Inflammation of the mammary gland is a problem that many women had to face in their life, especially in the first months of feeding a newborn baby. Most often, breast inflammation (mastitis) develops after the first birth (96%). This is lactational mastitis. Inflammation of the mammary gland occurs at a young age (juvenile mastitis), in children and even in newborn children. Men are no exception. Women from 18 to 45 years are more susceptible. This is due to the maximum hormonal activity of the body during this period.
In most cases, this is a one-way process. There is an acute and chronic form. Various cocci cause mastitis: staphylococcus, streptococcus.
The course and forms of inflammation of the breast
Clinically, mastitis is manifested by redness and thickening of the skin of the mammary gland, severe pain, swelling, fever to high numbers.
Inflammation of the breast with improper treatment tactics goes through several stages in its development:
- serous form (no infection);
- An abscess of the mammary gland or both glands (develops with insufficient treatment of acute infected or serous forms of mastitis);
- phlegmonous form (the inflammatory process is pronounced and is accompanied by severe intoxication);
- gangrene of the mammary gland (the condition is very serious, conservative therapy in these cases is ineffective).
In most cases, the diagnosis and treatment of mastitis occurs in the acute stage of inflammation. For this reason, the chronic stage of inflammation is rare. Purulent forms (abscess, phlegmon and gangrene of the mammary gland) can cause a life-threatening complication - sepsis. But they are infrequent and are the result of ineffective treatment or serious problems with the immune system.
Breast Inflammation - Causes
The main causes of breast inflammation:
1. Lactostasis.
With lactostasis (stagnation of milk), ideal conditions arise for the development and further spread of infection.
With the participation of the pathogen, milk is fermented, which contributes to the further multiplication of the infectious agent and the occurrence of purulent inflammation.
The development of lactostasis causes a large amount of milk, especially in the first days after the birth of the baby: after feeding, there is an excess of milk, and this leads to stagnation;
the large size of the mammary gland does not make it possible to uniformly completely remove milk from all parts of the breast;
incorrect or uncomfortable attachment of the baby to the breast: as a result, milk is not sucked out from all ducts, but lactostasis and in the future - inflammation - occur in separate sinuses.
2 Anatomical structure of the nipple.
3. Scratches of the skin, damage to the nipple as a result of feeding - the entrance gate for infection.
4. Injury to the ducts of the breast
5. Reduced immunity after childbirth.
6. Inflammatory diseases, a source of infection in the body, from where it can enter the mammary gland. In such cases, the pathogen, getting into milk, multiplies rapidly, especially with lactostasis, and causes a violent inflammatory process.
7. Subcooling.
Outside lactation, common causes of breast inflammation are:
- subcooling;
- any infectious disease when a source of infection is present in the body;
- reduced immunity;
- benign or malignant breast tumors;
- injuries of the mammary gland, which open access to infection;
- foreign bodies (piercing or implant);
- stresses.
In men, mastitis is not as common as in women, but if there are certain reasons, serious inflammation of the mammary gland can develop. Reasons may include:
- endocrine disorders that reduce the production of androgens (male sex hormones);
- adrenal tumors, which leads to hormonal imbalance - the production of estrogen (female sex hormones) begins to prevail;
- some urological diseases;
- metabolic disorder;
- injuries of the mammary glands with subsequent infection.
Hormonal imbalance in men (the most common cause of mastitis), in turn, appears when:
- regular use in large quantities of alcohol (especially beer),
- the use of various types of anabolics (often among athletes);
- the use without prescribing and control of a doctor of certain drugs that reduce blood pressure and tranquilizers;
- some endocrine diseases and diseases of the gastrointestinal tract.
Breast inflammation - symptoms at different stages of development
During lactation, mastitis develops in the first two to three days after lactostasis (stagnation of milk) has arisen for some reason. The process is usually one-sided. Only in 16 - 21% both mammary glands are affected. It develops acutely, in the future the process can go into a chronic form. The occurrence of purulent inflammation occurs either with inadequate treatment, or with the patient's inattentive attitude to his condition
1. Acute mastitis begins with the development of serous inflammation. It is clinically manifested by moderate local pains, redness at the site of inflammation, possibly compaction and edema. Later symptoms of general intoxication join in: an increase in temperature to 380 ° C and, possibly, higher, general weakness, headaches. It is not difficult, is well treated in a short time. During this period, it is important to start treatment immediately to avoid further progression.
In the absence or untimely initiation of treatment, the process develops: swelling, hyperemia increases, sharply painful compaction occurs, the temperature rises, and the general condition worsens. Palpated enlarged regional lymph nodes. So the infiltrative form of inflammation of the mammary gland proceeds.
After three to four days, the process can go to the next stage - abscessed.
2. In the thickness of the infiltrate there is a purulent cavity - an abscess, which is well palpated by palpation. On palpation, the abscess is more “soft” to the touch compared to the infiltrate due to the presence of purulent contents in its cavity. In the future, the number of abscesses may increase as the infection spreads. Superficial abscesses sometimes open on their own.
3. In the absence of treatment or inadequate treatment, the thin walls of the abscess may melt, the process becomes widespread, and phlegmon forms. On palpation of the border of the site of compaction it is difficult to determine, since the phlegmon does not have a clear delineation. The condition is sharply aggravated. Concerned about intense pain in the mammary gland, intoxication is increasing: the temperature rises to 400 C and higher, chills appear, weakness is increasing. Characteristic external signs of phlegmonous inflammation appear: the mammary gland sharply increases in size due to edema, acquires a purple-cyanotic color, and the nipple is retracted.
4. The most severe form of inflammation of the breast is gangrenous. In this far-launched purulent process, the mammary gland is tense, hard, sharply painful, greatly enlarged, purple - cyanotic, with black spots - foci of necrosis, sometimes with blisters, as after burns.
5. The generalization of purulent infection - sepsis - is a threat to life.
So acute mastitis proceeds.
Chronic inflammation of the mammary gland is, as a rule, a secondary process, occurs in the absence of treatment for acute mastitis. There are cases of primary chronic inflammation of the mammary gland, but much less often. The clinical picture of chronic mastitis in an infiltrative form is not pronounced: the mammary gland slightly increases, a moderately painful or painless very dense infiltrate is palpated, sometimes enlarged lymph nodes. The general condition is disturbed mildly, the temperature may slightly increase.
The clinic of non-lactating inflammation of the mammary gland is weakly expressed, proceeds with the formation of an abscess, has no characteristic features.
Breast inflammation - treatment
Due to the fact that inflammation of the mammary gland in most cases is bright and cannot be overlooked, patients seek medical help on time. With early treatment, its effectiveness is high and the time is short. If treatment occurs at the initial stages of the development of serous inflammation, when only unpleasant sensations of bursting, heaviness, swelling in the mammary gland appear, and external manifestations of mastitis are still absent, then stagnation (lactostasis) has to be treated. At this stage, sometimes it is enough to adjust the correct and timely emptying of the mammary gland - the feeding and decantation regimen. If the development of the inflammatory process continues (temperature rises, pains, swelling), the use of drug therapy and physiotherapeutic procedures (UHF, ultrasound) is necessary.
Drug therapy includes the appointment of antibacterial drugs and, if necessary, antispasmodics. Antibiotics are prescribed for a period of not more than 10 days. Semisynthetic penicillins (Osmapox, Flemoxin - Solutab, Amoxicillin - ratioform, Ospen, protected penicillins - Amoxiclav, Augmentin, etc.) and cephalosporins (Cefazolin, Cephalexin, Cefuroxime, etc.) are used. The effectiveness of treatment is evaluated after 48 - 72 hours.
According to statistics, in 4 - 10% of cases, despite the adequate antibacterial therapy started in time, a breast abscess develops. In such cases, surgery is required. Sometimes it is effective to carry out a puncture with the evacuation of purulent contents and the further administration of an antibiotic in the place of the abscess (in mild cases). If the general condition is serious, intoxication is increasing, immediate hospitalization is required with further opening and drainage of the abscess and subsequent antibiotic treatment.
If the process is suspended during lactation inflammation of the mammary gland and negative bacterial cultures of milk, breastfeeding can be continued with expressed pasteurized milk from a bottle. It is not recommended to apply the baby and store expressed milk to the breast, even healthy,. In each case, the doctor must decide the issue of breastfeeding.
Important to remember, that self-medication with mastitis at any stage is dangerous, can have unpredictable consequences, leads to prolongation of inflammation and complications.
The use of "warming" alcohol compresses and camphor oil is strictly contraindicated. Alcohol contributes to the aggravation of lactostasis. And any warming procedure for purulent inflammation accelerates the spread of infection and its further development. Only at the initial stages of mastitis can compresses with cabbage leaf, medicinal herbs (mother and stepmother, aloe juice, Kalanchoe), grated carrots, kombucha, rice broth be possible. After the elimination of the inflammatory process, it is possible to use massage, physiotherapeutic procedures.
With untimely treatment or self-medication, phlegmonous inflammation can develop. This is a diffuse inflammatory process in which conservative treatment is already ineffective - urgent intervention is indicated in a surgical hospital. Often the question is about removal of the mammary gland.
As for the treatment of mastitis in men, it is necessary to determine the cause of inflammation and treat the underlying disease. In the case of the serous phase of inflammation of the mammary gland in men, the treatment is conservative, rest is necessary, adherence to bed rest, taking antibiotics, anti-inflammatory drugs and antispasmodics, if necessary, physiotherapeutic treatment. With the development of a purulent abscess - hospitalization in the surgical department.
Important points for the prevention of breast inflammation
To prevent inflammation of the mammary gland, it is necessary to observe, first of all, the rules of personal hygiene: morning shower, during lactation - wearing cotton underwear, the use of special absorbent pads, mandatory processing of the mammary glands before feeding and decantation of milk residues after feeding, to avoid injuries and hypothermia.
Very important do not abuse the tan both on the beach and in the solarium, do not overcool and do not overheat, treat infectious diseases on time, monitor immunity.
Men need to abandon or minimize bad habits, consult a doctor on time for endocrine and urological problems.
The most reliable way to prevent mastitis is not to self-medicate and visit a doctor in a timely manner for any signs of malaise in the mammary glands.
