“My doctor says I have an infection, but when I Googled my symptoms, I saw that I have all the symptoms of inflammatory breast cancer . Is my doctor wasting my time with an antibiotic? Should I insist on a biopsy?”
We frequently get variations on this question here at HealthCentral. How can you tell whether you have an infection or a rare type of breast cancer called inflammatory breast cancer (IBC)? The short answer is you cannot without a doctor. However, understanding the similarities and differences between breast infections and IBC may help you decide what steps you need to take to get a proper diagnosis.
Breast infections include lactational mastitis, non-lactational mastitis, and abcesses.
Lactational mastitis. When a woman is breast feeding, bacteria can get into her milk ducts. Usually the constant flow of milk washes the bacteria right out, but sometimes a duct becomes blocked, and bacteria multiply causing an infection. According to the Mayo Clinic, “In most cases, you'll feel ill with flu-like symptoms for several hours before you recognize that there's a sore red area on one of your breasts. As soon as you recognize this combination of signs and symptoms, it's time to contact your doctor.”
Mastitis symptoms include fever, pain, a lump, and a swollen, tender breast that may feel warm or hot to the touch. The red, inflamed area often forms a wedge shape.
Your obstetrician or lactational consultant will be familiar with mastitis. He or she may prescribe warm compresses, emptying as much milk as possible out of the breast, and an antibiotic that won’t hurt the baby. It is fine to keep on breastfeeding in most cases. In fact, it will help clear the milk ducts.
Non-lactational mastitis. The symptoms for non-lactational mastitis are the same as for lactational, but this form of mastitis is much less common. Women who get mastitis when they are not breastfeeding often are diabetic, have had recent breast surgery, or have a condition that suppresses their immune system.
Subareolar Abscess. According to Dr. Susan Love’s Breast Book, an abscess can form behind the nipple and need draining. Symptoms are similar to mastitis, but the red, swollen area will be in the areola area, not spread across the breast. These abcesses can be a complication of mastitis or can form on their own when ducts in the milk glands or nipples are blocked. Dr. Love says these infections can recur about 40% of the time, especially in women who smoke, so once you are diagnosed with a subareolar abscess, you will need to be vigilant in case it comes back.
Redness and breast rashes can also signal some sort of skin issue, such as a fungal infection, so the above list is not a complete catalog of every possible problem. If you have any of the above symptoms, you need to see your doctor for two reasons: you will probably need an antibiotic, and you need to have inflammatory breast cancer ruled out.