What are the other Names for this Condition? (Also known as/Synonyms)

• Breast Abscess
• Infection of the Breast Tissue
• Mastitis

What is Breast Infection? (Definition/Background Information)

• Breast Infection is a common infection that involves the fatty tissues present in the breast. It is also known as Mastitis
• The condition is generally seen in lactating mothers, but may also affect menopausal women and women with certain underlying health conditions
• Breast Infection is mostly caused by Staphylococcus aureus bacterium that can enter from the baby’s mouth to the milk ducts through a crack in the nipples of the breast
• The infection is characterized by swelling of the breast affecting the milk ducts and causing lumps, pain, swelling, redness, also increasing the temperature in the breast
• Breast Infection is normally treated with antibiotics and through conservative measures, such as rest, warm and cold compresses, which help speed up the recovery process. The prognosis is usually excellent with adequate treatment

Breast Infection is different from subareolar abscess, a relatively rare condition mostly observed in young and middle-aged women, who are not breastfeeding. The primary cause of subareolar abscess is the blockage of a breast duct located in the nipple area and subsequent infection of the areolar gland. It has been reported that a vast majority of women with this condition are smokers.

Who gets Breast Infection? (Age and Sex Distribution)

• Breast Infection generally occurs in breastfeeding women. It usually occurs within 1 to 6 months after child delivery
• It is observed that in between 1% to 3% of the breastfeeding mothers may be affected by this infection
• Even though it usually occurs within the first few weeks after delivery, the condition may also develop in women that have not delivered recently
• Women undergoing menopause can also be affected
• There are no specific racial or ethnic group preferences noted

What are the Risk Factors for Breast Infection? (Predisposing Factors)

The risk factors for Breast Infection may include:

• Breastfeeding women are at high risk for this infection; when it occurs in this subset of women, it is known as Lactation Mastitis
• Exposure to Staphylococcus aureus bacteria increases the risk of occurrence of this infection
• Women in the menopausal stage are also at a high risk for Breast Infection
• Diabetes: Women with uncontrolled diabetes are generally vulnerable
• Chronic illness: Women, who are affected by long-term illnesses, are easily prone to this infection
• Compromised immune system caused by AIDS, HIV infection, and other such factors can increase one’s susceptibility to Breast Infection
• Women who have had breast surgery along-with radiation therapy

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Breast Infection? (Etiology)

The infection that occurs in the fatty tissues present in the breast is termed Breast Infection (or Mastitis). It is characterized by swelling of the breast affecting the milk ducts and causing lumps and pain in the breast.

• It is frequently caused by Staphylococcus aureus bacterium that can enter the breast through a crack or a sore in the nipples
• This is followed by Streptococcus agalactiae, which is the second most common pathogen (bacterium) causing Breast Infection
• Apart from Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus (MRSA) can also cause Breast Infection
• Other possible causes include:
  • Inflammatory carcinoma: A form of cancer that occurs in the skin or tissues that cover the organs of the body
  • Engorgement or overfilling of the breast with excess milk can contribute to the development of Breast Infection
  • Not emptying the breast fully (while feeding) can also lead to infections

What are the Signs and Symptoms of Breast Infection?

The common signs and symptoms in women with Breast Infection may include:

• One side breast gets swollen and becomes bigger in size
• Lumps start appearing in the breasts
• Breast pain
• Fever and chills
• Body ache
• Fatigue and loss of energy
• Overfilling of the breast with milk
• Tremors
• Flu-like symptoms including:
  • Nausea
  • Vomiting
• Itching sensation
• Discharge of pus from the nipples
• Sensation in the nipples is affected
• Tender and swollen breast; redness of the breast
• The breast is warm to touch
• Lymph nodes in the armpits may become tender 
• Enlargement of the lymph nodes in the armpit may also be noted

How is Breast Infection Diagnosed?

The signs and symptoms of Breast Infection occurring in lactating mothers is often helpful in making the diagnosis. But in order to confirm the infection, the milk from the nipple may be sent for a culture test.

• A physical examination of the breast may be performed to see if there are any lumps and swelling in the breast
• An ultrasound scan may be done to check for the presence of a breast abscess. Depending on the location of the breast abscess, treatment to drain the abscess may be performed on a case-by-case basis
• Tests for women who are not breastfeeding may include:
  • Mammography (or X-ray of the Breast): It is an imaging technique that uses low-dose X-rays to examine the breasts and detect breast disease early
  • Breast biopsy: Sample tissues from the breasts are taken and sent for testing in a lab to check for breast cancer or other breast disorders. A biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions can have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Breast Infection?

The complications of Breast Infection may include:

• Discharge of pus from the nipple
• Chronic mastitis: Infection in the breast that may last for a very long time
• Severe Breast Infection can lead to abscess formation:
  • The treatment for abscess includes a surgical drainage
  • In some cases, the healthcare provider may advise mothers to stop breastfeeding their children until the infection is treated adequately
• Recurrence of infection following suitable treatment is a possibility

How is Breast Infection Treated?

The following treatment/management methods may be adopted to treat/control Breast Infection:

• Applying moist heat on the breast for 15-20 minutes four times a day may be beneficial
• Heat packs and ice pack massages can be applied on the breast after feeding the child
• Over-the-counter medications, such as acetaminophen and ibuprofen, may be used for treating the symptoms
• Antibiotic medications are prescribed for effectively treating the bacterial infection. Oral antibiotics may be recommended for simple infections and may include:
  • Cephalexin
  • Dicloxacillin
  • Erythromycin
• If the condition is due to severe infection or causes painful engorgement of the breast, a breast pump can be used to drain the breast. If infection is severe, then the drained breast milk is often discarded. If the infection is mild, a healthcare professional would recommend whether to discard the breast milk or not
• If the infection is recurring and causing a huge discomfort, then the patient may require hospitalization for intravenous antibiotic therapy
• Intake of plenty of water and eating a well-balanced diet is recommended
• When the infection develops into an abscess, surgical intervention to drain the abscess is usually undertaken

Regular follow-up with the family physician is required to prevent complications and from the condition becoming chronic.

How can Breast Infection be Prevented?

The risk for Breast Infection may be lowered or prevented via the following measures:

• Nipples must be taken care of properly, so that it does not crack and cause irritation
• Frequent feeding of the baby is advised to avoid painful overfilling of the breast with excess milk
• Following proper and correct breastfeeding techniques is recommended
• Stoppage of breastfeeding should be undertaken gradually over time, and not done abruptly
• Breastfeeding equally from both the breasts can help minimize the risk for infection
• Maintaining good hygiene habits such as:
  • Frequent washing of hands
  • Regular cleaning of the nipples/breasts
  • Baby must be always kept clean and neat

What is the Prognosis of Breast Infection? (Outcomes/Resolutions)

• In a vast majority of cases, the prognosis of Breast Infection is very good with proper antibiotic therapy. However, the infection is likely to recur (later) even after the full course of antibiotic therapy
• Postmenopausal women with Breast Infection and abscesses are at a greater risk for recurrences

Additional and Relevant Useful Information for Breast Infection:

The La Leche League is a network group which dedicates itself to helping breastfeeding mothers.