Skip to main content
SpringerLink
Log in

Mastitis, Breast Abscess, and Granulomatous Mastitis

  • Chapter
  • First Online:
Diseases of the Breast during Pregnancy and Lactation

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1252))

Abstract

Breastfeeding is immunoprotective and World Health Organization recommends exclusive breastfeeding for about six months with continuation of breastfeeding for one year or longer as mutually desired by mother and infant. But the target for duration of exclusive breastfeeding has not been reached in a significant number of women. It may be due to inflammatory breast disease such as milk stasis or lactational mastitis.

In this chapter we discuss the most common complications of breastfeeding including milk stasis, mastitis, and breast abscess. Also idiopathic granulomatous mastitis, a less common condition, is discussed due to its confusing characteristics and not universally-accepted treatment strategies .

Breastfeeding mastitis is inflammation of the breast that can be infectious or non-infectious. With proper diagnosis and treatment of this condition, more severe complications like breast abscess could be avoided, so that breastfeeding could be continued in some circumstances.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. World Health Organization (2003) Nutrition. www.who.int/nutrition/topics/exclusive_breastfeeding/en (accessed 2019) 2012 July 29

  2. Gartner LM, Black LS (1997) Breastfeeding and the use of human milk. Pediatrics 100(6):1035–1039

    Google Scholar 

  3. Wockel A, Beggel A, Gensch M, Abou-Dakn M (2007) Psychological stress and puerperal mastitis-possible pathophysiological mechanisms. Curr Wom Health Rev 3(2):123–127

    Google Scholar 

  4. Kinlay JR, O’Connell DL, Kinlay S (1998) Incidence of mastitis in breastfeeding women during the six months after delivery: a prospective cohort study. Med J Australia 169(6):310–312

    CAS  PubMed  Google Scholar 

  5. Amir LH, Committee AoBMP (2014) ABM clinical protocol# 4: mastitis, revised March 2014. Breastfeed Med 9(5):239–243

    PubMed  PubMed Central  Google Scholar 

  6. Irusen H, Rohwer AC, Steyn DW, Young T (2015) Treatments for breast abscesses in breastfeeding women. Cochrane Database Syst Rev 8:CD010490

    Google Scholar 

  7. Spencer JP (2008) Management of mastitis in breastfeeding women. Am Fam Physician 78(6):727–731

    Google Scholar 

  8. Kataria K, Srivastava A, Dhar A (2013) Management of lactational mastitis and breast abscesses: review of current knowledge and practice. Indian J Surg 75(6):430–435

    PubMed  Google Scholar 

  9. Scott-Conner CE, Schorr SJ (1995) The diagnosis and management of breast problems during pregnancy and lactation. Am J Surg 170(4):401–405

    CAS  PubMed  Google Scholar 

  10. Wöckel A, Abou-Dakn M, Beggel A, Arck P (2008) Inflammatory breast diseases during lactation: health effects on the newborn-a literature review. Mediators Inflamm 2008:298760

    PubMed  PubMed Central  Google Scholar 

  11. Wöckel A, Beggel A, Rücke M, Abou‐Dakn M, Arck P (2010, Jan) Predictors of inflammatory breast diseases during lactation–results of a cohort study. Am J Reprod Immunol 63(1):28–37

    Google Scholar 

  12. Yu JH, Kim MJ, Cho H, Liu HJ, Han S-J, Ahn T-G (2013) Breast diseases during pregnancy and lactation. Obstet Gynecol Sci 56(3):143–159

    PubMed  PubMed Central  Google Scholar 

  13. Scott-Conner C (1997) Diagnosing and managing breast disease during pregnancy and lactation. Medscape Womens Health 2(5):1

    CAS  PubMed  Google Scholar 

  14. Wambach KA (2003) Lactation mastitis: a descriptive study of the experience. J Hum Lact 19(1):24–34

    PubMed  Google Scholar 

  15. Osterman KL, Rahm V-A (2000) Lactation mastitis: bacterial cultivation of breast milk, symptoms, treatment, and outcome. J Hum Lact 16(4):297–302

    CAS  PubMed  Google Scholar 

  16. Reddy P, Qi C, Zembower T, Noskin GA, Bolon M (2007) Postpartum mastitis and community-acquired methicillin-resistant Staphylococcus aureus. Emerg Infect Dis 13(2):298–301

    CAS  PubMed  PubMed Central  Google Scholar 

  17. World Health Organization (2000) Mastitis: causes and management. World Health Organization, Geneva. Publication Number. WHO/FCH/CAH/00.13

    Google Scholar 

  18. Johnson HM, Mitchell KB (2020) Lactational phlegmon: a distinct clinical entity affecting breastfeeding women within the mastitis-abscess spectrum. Breast J 26(2):149–154

    Google Scholar 

  19. Marchant DJ (2002) Inflammation of the breast. Obstet Gynecol Clin 29(1):89–102

    Google Scholar 

  20. Lawrence RA, Lawrence RM (2010) Breastfeeding e-book: a guide for the medical professional: Elsevier Health Sciences

    Google Scholar 

  21. Jahanfar S, Ng CJ, Teng CL (2009) Antibiotics for mastitis in breastfeeding women. Cochrane Database Syst Rev 1:CD005458

    Google Scholar 

  22. Son EJ, Oh KK, Kim EK (2006) Pregnancy-associated breast disease: radiologic features and diagnostic dilemmas. Yonsei Med J 47(1):34–42

    PubMed  PubMed Central  Google Scholar 

  23. Sangri AM, Shaikh AG, Unar F (2017) Benign breast diseases in pregnancy. Pak J Surg 22(4):125–128

    Google Scholar 

  24. Barbosa-Cesnik C, Schwartz K, Foxman B (2003) Lactation mastitis. JAMA 289(13):1609–1612

    PubMed  Google Scholar 

  25. Kvist LJ, Rydhstroem H (2005) Factors related to breast abscess after delivery: a population-based study. BJOG 112(8):1070–1074

    PubMed  Google Scholar 

  26. Stafford I, Hernandez J, Laibl V, Sheffield J, Roberts S, Wendel G (2008) Community-acquired methicillin-resistant Staphylococcus aureus among patients with puerperal mastitis requiring hospitalization. Obstet Gynecol 112(3):533–537

    PubMed  Google Scholar 

  27. Branch-Elliman W, Golen TH, Gold HS, Yassa DS, Baldini LM, Wright SB (2011) Risk factors for Staphylococcus aureus postpartum breast abscess. Clin Infect Dis 54(1):71–77

    PubMed  Google Scholar 

  28. Abou-Dakn M, Richardt A, Schaefer-Graf U, Wöckel A (2010) Inflammatory breast diseases during lactation: milk stasis, puerperal mastitis, abscesses of the breast, and malignant tumors–current and evidence-based strategies for diagnosis and therapy. Breast Care 5(1):33–37

    PubMed  PubMed Central  Google Scholar 

  29. Dixon JM (1988) Repeated aspiration of breast abscesses in lactating women. Br Med J 297(6662):1517–1518

    CAS  Google Scholar 

  30. Schwarz RJ, Shrestha R (2001) Needle aspiration of breast abscesses. Am J Surg 182(2):117–119

    Google Scholar 

  31. Tewari M, Shukla H (2006) An effective method of drainage of puerperal breast abscess by percutaneous placement of suction drain. Indian J Surg 68(6):330–333

    Google Scholar 

  32. Kousar N, Durrani TA, Ghafoor T, Qazi W (2018) Large lactational breast abscess: primary closure with drain versus conventional incision and drainage. JSZMC 9(3):1439–1442

    Google Scholar 

  33. Dirbas F, Scott-Conner C (2011) Breast surgical techniques and interdisciplinary management. Springer Science & Business Media

    Google Scholar 

  34. Al-Khaffaf B, Knox F, Bundred NJ (2008) Idiopathic granulomatous mastitis: a 25-year experience. J Am Coll Surg 206(2):269–273

    PubMed  Google Scholar 

  35. Ocal K, Dag A, Turkmenoglu O, Kara T, Seyit H, Konca K (2010) Granulomatous mastitis: clinical, pathological features, and management. Breast J 16(2):176–182

    PubMed  Google Scholar 

  36. Omranipour R, Mohammadi S-F, Samimi P (2013) Idiopathic granulomatous lobular mastitis-report of 43 cases from Iran; introducing a preliminary clinical practice guideline. Breast Care 8(6):439–443

    PubMed  PubMed Central  Google Scholar 

  37. Sakurai K, Fujisaki S, Enomoto K, Amano S, Sugitani M (2011) Evaluation of follow-up strategies for corticosteroid therapy of idiopathic granulomatous mastitis. Surg Today 41(3):333–337

    CAS  PubMed  Google Scholar 

  38. Yau FM, Macadam SA, Kuusk U, Nimmo M, Van Laeken N (2010) The surgical management of granulomatous mastitis. Ann Plast Surg 64(1):9–16

    CAS  PubMed  Google Scholar 

  39. Seo HR, Na KY, Yim HE, Kim TH, Kang DK, Oh KK, Kang SY, An YS, Chun M, Kim W, Park RW (2012, Mar 1). Differential diagnosis in idiopathic granulomatous mastitis and tuberculous mastitis. J Breast Cancer 15(1):111–118

    Google Scholar 

  40. Kaviani A, Vasigh M, Omranipour R, Mahmoudzadeh H, Elahi A, Farivar L et al (2019) Idiopathic granulomatous mastitis: looking for the most effective therapy with the least side effects according to the severity of the disease in 374 patients in Iran. Breast J 25(4):672–677

    Google Scholar 

  41. Azlina AF, Ariza Z, Arni T, Hisham AN (2003) Chronic granulomatous mastitis: diagnostic and therapeutic considerations. World J Surg 27(5):515–518

    PubMed  Google Scholar 

  42. Bani-Hani KE, Yaghan RJ, Matalka II, Shatnawi NJ (2004) Idiopathic granulomatous mastitis: time to avoid unnecessary mastectomies. Breast J 10(4):318–322

    PubMed  Google Scholar 

  43. Garcia-Rodiguez JA, Pattullo A (2013) Idiopathic granulomatous mastitis: a mimicking disease in a pregnant woman: a case report. BMC Res Notes 6:95

    PubMed  PubMed Central  Google Scholar 

  44. Goldberg J, Baute L, Storey L, Park P (2000) Granulomatous mastitis in pregnancy. Obstet Gynecol 95(5 Pt 2):813–815

    Google Scholar 

  45. Poniecka AW, Krasuski P, Gal E, Lubin J, Howard L, Poppiti RJ (2001) Granulomatous inflammation of the breast in a pregnant woman. Acta Cytol 45(5):797–801

    CAS  PubMed  Google Scholar 

  46. Kessler E, Wolloch Y (1972) Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 58(6):642–646

    CAS  PubMed  Google Scholar 

  47. Taylor GB, Paviour SD, Musaad S, Jones WO, Holland DJ (2003) A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis. Pathology 35(2):109–119

    PubMed  Google Scholar 

  48. Going JJ, Anderson TJ, Wilkinson S, Chetty U (1987) Granulomatous lobular mastitis. J Clin Pathol 40(5):535–540

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Lucas R, Gussman D, Polis RL, Rattigan MI, Matulewicz TJ (2014) Idiopathic granulomatous mastitis with erythema nodosum simulating breast abscess in pregnancy: a case report. Obstet Med 7(1):37–39

    PubMed  Google Scholar 

  50. Kaviani A, Zand S, Karbaksh M, Ardalan FA (2017) Synchronous idiopathic granulomatosis mastitis and breast cancer: a case report and review of literature. Arch Breast Cancer 6:32–36

    Google Scholar 

  51. Aghajanzadeh M, Hassanzadeh R, Sefat SA, Alavi A, Hemmati H, Delshad MS, Alavi CE, Rimaz S, Geranmayeh S, Ashtiani MN, Habibzadeh SM (2015, Aug 1) Granulomatous mastitis: presentations, diagnosis, treatment and outcome in 206 patients from the north of Iran. Breast 24(4):456–460

    Google Scholar 

  52. Azizi A, Prasath V, Canner J, Gharib M, Sadat Fattahi A, Naser Forghani M, Sajjadi S, Farhadi E, Vasigh M, Kaviani A, Omranipour R (2020, Apr 5) Idiopathic granulomatous mastitis: management and predictors of recurrence in 474 patients. Breast J

    Google Scholar 

  53. Akbulut S, Arikanoglu Z, Senol A, Sogutcu N, Basbug M, Yeniaras E et al (2011) Is methotrexate an acceptable treatment in the management of idiopathic granulomatous mastitis? Arch Gynecol Obstet 284(5):1189–1195

    CAS  PubMed  Google Scholar 

  54. Ma X, Min X, Yao C (2020) Different treatments for granulomatous lobular mastitis: a systematic review and meta-analysis. Breast Care 5(1):54–60

    Google Scholar 

  55. Bouton ME, Jayaram L, O’Neill PJ, Hsu CH, Komenaka IK (2015) Management of idiopathic granulomatous mastitis with observation. Am J Surg 210(2):258–262

    PubMed  Google Scholar 

  56. Lai EC, Chan WC, Ma TK, Tang AP, Poon CS, Leong HT (2005) The role of conservative treatment in idiopathic granulomatous mastitis. Breast J 11(6):454–456

    PubMed  Google Scholar 

  57. Joseph KA, Luu X, Mor A (2014) Granulomatous mastitis: a New York public hospital experience. Ann Surg Oncol 21(13):4159–4163

    PubMed  Google Scholar 

  58. DeHertogh DA, Rossof AH, Harris AA, Economou SG (1980) Prednisone management of granulomatous mastitis. NEJM 303(14):799–800

    CAS  PubMed  Google Scholar 

  59. Su FH, Liu SC, Suen JH, Chen DS, Sister Mary Ann Lou (2005) Idiopathic granulomatous mastitis: a case successfully treated with a minimum dose of a steroid. Chang Gung Med J 28(6):431–435

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran

    Ramesh Omranipour & Mahtab Vasigh

  2. Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran

    Ramesh Omranipour

Authors
  1. Ramesh Omranipour
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mahtab Vasigh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ramesh Omranipour .

Editor information

Editors and Affiliations

  1. Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran

    Sadaf Alipour

  2. Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran

    Ramesh Omranipour

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Omranipour, R., Vasigh, M. (2020). Mastitis, Breast Abscess, and Granulomatous Mastitis. In: Alipour, S., Omranipour, R. (eds) Diseases of the Breast during Pregnancy and Lactation. Advances in Experimental Medicine and Biology, vol 1252. Springer, Cham. https://doi.org/10.1007/978-3-030-41596-9_7

Download citation

Publish with us

Policies and ethics

Search

Navigation