breast infection/mastitis

Breast infection most commonly affects women between the ages of 18 and 50 and is much less common than it used to be. Breast infection can be split into two groups: those which occur in women who are breastfeeding and that which occurs spontaneously

Mastitis is an infection of the tissue of the breast that occurs most frequently during the time of breastfeeding. This infection causes pain, swelling, redness, and increased temperature of the breast. It can occur when bacteria, often from the baby's mouth, enter a milk duct through a crack in the nipple. This causes an infection and painful inflammation of the breast.
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 as well as in women after menopause. Other causes of infection include chronic mastitis and a rare form of cancer called inflammatory carcinoma.
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. These fill with milk during lactation after a woman has a baby. When a girl reaches puberty, changing hormones cause the ducts to grow and cause fat deposits in the breast tissue to increase. The glands that produce milk (mammary glands) that are connected to the surface of the breast by the lactiferous ducts may extend to the armpit area (axilla).
A breast infection that leads to an abscess (a localized pocket or collection of pus) is a more serious type of infection. If mastitis is left untreated, an abscess can develop in the breast tissue. This type of infection may require surgical drainage.


Non-breastfeeding infection:
Women who are not breastfeeding can still develop infection. The most common site affected is the area close to the nipple. Most women who get this type of infection are in their late 20s and early 30s and about 90 per cent of them smoke cigarettes.It seems that something in cigarette smoke damages the duct underneath the nipple and causes it to become infected. This condition is called periductal mastitis and causes pain and redness around the nipple and there is sometimes an associated lump.Antibiotics will get rid of the infection, but if the duct underneath the nipple is damaged, then it is likely that the infection will recur. If you do get recurrent episodes of infection, then you may have to have an operation to remove the diseased duct or ducts.



Causes :
Mastitis (inflammation of breast tissue) is a common benign cause of a breast mass. It is commonly seen in women after childbirth while breastfeeding. These masses are often quite painful. Women who are not breastfeeding can also develop mastitis. In healthy women, mastitis is rare. However, women with diabetes, chronic illness, AIDS, or an impaired immune system may be more susceptible to the development of mastitis.
Bacteria normally found in a baby's mouth or on the nipple can enter the milk ducts through small cracks in the skin of the nipple and can multiply rapidly in the breast milk. This can lead to a superficial small area of inflammation (frequently from streptococcal bacteria) or a deeper walled–off infection or abscess (frequently from staphylococcal bacteria).
Mild temperature elevations (previously termed milk fever) accompanied by some breast or nipple soreness is usually secondary to engorgement and dehydration immediately (24–72 hours) after delivery and is treated by improved breastfeeding technique. The body temperature should not be above 39°C (102.2°F), nor should the fever persist for longer than about 4–16 hours. This condition may also occur in women who are not breastfeeding and have not completely suppressed lactation yet.
About one to three percent of breastfeeding mothers develop mastitis, usually within the first few weeks after delivery. Most breast infections occur within the first or second month after delivery or at the time of weaning. Typically, the infection is only in one breast. 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. These clogged ducts make the breast more prone to bacterial infection. This type of infection tends to come back after treatment with antibiotics.


Symptoms :
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
-Rigor or shaking
Abscess: Sometimes a breast abscess can complicate mastitis. Harmless, 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 the following:
-Tender lump in the breast that does not get smaller after breastfeeding a newborn (If the abscess is deep in the breast, you may not be able to feel it). The mass may be moveable and/or compressible.
-Pus draining from the nipple
-Persistent fever and no improvement of symptoms within 48–72 hours of treatment