breast infection

A swelling that suddenly appears in one breast

Excessive pain on touch

Excruciating pain while breast feeding

Redness and warmth over that particular area

Pus coming out of nipples

Fever with chills

Generalised weakness

Painful lump in the armpit/ that side of breast where the breast lump is

Diagnosis of breast infection

Diagnosis is made by a Breast Specialist in a Breast Clinic. The doctor will ask questions and do a physical examination. He / she will then order an ultrasound which will help differentiate between mastitis / breast abscess (pus). A mammography may be required in case inflammatory cancer is suspected. If the doctor feels the requirement of an FNAC (needle breast biopsy) or sending aspirated fluid for culture, he may do so. Certain blood tests may also be ordered.

Treatment of breast infections

Treatment is by antibiotics and anti inflammatory medicines given for a long time (10 -14 days).

General measures include expression of milk (manually or by breast pumps) in nursing mothers / continuing breast feeding

Hot /cold compresses

Breast support

Plenty of liquids/ hydration

Good diet

Mastitis starts settling with theses measures; if it doesn’t then it may progress into breast abscess where by pus starts forming. This pus is not responsive to the antibiotics. Small abscess can be drained by means of needle (ultrasound guided if required). This may take more than one sitting. Larger abscesses need to be incised by a good Breast Surgeon.Pus obtained is sent for culture and this will guide in case antibiotic needs to be changed.

Prevention

Maintain hygiene

Do not allow milk to stay in the breast for long time

If the baby is not breast feeding soften the breast by manual expression or by means of a breast pump. Static milk in an engorged breast is an open invitation for the bacteria to multiply and infect the breast. Cracked nipples need to be taken care of.

Feeding equally from both breasts.

If you are suffering from any symtoms mentioned above , do not hesitate to consult Gynaecologist Dr Ruchi Rai Ahuja who has an immense experience of managing post delivery patients with breast infection. Dr Alok Ahuja is a highly experienced surgeon in the field of breast diseases.