Here’s How You Can Get Mastitis Without Breastfeeding

We often associate mastitis, or inflammation of breast tissue, with complications that get in the way of breastfeeding because of clogged milk ducts. Although that’s certainly a common cause of inflammation, you don’t need to be breastfeeding to develop inflammation in your breast tissue. And if you’re experiencing inflammation for long periods of time without treating the underlying cause, that inflammation can lead to further complications.

Internal medicine physician Lakshmi Khatri, MD, explains what causes non-lactational mastitis, how it’s treated differently from lactational mastitis and why you should seek medical care whenever you experience symptoms.

How did you get mastitis?

Mastitis is an inflammatory condition of the breast that often results from or leads to an infection. In non-lactational mastitis, inflammation is often caused by the compression or blockage of milk ducts and the swelling of surrounding breast tissue. This can happen for a few different reasons:

• Periductal mastitis is the most common cause of non-lactational mastitis. It often occurs because areas of your breast underneath your areola become inflamed, causing a blockage of milk ducts or pus-filled abscesses to form. “Periductal mastitis is most common when you smoke because smoking can cause changes in the cells of your ducts,” says Dr. Khatri. “When younger patients come in with recurrent abscesses — meaning they continue to come back even after they resolve — they often have to see a surgeon to get a duct excised or removed.”
• Ductal ectasia is a noncancerous breast condition that can cause inflammation and thickening of your milk ducts. It can be associated with nipple discharge. This is most common in women who are approaching menopause.
• Idiopathic granulomatous mastitis (IGN) is a rare inflammatory breast condition with an unknown cause that often mimics or appears similar to inflammatory breast cancer.
• Bacterial infections like tuberculosis, staphylococcus (staph) and streptococcus (strep throat) can also lead to the development of inflammation in your breast and non-lactational mastitis.

“Your skin is a barrier from infection, so if the skin is broken down for another reason, then it’s very easy for bacteria that live on top of the skin to infiltrate and cause an infection,” explains Dr. Khatri. “That would cause localized redness, heat, warmth and pain.”

Symptoms of mastitis when not breastfeeding

Lactational and non-lactational mastitis can cause similar symptoms like pain, redness and swelling. But non-lactational mastitis often presents different symptoms like:

• Pain on one side of your body, typically the same side of the affected breast.
• Firm and/or painful breast lumps usually found around the areola.
• Breast abscesses that can rupture, causing nipple discharge.
• Swollen lymph nodes in your neck or armpits.

“Specifically, idiopathic granulomatous mastitis usually presents on the periphery of the breast farther away from the areola and central part of the breast,” clarifies Dr. Khatri.

What can be mistaken for mastitis?

The redness and pain that’s associated with non-lactational mastitis can also occur with inflammatory breast cancer. Although rare, inflammatory breast cancer occurs as a result of cancerous cells blocking lymph vessels — small hollow tubes that drain lymph fluid out of your breasts. These blockages can then lead to inflammation which can sometimes be mistaken for mastitis.

“Inflammation can happen in any scenario in which you’re blocking that lymphatic drainage,” says Dr. Khatri. “With inflammatory breast cancer, you can end up with redness of the skin, pain, and sort of an orange peel appearance where your pores are really obvious and the skin becomes really thick.”

Cellulitis is another condition that can be mistaken for mastitis because it’s an infection of the skin that can occur anywhere on your body, including your breasts.

“Cellulitis happens often because bacteria can penetrate the skin when there is a breakdown of the barrier,” she continues. “This is common with an underlying skin condition like eczema or with inflammation under the breasts from moisture.”

Treatment options

There are some things you can do at home to manage the severity of your symptoms when you have mastitis like:

• Using a warm compress to help promote drainage if an abscess is present.
• Taking over-the-counter nonsteroidal anti-inflammatory (NSAIDs) medications like ibuprofen to help with inflammation.

But symptom management is only a small part of the solution when you have a breast infection.

“Unlike with lactational mastitis, where there are ways to mitigate it and resolve it without the need for antibiotics, in most cases with non-lactational mastitis, you’re going to need treatment of some sort,” states Dr. Khatri.

If you have periductal mastitis or breast abscesses, you’ll need to have those abscesses drained and will likely need antibiotics to help clear the infection. If you have IGN, you may need a biopsy to determine whether it’s mastitis or breast cancer that’s causing your inflammation.

Surgery may be needed in some situations when you have a significantly large abscess that needs to be drained.

“Surgery is used as a last resort,” she notes. “If it’s severe and painful enough, surgeons will take patients to the operating room for these procedures, but it’s often an outpatient surgery. Radiologists can use a needle to drain the fluid from inside the pocket of pus or abscess if there is one. Surgeons can also do it in the office by numbing the area and making a very small incision to release all of the pressure from that fluid.”

Is it an emergency?

If left untreated, mastitis can lead to systemic issues with worsening symptoms like:

• Fevers over 100.4 degrees Fahrenheit (38 degrees Celsius).
• Chills.
• Nausea or vomiting.
• Increased heart rate.
• Body aches.
• Extreme fatigue.

“If you’re experiencing these systemic symptoms, these are signs that indicate your mastitis may be significant enough that you’ll need IV antibiotics,” says Dr. Khatri.

Can mastitis resolve on its own?

Non-lactational mastitis isn’t something that will resolve on its own. More than that, it’s often confused with more serious conditions like breast cancer. If you’re experiencing any of the symptoms of mastitis, getting evaluated by a trusted healthcare provider as soon as possible is crucial in making sure you receive the appropriate treatment and that it’s actually mastitis that’s causing your symptoms.

“I wish there were some really easy home remedies for this, but that’s not the case for non-lactational mastitis,” says Dr. Khatri. “It’s an inflammatory condition and treatment needs to be tailored to the cause.”