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    Mastitis

    Overview
    Causes
    Symptoms
    Risk Factors
    Prevention
    Diagnosis
    Treatment
    Where to Seek Treatment

    Contributed by:
    SingHealth Duke-NUS Breast Centre



    Overview

    Mastitis is usually an infection of the breast tissues. It is common in breastfeeding women.

    It can occur anytime during lactation but is more common in the first 3 months of lactation. About up to 10 percent of women who breastfeed may be affected.

    Causes

    This may be from a blocked milk duct, or bacteria that enters the breast tissue through cracks or breaks in the skin or nipple.

    Symptoms

    Symptoms include:

    • Breast pain
    • Swelling
    • Redness and warmth
    • Development of a breast lump
    • Fever, chills and tiredness

    Risk Factors

    Mastitis is most often related to:

    • Breastfeeding
    • Sore or cracked nipples
    • Using only one position to feed
    • Wearing a tight bra that may restrict milk flow
    • Mastitis not related to breastfeeding may be seen in women with diabetes mellitus

    Cancer Risk
    Mastitis does not increase the risk of breast cancer.

    Idiopathic Granulomatous Mastitis (IGM)
    Women not lactating or breastfeeding can also get mastitis. In some of these women, the cause is unknown. This may be resolved with a course of antibiotics, but if IGM persists, it may become complicated and abscesses may result.

    Surgery to drain the infection and to obtain tissue for biopsy may be needed. In some severe cases, steroid therapy may be considered if an infective cause is excluded.

    Prevention

    Women are encouraged to breastfeed frequently, especially when breasts feel engorged. Try to ensure that your baby latches on properly during feeding and allow the baby to finish feeding.

    Avoid pressure on the breasts e.g. tight bra/clothing and adjust breastfeeding techniques to avoid breast engorgement.

    Diagnosis

    Diagnosis is made on assessment of history and by clinical physical examination. Breast imaging such as breast ultrasound may be needed to assess for abscess formation (collection of pus material within the breast).

    Mammograms are usually not needed and can be uncomfortable. A biopsy may be indicated if symptoms persist after a course of antibiotics.

    Treatment

    Antibiotics and pain relief are the main courses of treatment. Usually a course of oral antibiotics is sufficient. However, if the condition persists or worsens, intravenous antibiotics may be required. If it is not treated adequately, an abscess may form and this may require surgical drainage.

    Where to Seek Treatment

    Specialist services available at the SingHealth Duke-NUS Breast Centre located at:

    National Cancer Centre Singapore Tel: 6436 8088
    Singapore General Hospital Tel: 6321 4377
    Changi General Hospital Tel: 6850 3333
    Sengkang General Hospital Tel : 6930 6000
    KK Women's and Children's Hospital Tel: 6294 4050

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