Treatment for nonlactational mastitis following radiation for breast cancer

By Georgia Ivie Wednesday, July 04, 2007

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I would like to know if there is anyone who has developed nonlactational mastitis following radiatiion for breast cancer. My surgeon says I am the first one she has ever encountered. I have been under treatment by this doctor but I am having trouble because of allergies to medication. I can only take 3 antibiotics, keflex (which I apparently have develop a resistance to, a new Rx for erthromycin (had to stop because of severe pain and nuseau) and she is refusing to give me the only one left tetracycline because she says she has never prescribed this drug before. Any suggestions??? I am at the point of total disgust...not including severe pain, redness in my breast and headaches, with fever if I do not take something for it...Thanks...Georgia Ivie, NC

new calcifications after radiation

Comments (48) | Add comment

8/ 8/07 7:20am

This mastitis is not that rare. I get it regularly. At first every month or so.Now 6 years post cancer/radiation I have just had a year free before this attack.I've been often in hospital on I.V. Flucloxacillin and Genticin for a week. But have NO useful veins now! Longterm oral fluclox.and penicillin may have helped frequency and severity of attacks.Latest idea from a microbiologist was Coamoxiclavulanic for ten days then stop.I had this a year ago and this attack is also responding to this. You are limited because of your allergies but Tetracycline is a very safe well tried bit old fashioned drug.Slow to produce allergy, only side effects of importance are yellow teeth in children and unborn,reacts with contraception Pill's absorption. The other idea is to disinfect the skin to prevent the re-infection. I think this has worked and kept me well for a year. I use antibacterial shower gel and moisteriser as required

Georgia Ivie 38

2/ 4/08 9:15pm

My radiation oncologist did not feel this was caused by just the radiation. I finally got so bad the surgeon went back in this last October 22nd and went back to ground O as she says and re-biopsy Once again, the pathology from the hospital came back with mastitis/cellulitis but said they could not isolate the bacteria...three days after I went home my breast opened up and another culture was performed...Lo and behold, it was a bacteria that they say is found in human feces...mine had to come from the operating room when I had my 2nd surgery in November 28 2006...mine has involved a pic line that had to be taken out becauseof problems with my heart as well as discovering a blood clot when the line was removed. I am now on Doxycycline 200 mg. per day...making me sick but I started taking some acephix hopefully will clear up soon.

Jan

9/19/09 11:38am

I have had mastitis from radiation and still have it and tired of living on antibiotics. I get very sick from them and have gastrointestinal problems.....it has been almost 5 yrs for me and have had more infections lately ........I feel bad for you because I know what you are going through......I wish I had some answers.....mine is from radiation burns.......they burnt me black.....went through hell..........Jan

Renee

2/ 4/08 8:09pm

I am in the process of having mine treated now. The attack came on violently and suddenly and I ended up in the hospital on IV antibiotics for three days, now on long term antibiotics and it's still not completely cleared up. Been almost two full months, but I understand now, it's not that uncommon at all for women who have had lumpectomies and radiation. Wish someone had told me before it scared me to death.

jeanfromNJ

3/ 7/08 12:53pm

Hi Georgia -

Yes! I have the same symptoms and have been treated with Keflex which didn't help. now i am on Augmentin. I see your post is from 2007. Can you give me any advice on how to get through this. The pain is unbearable. I'd like to hear from someone on what drugs work best and what my next steps shold be.

Thanks.

JeanfromNJ

Anonymous

3/ 8/08 11:17am

I am not sure I can be of much help...my infection was caused by a bacteria I apparently picked up from the 2nd surgery but was not diagnosed until almost a year later. They have been able to determine what antibiotic the bacteria is sensitive to and finally my breast is starting to heal. Fortunately, it was an antibiotic I could take...I have a lot of drug allergies. I am putting you on my prayer list, hopefully it will improve. Georgia Ivie in NC

Jean from New Jersey

3/ 8/08 11:55am

Hi Georgia,

Thank you for your reply. Can you tell me what antibiotic you took? Thank you for your prayers.

Jean from NJ

Georgia Ivie 38

3/ 8/08 9:38pm

Jean: the antibiotic the bacteria was sensitive to was Doxyclyclne. I have been on the IV through a PIC line and unfortunately I had problems with it so they took it out and am now on the pill...100 Mg. 2 times a day q12h. Hope this helps you out...Georgia in NC

Nancy Hayes

3/22/12 10:53am

I went through the same thing. They put me on Antiobtics for 10 days interveously. Sent me to a infectious diese doctor who put me on Prednisone which helped bring some of the swelling and redness down. It was 2 tablets 10mg twice a day for four days and 1 tablet twice a day for 3 days. Hope this is some help.

Sandy

3/22/12 11:01am

I have experienced this 4 times in approximately 3 years since my radiation. Fortunately, I immediately get on the antibiotics and I get better. I will be hitting my 5 year anniversary in January and my doctor has told me this is just something that is probably going to reoccur, just a bump in the road for me. My breast is still slightly enlarged and I have lymphedema in it with the orange peel skin. Other than that, I'm as fit as a fiddle!! Loving life and a new Grandma so things couldn't be better.

PJ Hamel, Health Guide

3/22/12 8:52pm

Sandy, happy 5th anniversary in advance! I'm glad you're able to deal with this "bump in the road" effectively; sounds like you've got a real can-do spirit. Be well - PJH

PJ Hamel, Health Guide

3/22/12 8:53pm

Nancy, I hope you've recovered fully, and that you don't have to go through this again. Thanks for sharing your experience here - it DOES help women to hear from others who've gone through the same thing... PJH

Paulann

7/ 7/12 9:09pm

Do you have punch biopsy to make sure that it is not Inflammatory breast cancer?

PJ Hamel, Health Guide

7/ 8/12 6:08pm

Paulann, in general IBC wouldn't be affected by antibiotics; it would simply get worse and worse. Hopefully none of the readers here have ignored worsening symptoms, but have brought them to the attenton of their doctor, and dealt with whatever was causing them. Thanks for your input - it's always a good reminder to be extra-careful about ruling out IBC, which can be tricky to diagnose. PJH

8/16/12 2:44pm

This is all very new to me. I had lumpectomy and radiation almost a year ago. I had almost no side effects. Yesterday I woke up with a red and warm breast and I called my oncologist who immediately put me on antibiotics. Today it is already getting much better. I was really nervous all day about this. In all of the literature they gave me to read, I found nothing about mastitis after radiation. I wish I had read this site yesterday. I was panicked that I had IBC. Glad you are doing well after 5 years.

PJ Hamel, Health Guide

8/16/12 4:19pm

The mastitis might very well have nothing to do with your lumpectomy and radiation; it could be completely coincidental. At any rate, I'm glad it's responding to the antibiotics. Keep your eye on it, and be sure to contact the doctor if the healing seems to stop; or if the redness and swelling return. Good luck - PJH

bobbie

8/ 6/09 7:33pm

Yes I am 5 months out of radiation and I have severe pain, and have been told I have mastitis, I have taken two rounds of bactrium and its gotten some better but not gone. Now I am having blood work and MRI to try and figure out what is going on. Good luck to you

Anonymous

10/ 7/09 11:06am

Hello, I am two months out of radiation, also had chemo and lumpectomy. Now my breast is swollen, red and very painful, no fever...family Dr. put me on Keflex yesterday...want to see oncologist but am told to wait...any news about the way you are progressing...thank you

char

5/ 3/10 2:45pm

I developed this breast infection 6 months after radiation and 2 months after chemo. I was scared silly it was IBC - but dr did a needle withdrawl of the fluid and was tested postive for staph infection - have been on antibiotics for 2 months - symptons have gotten better, but not 100% gone - my dr said it could take 6 months to heal - and I've developed scar tissue - hardness - as well - anyone else experience this?

Lindy lue

12/ 2/10 3:50pm

It has been about 6 months since I had radiation,, after I comlpeted 16 weeks of cheme, now they tell me I have metastis, and starting me on Keflex,, after reafing these posts I am unsure if this will be beneficial,,, is this usually the result of staph ? I went through that too and loads of antibotics, and a second surgury,,, anything you could tell me would be greatly appreciated,,

Phyllis Johnson, Health Guide

12/ 3/10 5:38am

Although some of the other people posting didn't have good results from Keflex, it's hard to know how similar their situations are to your own. Only your own doctors know the details of your entire medical history including possible allergies or reactions to other antibiotics, and only your own doctors are looking at your particular set of symptoms. See if this round of antibiotics helps and then go from there.

Georgia Ivie

12/ 5/10 12:24pm

Hi Lindy Lue, I had the unfortunate experience of picking up an infection at a local hospital in NC when it was finally identified by an outsdie lab, the culture and sensitivity showed I had been on the wrong antibiotic for almost a year. It is very important for a culture of the bacteria to be done to verify what it is sensitive to...finally my infection is starting to clear up and expect it should be gone hopefully within the next three to six months at the most. My cancer doctors sent me to Duke University to the Dr. who heads the Infectious Disease Control, and I am truly thankful for that...slowly but surely, my pain is decreasing...ask if a culture has been done, it is your body, you need to be on top of your treatment, do not let any dr. intimidate you, none of mine do, I believe I have the best in the world...Georgia Ivie

Anja

1/15/11 9:47am

Hi I've got radiation mastitis for 6 months now.It started 2 months after the last radiation treatment. I've had Augmentin but that didn't help. My bloodtest showed that the mastitis was not caused by a bacteria so my Dr has now suggested Hyperbaric Oxygen therapy. She said that there have been good results in treating mastitis with this therapy.
Maybe you can ask around if this therapy is available near you?

Anja

Georgia Ivie

1/15/11 11:04am

Anja: They have a hyperbaric chamber at Duke but because of a heart condition I decided against using it. It is also my understanding it does work quite well. If your doctor has suggested it give it a try...follow your insticts, you know your body better than anyone else....besides, personally I believe nothing ventured, nothing gained....if there is a reasonable chance that it will stop your pain, go for it...Georgia....I will keep you in my prayers....

gloria

3/12/11 7:17pm

Absolutely...I had lumpectomy in November...fininished by course of radiation on Feb. 14 and was getting along fine with the exception of burned breast...I didn't have to do chemo, but last Friday my breast started hurting, swelling, and burning...naturally it was on Friday night so had to wait until Monday to see the doctor...they had put me on the hormone pills and one of the side effects was breast tenderness so I thought this was what I had...When I went to doctor on Monday morning he said it was mastitis from the radiation and put me on Keflex...it s still not much better...I was getting paranoid and thought I had inflammatory breast cancer, but just happened on here and am glad to find it has happened to others (sorry guys..hope you are better, but this scared the dickens out of me)....I guess back to doctor on Monday to see what to do next...as long as I am still I am ok, but if I move much it is painful...just loading dishwasher was bad...any more insight would be appreciated/Gloria

PJ Hamel, Health Guide

3/12/11 7:58pm

I'm glad you found our site, too. Sorry about the mastitis, though - I hope the antibiotics kick in soon - PJH

Phyllis Johnson, Health Guide

3/13/11 7:20am

Gloria, it is more likely that an infection from radiation is the cause of your symptoms; however, it is also possible to have inflammatory breast cancer after other types of breast cancer. Some women also develop IBC-like symptoms after breast surgery because the scar tissue blocks the movement of lymph fluid the way cancer cells do in IBC. If the Keflex doesn't kick in and work, consider asking for a culture to see what kind of bacteria are involved to make sure you are getting the best antibiotic. You need to ask about the possibility of a biopsy to rule out IBC if there is no clear evidence of infection. So don't panic, but do stay on top of the situation until the problem clears up. We are glad you found this site helpful.

gloria

3/25/11 8:58pm

On my third couse of keflex and it is getting better...had ultrasound last Friday and Wednesday went back to surgeon to drain, but there wasn't much to drain...a little pinkish fluid came out...so apparently antibiotics are working, slowly but surely....it is so much better than the beginning, but still bothersome. I go back to surgeon on the first so I am hoping it will be much much better by then...this is a painful condition...good luck to everyone...Gloria

PJ Hamel, Health Guide

3/25/11 9:21pm

And good luck to you as well, Gloria. I hope you continue to heal uneventfully. PJH

Diane

4/ 4/11 1:30am

Oh My God, I am so happy I found you guys. I finished radiation therapy about 6 months ago after a lumpectomy and woke up two days ago with red sore breast. I had mastitis a couple of months ago so I knew what it was, but the urgency of it coming on and the redness is nearly down to my stomach and under my arm. Am taking Diclocil from the doctor I saw on Saturday. Is this quite common amongst breast cancer patients after radiation? Remember reading nothing about this in those help/aid booklets? Is there any preventative suggestions out there? Diane

PJ Hamel, Health Guide

4/ 4/11 5:53am

I wouldn't say post-radiation mastitis is common, Diane - but it's not unheard of. Since you've had two cases of it recently, though, you should investigate further what might be causing this. Speak with your doctor about the relationship between radiation and mastitis, and ask him/her about preventive measures, if any. And, if the antibiotic doesn't take care of it completely, be sure to follow up; you want to be totally healed, to prevent any relapse. Finally, please read our post on breast rashes; could be you're dealing with something other than mastitis here. Best of luck - PJH

Phyllis Johnson, Health Guide

4/ 4/11 6:22am

Diane, I'm not a doctor and sometimes terms like mastitis and cellulitis are used generally to mean breast or soft tissue infections; however, I think mastitis is officially an infection in the milk ducts of the breast. What you have is spreading outside your breast, so it might be more properly called cellulitis. Ask the doctor more about that because you want to have the proper coding on your paperwork. If this antibiotic doesn't quickly begin to work, please call the doctor back. You might have an antibiotic-resistant infection.

After my mastectomy I needed a biopsy of a red spot on my chest wall. I turned out fine, but a few months later, I developed cellulitis around the scar. Once it was healed, the doctor recommended massaging the area to prevent future infections. He said there wasn't much blood flow there. So I have been doing that and haven't had any more infections in that area. I wouldn't massage while there is still infection. I don't know if that would help in your case, but it might be worth a try.

gloria

4/25/11 1:08pm

Finally getting some relief...after 3 courses of Keflex...went to Surgeon who promptly opened breast and left me with open incision to drain fluid filled breast..biopsy revealed no other cancer so that was good news...going back on Wednesday and hope we can close this incision...getting much better...but do not like the packing part of it...the after effects of the radiation was much worse than the initial lumpectomy...hope I am on the mend and hope everyone else is too...

PJ Hamel, Health Guide

4/25/11 3:15pm

Thanks for the update, Gloria. I hope your recovery continues uneventfully (and quickly!) PJH

Jane

6/18/11 1:42pm

I had my lumpectomy in 2001 and I have had these bouts at least once a year. I get a high temp, hit the bed for at least 12 to 14 hours, red breast and tenderness. The oncologist I was going to used to give me stuff by IV, but now I'm seeing a Kaiser doctor and she has me on Clindamycin 300MG 4x a day. I took Tylenol to help with the fever, but it takes a couple of days for the infection to go away. The doctor wants me on the medication for 5 days. Now it seems like it is happening more than once a year.. I'm 66 and it is really a pain.. No rhyme or reason to it. You know immediately that you have it by the high temp, then you look at that reddening of the breast growing and growing. Now I keep medication here so when it starts I just start on it right away and then let the doctor know. I didn't know till today this had a name. It's good to hear I'm not going nuts. I've also been more prone to infections since the breast cancer and I did go through chemo as well as the radiation.

PJ Hamel, Health Guide

6/18/11 9:16pm

Jane, have you considered getting a second opinion from a breast specialist? With 10 years of recurring infections, you'd think someone would want to figure out what's wrong, what's causing the infections, rather than simply treating them once they appear... Might be worth asking to see a breast specialist. Best of luck to you - PJH

Jane

6/18/11 11:21pm

I've had 2 oncologists and now I'm with Kaiser. Until I found this web site I never even knew there was a name for this. I did send it to my doctor, but that is a good idea. I wonder if there is a good one in the Portland Oregon area.

Thanks for the suggestion.

PJ Hamel, Health Guide

6/19/11 7:17am

Jane, check out our list of federally-designated Comprehensive Cancer Centers; that's where your best breast specialists are likely to be found. Be well- PJH

BROWNIE

7/ 2/11 10:39pm

I AM A YOUNG 65 YEAR OLD GOOD PHYSICAL CONDITION, STILL WORKING, EVERY NIGHT SHOWER PERSON, ONE CUP A DAY COFFEE DRINKER, EXCERISE 30 MINUTES FOUR TIMES A WEEK........DOCTOR NOT SURE WHY I GOT MASITIS.

TAKING ANTIBIOCTIC..VERY UNCOMFORTABLE LIKE A GOLF BALL IN MY BREAST...

PJ Hamel, Health Guide

7/ 3/11 5:45am

Well, like any infection, and like cancer, sometimes these things just happen; it can be random. Hopefully the antibiotics will do their job, and you'll feel better soon... PJH

Phyllis Johnson, Health Guide

7/ 3/11 8:22am

Brownie, non-lactational mastitis is rare. My primary care doctor says she has seen one case in the fifteen years she has been in practice. Unfortunately the symptoms for mastitis are very similar to an uncommon form of breast cancer called inflammatory breast cancer (IBC). The guidelines for diagnosing IBC call for a biopsy to rule out IBC in non-lactational mastitis cases that do not respond to antibiotics. I hope your mastitis responds to the antibiotic quickly. If it does not, please ask for a referral to a breast specialist to have IBC ruled out. Let us know what happens.

Was Hurting

8/31/11 6:28pm

I had a lumpectomy and internal, focused radiation. I also developed a breast infection about 3 months later - red, painful, warm, swollen breast with fever treated with keflex.

One thing I was told is that bacteria can enter the breast thru the smallest of holes or cuts. The breast is more prone to this after cancer treatment. My therapist said even a small amount of remaining swelling can extend your pores - even these small openings are culprits as entry sites. You can sometimes see dark tiny spots which are these extended pores.

Extra sanitary precautions are in order and might help this from coming back. Wash hands often, wash breast every day - prehaps with antibacterial soap, change bra each day, do not wear too tight of a bra but do wear a good support one. Avoiding getting your breast in hot tubs, swimming in rivers, sweaty dirty situations without quick cleaning might all contribute.

Each of us is different and just as you can't always figure out who will get lymphedema, the same goes for breast infections but realizing we need to be careful does give us a little edge.

The antibiotics might change by patient, doctor preference, insurance program or severity of symptoms but they do seem to be what is needed. If it keeps coming back then cultures, second opinions, different and/or longer antibiotics or surgical intervention do seem to be in order. Because of our heightened sensitivity to our cancer treated breasts we are probably touching them now as much as we touch our faces. Make sure those hands get washed frequently.

I'm trying my hardest, without having it take over my life, to avoid this coming back as it was so painful and time consuming. I hope others get their own under control.

Best to you all.

Phyllis Johnson, Health Guide

8/31/11 9:15pm

Thanks for sharing your experience and excellent suggestions for avoiding post-surgical breast infections. It is important to be evaluated for inflammatory breast cancer (IBC) if an apparent breast infection does not respond to antibiotics. Most infections following breast surgery will indeed be infections, but in rare cases, a woman might have IBC.

Rainy

6/15/12 7:44pm

I had breast cancer six years ago followed by radiation.... The last two months my breast has been itching with what looks like a bad burn. The red peeling skin is on the lower part of my breast and is moving down to my upper stomach. The burn looks just like it did when I was burned from the radiation. I have an appointment with my cancer doctor at the end of the month, but I am getting really concerned about this. Has anyone else had this happen six years after the radiation? I would love to hear from you.

PJ Hamel, Health Guide

6/15/12 10:32pm

Rainy, this sounds like delayed radiation reaction, which some women experience years after their original treatment. It's in the same area that was treated, and oftentimes the same kind of rash - but up to many years later. No known cause. Hopefully it'll fade by the time you have your appointment, but if not - or certainly if it gets worse quickly – you'd best have your oncologist check it out, OK? Good luck - PJH

Jane

7/ 8/12 11:45pm

Without rhyme or reason, I would get the high temps and my breast would get all red and no one knew what to do. This went on since 2002. Finally I started with a new GP and she did some research and found it was a celleulitis (must be from the missing lymphnodes). She puts me on Clindamycin 300G I take one capsule by mouth daily for 10 days. Now I have a perscription with me at all times, in case I'm travelling, I have my medication with me. I usually get the high fever and I'm out for about 24 hours, then I just continue with the medication for the 10 days. It's starting to come less and less. I used to get it a couple of times a year, but it's been over a year since I've had it (knock on wood), but I'm prepared with the meds. My oncologist had no idea, finally I switched providers and went with Keiser and my GP started treating it like I said and I've been ok. It's been about 3 years since I started with Keiser and I've only had 2 bouts, and the last one was over a year ago. Hope that helps.

Jane

PJ Hamel, Health Guide

7/ 9/12 5:06am

Jane, that's great that your new doc was able to finally figure out what's going on - and prescribe a successful treatment plan. Cellulitis can be dangerous if left untreated; I'm glad you now know what this is for sure, and are ready with your medication. I hope you've seen the last of this - I'm knocking on wood with you! Take care - PJH

Phyllis Johnson, Health Guide

7/ 9/12 7:55am

Jane, I have also had cellulitis in my radiation/scar area. After I finished the course of antibiotics, my doctor suggested massaging the area daily. He said there isn't much blood flow in that area, which can lead to an infection. I don't know if it is the massage, or if I have just been lucky, but I haven't had cellulitis since then. It sounds like you have a good management strategy in place. I hope your bouts of cellulitis become less and less frequent until they go away entirely.

Treatment for nonlactational mastitis following radiation for breast cancer

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