Recurring Breast Issues: Seeking Solutions for Persistent Inflammation

Breast issues keep recurring?

The breast often becomes red, swollen, and inflamed, and each time it recurs, the swelling never fully resolves.
It always requires incision and drainage when it becomes abscessed.
I have been pregnant before, and the lump is located beneath the areola; when it is not inflamed, I cannot feel anything, but when it is inflamed, the breast becomes red and swollen.
An ultrasound indicated a 5 cm mass, which the doctor described as similar to a fibroma or sebaceous cyst, and it can recur like acne.
The symptoms are somewhat similar to mastitis.
Recently, it has started to swell again, and I experience sharp pain when lying down or when pressure is applied.
I do not want to take medication because my previous experiences have shown that medication only accelerates the process of abscess formation, leading to surgery and drainage every year.
Is there a solution to this problem?

Lala, 20~29 year old female. Ask Date: 2016/10/02

Dr. Wu Jianting reply Breast and Thyroid

Non-lactational mastitis is indeed more challenging, with a higher recurrence rate.
The primary surgical intervention involves drainage and debridement, particularly the excision of obstructed ducts.
In cases of recurrent episodes, more extensive surgery may be considered.
Minimally invasive procedures can remove granulation tissue through smaller incisions, representing a newer approach.
However, there is currently no definitive conclusion regarding the advantages and disadvantages compared to traditional surgery.
Thank you for your question.

Reply Date: 2016/10/02

More Info

Recurring breast inflammation and pain can be a distressing and frustrating experience, especially when it leads to repeated surgical interventions for drainage. Based on your description, it seems you are dealing with a complex situation involving recurrent breast inflammation, possibly related to a condition like a breast abscess or a fibrocystic change.
Firstly, it’s essential to understand that recurrent breast inflammation can stem from various causes, including infections, blocked ducts, or benign tumors such as fibroadenomas or sebaceous cysts. Your mention of a 5 cm mass that resembles a fibroma or cyst suggests that there may be a structural issue contributing to your symptoms. These masses can sometimes become inflamed or infected, leading to the symptoms you are experiencing.

Given your history of recurrent infections and the need for drainage procedures, it’s crucial to address both the immediate symptoms and the underlying causes. Here are some steps you might consider:
1. Consult a Specialist: Since you have already seen various doctors, it might be beneficial to consult a breast specialist or a surgeon who specializes in breast conditions. They can provide a more comprehensive evaluation of your situation, including the mass you mentioned.

2. Imaging Studies: If you haven’t had a recent ultrasound or mammogram, it may be worthwhile to undergo these tests again. Imaging can help determine the nature of the mass and whether it has changed over time. This is particularly important if the mass is suspected to be a cyst or a benign tumor.

3. Biopsy: If there is any uncertainty regarding the nature of the mass, a biopsy may be necessary. This can help rule out any malignant processes and provide clarity on the best course of action.

4. Surgical Options: If the mass is confirmed to be benign but is causing recurrent issues, surgical removal might be a viable option. This could prevent future infections and the need for repeated drainage procedures. Discuss the risks and benefits of surgery with your doctor.

5. Lifestyle and Home Remedies: While waiting for a definitive treatment plan, consider some home remedies to manage inflammation. Warm compresses can help alleviate pain and reduce swelling. Additionally, maintaining a healthy diet and staying hydrated can support your immune system.

6. Medication Management: If you are hesitant to take antibiotics due to past experiences, discuss alternative medications with your doctor. Sometimes, a different class of antibiotics or anti-inflammatory medications may be more effective without leading to rapid recurrence of infection.

7. Follow-Up Care: Regular follow-ups with your healthcare provider are essential. This allows for monitoring of the mass and any changes in your symptoms. Keeping a symptom diary can also be helpful for your doctor to understand the pattern of your condition.

8. Consider Underlying Conditions: Since you mentioned a history of pregnancy, it’s also worth discussing any hormonal factors that might be contributing to your symptoms. Conditions like hormonal imbalances can exacerbate breast issues.

In conclusion, while recurrent breast inflammation can be challenging, a thorough evaluation by a specialist, combined with appropriate imaging and possibly surgical intervention, can provide a pathway to relief. It’s essential to advocate for your health and seek out the care that addresses both your symptoms and the underlying causes effectively.

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