Breast Prediction · Patient’s Perspective
I am 49 years old, and I am about to enter my prime years, and I think my life is pretty good. I run a small shop, eat well, sleep well, and feel in good spirits~
Unexpectedly, just two weeks ago, my left breast began to flush and swell. In line with the principle of treating illness, , immediately went to a nearby hospital for a physical check-up. However, after anti-inflammatory and analgesic treatment, my symptoms did not improve significantly, so I tried some methods, including taking traditional Chinese medicine or applying them externally, but they seemed to have no effect.
I immediately decided to go to a professional hospital in the city. After the diagnosis of "left mastitis " was given at the outpatient clinic, I was admitted to the hospital to wait for further physical examination.
During this period, I also met a few old sisters. They all said that I was in such good spirits that I didn’t look like I would get sick. But there is no way, the disease is here, and the examination must be done seriously.
After the physical examination, the doctor found that except for the flushing and swelling around the left nipple and areola, and obvious local tenderness, he did not find many hard objects and tumors. He told me that it might be non-lactational mastitis and that further imaging examination and biopsy would be needed.
While I breathed a sigh of relief, I was also confused. Is this a disease only suffered by breastfeeding mothers?
Can you get mastitis even if you are not breastfeeding?
In many people’s perception, mastitis is a breast disease only suffered by breastfeeding women. In fact, non-lactating women may also suffer from mastitis, which can be divided into various types of inflammation according to the course of the disease. Today, the editor will take you through the three common clinical breast inflammations: acute mastitis that is common during lactation, and granulomatous mastitis and plasma cell mastitis that are common clinically during non-lactation period. Distinguish the different symptoms of mastitis from the basis of diagnosis and clinical staging~
Acute mastitis
·Judgement basis of acute mastitis
1. It is more common in primiparous women during lactation.
2. Breast pain on the affected side, the inflammatory site (mostly located in the lower outer quadrant of the breast) becomes red, swollen, hard, and tender, and may later form an abscess. The abscess is located under the areola, in the milk duct, in the breast or behind the breast. The fluctuation of deep abscess is not obvious, and the lymph nodes under the arm are swollen and tender.
3, there may be chills, high cold, leukocytosis .
4. Purulent fluid is often seen when the breast is punctured with obvious redness and swelling, and bacterial growth may occur in the culture of the puncture material.
5, anti-infection treatment has remarkable effect.
·Clinical stages of acute mastitis
Red and swollen stage : Due to breast milk stasis, local lumps appear in the breast, causing the patient to feel swelling and tenderness. There is inflammation inside the breast, but there is no abscess. The color of the breast skin is normal or slightly red. Some patients may experience mild heat on the skin.
Formation stage : If the inflammation develops severely, it will cause tissue necrosis to form an abscess. If not treated in time, the abscess will become larger and harder, causing throbbing tenderness or persistent severe pain. The skin of the breast becomes red, accompanied by a burning sensation, or even body fever, dry mouth, nausea and anorexia, etc. The patient's lateral axillary lymph nodes will also begin to swell.
The late stage of abscess ulcer : The abscess will break open on its own. If it is not broken open in time, surgery can be used to help drain the abscess. Once the pus is drained, the swelling and pain will be greatly reduced, the body temperature will return to normal, and the dressing will be changed for about a month, and the wound will begin to slowly heal. However, if the pus is not drained smoothly, it may turn into chronic mastitis and may even lead to breast fistula.
Plasma cell mastitis
· The diagnosis of plasma cell mastitis is based on
1. It mostly occurs in non-lactating and non-pregnant women aged 30-50 years.
2. It mostly affects one breast, and sometimes both breasts are affected at the same time. Most patients are accompanied by a history of nipple retraction, and slag-like secretions appear from the inverted nipples. A few patients have blood or watery discharge.
3. There is a lump next to the areola and the skin is red. An abscess forms in 7-10 days. There is an obvious odor after ulceration. The wound does not heal for a long time or relapses after healing. When suppuration occurs, the breast becomes warm and accompanied by headache. The disease relapses repeatedly and the mass adheres to the skin, and fistula is formed after ulceration.
4, fine-needle puncture biopsy showed a large number of plasma cell infiltrates without malignant tumor cells.
5. Combined with auxiliary examination methods, imaging examination shows characteristics such as inflammatory reaction and abscess.
·Clinical stages of plasma cell mastitis
Insidious stage : The nipple is sunken, with acne -like secretions, a foul smell, or accompanied by areolar lumps, and the pain is not obvious.
Acute stage : The mass in the areola area increases and stretches to a certain quadrant . The swelling and pain are obvious, and an abscess is formed. The local area is red and fluctuating. The systemic symptoms include chills, fever, headache, etc. tongue coating can be thin yellow and red tongue.
Chronic stage : When the local infection is controlled, the disease often enters the chronic stage, systemic symptoms reduce or disappear, abscesses rupture, fistulas form, there is a small amount of purulent secretion in the ulcers, and the local skin may be deformed like orange peel. Repeatedly, long-lasting.
Granulomatous mastitis
· The diagnosis of granulomatous mastitis is based on
1. It mostly occurs in multiparous women of childbearing age.
2. Painful lumps that appear in a short period of time usually start peripherally and progress rapidly. They can spread to the back of the nipple and areola, or even the entire breast.
3, pathological examination showed neutrophils and lymphocyte infiltration.
4. There is abscess formation in the granuloma, and the lesion is located in the breast lobule.
5. There are no acidophilic bacteria and molds in the lesions.
·Clinical stages of granulomatous mastitis
Acute phase : often refers to the mass stage, the inflammatory reaction triggered by irritants in the breast ducts or acini, causing inflammatory factors to cause congestion and edema in the gland lobes, which can be manifested as redness and swelling. , painful symptoms, which can cause lumps in the breast area in the early stages.
Subacute phase : Including the ulceration phase and sinus tract phase, along with the inflammatory reaction, some glands may have abscesses and granulomatous necrosis. The necrotic lesions may form ulcers in local skin parts, and may form ulcers if they continue to develop. sinus can secrete necrotic substances from the sinus area.
Delayed period : It also refers to the recovery period. As time goes by, the tumors can shrink and the inflammation will be temporarily relieved. If there are factors such as poor body resistance, the disease may occur again.
