Breast Inflammation: When to Seek Further Medical Advice

Mastitis

Hello Doctor: After my menstrual period started, I noticed that only my right breast has reduced swelling, while my left breast remains swollen and painful.
(There is no fever, and there is no redness or heat.) I visited a breast surgeon on Monday, and after a physical examination and an ultrasound, the doctor suspected inflammation and advised me to take medication for a week.
Today is the third day of taking the medication, and I still feel quite swollen, but the pain has decreased.
The more I read online, the more doubts and anxiety I have.
I also feel like my left armpit seems a bit swollen.
Should I complete the course of antibiotics first, or should I consult another physician for further evaluation? Thank you!

Shui Yun Cao, 30~39 year old female. Ask Date: 2013/06/05

Dr. Zhou Jiazhen reply Breast and Thyroid

Hello, the symptoms are mostly caused by hormonal imbalances in the body.
If there is no fever and no redness or swelling in the breasts, symptomatic treatment is sufficient (pain relievers and anti-inflammatory medications).
In addition to medication, it is important to pay attention to diet and lifestyle.
Reduce the intake of animal fats and fried foods, limit caffeine-containing foods, avoid excessive fatigue, maintain a regular lifestyle, and avoid staying up late or insomnia.
Reducing emotional fluctuations and stress can also help alleviate pain.
However, if symptoms persist, it is recommended to follow up with a breast surgery clinic within one week after the end of menstruation.
For the swelling in the armpit, it is necessary to first assess whether it is caused by accessory breast tissue in the axilla.
Wishing you peace and health.
Sincerely, Dr.
Chou Chia-Cheng, Chief of Surgery, Taoyuan Hospital, Department of Health.

Reply Date: 2013/06/05

More Info

Breast inflammation, commonly known as mastitis, can be a distressing condition, particularly when it recurs or does not respond to initial treatments. Your situation, where you have experienced persistent swelling and discomfort in your left breast, despite treatment, raises several important considerations.

Firstly, it is essential to understand that breast inflammation can occur for various reasons, including infections, blocked milk ducts (especially in breastfeeding women), or even non-infectious causes such as hormonal changes or trauma. In your case, since you have already been evaluated by a breast specialist who performed a physical examination and an ultrasound, it is a positive step that you are under medical care.

You mentioned that you are currently on a course of antibiotics, and while you have noticed a reduction in pain, the swelling persists. This is not uncommon; sometimes, inflammation can take longer to resolve than the pain associated with it. The fact that you are not experiencing fever or significant redness is reassuring, as these symptoms often indicate a more severe infection.

However, the concern about swelling in your left axilla (armpit) is noteworthy. Swelling in this area could indicate lymphadenopathy, which may occur due to localized inflammation or infection. It is crucial to monitor this symptom closely. If the swelling worsens or if you develop new symptoms such as fever, increased pain, or systemic symptoms (like fatigue or malaise), you should seek medical attention promptly.

Regarding your question about whether to complete the antibiotic course or seek a second opinion, it is generally advisable to finish the prescribed course of antibiotics unless directed otherwise by your healthcare provider. Antibiotics need time to work, and stopping them prematurely can lead to incomplete treatment and potential resistance. However, if you feel that your symptoms are not improving or are worsening, it is entirely reasonable to reach out to your healthcare provider for further evaluation.
If you decide to seek a second opinion, consider consulting another breast specialist or a general surgeon with experience in breast conditions. They may recommend additional imaging studies, such as a mammogram or MRI, to assess the situation further. In some cases, if an abscess is suspected, a procedure to drain the fluid may be necessary.

In summary, while it is essential to complete your antibiotic treatment, do not hesitate to communicate with your healthcare provider about your ongoing symptoms. If you feel uncertain or anxious about your condition, seeking a second opinion can provide peace of mind and ensure that you receive the most appropriate care. Remember, your health and comfort are paramount, and it is always better to err on the side of caution when it comes to persistent or concerning symptoms.

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