Periductal mastitis occurs when the tissue containing the milk ducts under the nipple and areola skin become inflamed and infected. It’s a benign condition which can affect women of all ages but is more common in younger women and smokers.
- the breast becoming tender and hot to the touch
- the skin may appear reddened
- discharge from the nipple, which can be bloody or non-bloody
- Discharge from the area of skin change on the breast
- a pulled-in (inverted) nipple.
Occasionally, a collection of pus (abscess) or an abnormal opening between the duct and the skin may develop (fistula).
People who smoke have a significantly increased risk of being affected by periductal mastitis, because some chemicals in cigarette smoke can cause inflammation in the ducts behind the nipple. Nipple piercings can also increase the chances of infection and make periductal mastitis more difficult to treat.
The condition is normally relatively easy to identify on clinical examination, but it is common to arrange investigations such as a mammogram and ultrasound scan to confirm this.
If you have discharge from the nipple or breast, a sample may be sent to check for any evidence of active infection and to help guide the use of antibiotics.
Some people may not need any treatment for periductal mastitis as it can clear up by itself. Continuing to smoke can prevent the inflammation from clearing up, so if you smoke it’s a good idea to try to cut down or to stop.
You may also want to take pain relief as the breast is frequently painful with this condition, and antibiotics may be required.
If you have developed an abscess then it may need to be drained, but this may often be done using a fine needle and syringe to draw off any pus. It is uncommon to need an operation for this condition.
If periductal mastitis doesn’t get better after taking antibiotics or if it comes back repeatedly, you may need to consider having an operation to remove the affected duct or ducts. As with all surgery, there are risks as well as benefits to an operation, and it is important that any questions you have about surgery are answered before you commit to an operation.
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