Redness, swelling, warmth, tenderness, and changes in the appearance of the breast can be concerning, especially when they develop suddenly or without an obvious explanation. These symptoms can be associated with several breast conditions, including mastitis and inflammatory breast cancer, which can sometimes look remarkably similar despite being very different conditions.
Mastitis is a common inflammatory condition of the breast that most often occurs during breastfeeding, while inflammatory breast cancer is a rare and aggressive form of breast cancer. Although the two conditions are very different, they can sometimes cause remarkably similar changes in the breast, making them difficult to distinguish based on symptoms alone. Knowing the differences can help you understand when it’s time to seek further evaluation.
What Is Mastitis?
Mastitis is inflammation of the breast tissue. It most commonly occurs in people who are breastfeeding and is often referred to as lactational mastitis. However, mastitis can also occur in people who are not breastfeeding. Mastitis may involve inflammation alone or develop alongside a bacterial infection, in which antibiotics may be prescribed.
During breastfeeding, inflammation can develop when milk is not moving effectively through the breast, leading to swelling and inflammation within the surrounding tissue. Bacterial infection can occur as well, particularly when bacteria enter through a damaged or cracked nipple.
Symptoms can develop relatively quickly and may include:
- Breast redness or discoloration
- Swelling
- Warmth
- Breast tenderness or pain
- A thickened or firm area within the breast
- A breast lump
- Burning or discomfort
- Fever or chills, particularly when infection is present
Can Mastitis Happen If You Are Not Breastfeeding?
Yes. Non-lactational mastitis can have different causes and may be associated with factors such as staph infection or other inflammatory processes. As there is no breastfeeding-related explanation for the inflammation, persistent symptoms in a nonlactating person may warrant further evaluation.
How Is Mastitis Treated?
Treatment depends on the underlying cause and severity of the inflammation.
For mild cases, supportive care may include rest, hydration, cold compresses, and medication to help manage pain and inflammation. For people who are breastfeeding, continuing to breastfeed is generally considered safe and does not need to be stopped simply because mastitis is present. If a bacterial infection is suspected, your care team may prescribe antibiotics. If symptoms do not improve with treatment, further evaluation may be necessary.
What Is Inflammatory Breast Cancer?
Inflammatory breast cancer, or IBC, is a rare and fast-growing form of breast cancer. Unlike many breast cancers that first present as a distinct lump, inflammatory breast cancer often causes several changes across a larger portion of the breast. Cancer cells can block lymphatic vessels within the skin of the breast, causing fluid to build up and resulting in redness, swelling, and changes in the appearance of the skin.
Inflammatory breast cancer is uncommon, accounting for approximately 1% to 5% of all breast cancers in the United States. Despite being rare, it is important to recognize because it can progress quickly. Most inflammatory breast cancers are invasive ductal carcinomas, meaning they begin in cells lining the milk ducts and then grow beyond the ducts into surrounding breast tissue.
What Does Inflammatory Breast Cancer Look Like?
Inflammatory breast cancer can cause several changes that overlap with mastitis.
Possible symptoms include:
- Rapid swelling of the breast
- Red, pink, reddish-purple, or bruised-looking skin
- Breast warmth or tenderness
- An increase in breast size
- Skin that appears dimpled or pitted, also known as peau d'orange
- Swollen lymph nodes under the arm or near the collarbone
One important difference is that inflammatory breast cancer often does not cause a distinct lump that can be felt.
Symptoms of inflammatory breast cancer typically develop rapidly. However, these same symptoms can occur with infection, injury, and other breast conditions. That is why the appearance of redness or swelling alone cannot determine the cause.
How Is Inflammatory Breast Cancer Diagnosed?
Because inflammatory breast cancer can develop and progress quickly, diagnosis typically begins with a clinical breast examination. A doctor will evaluate changes such as redness, swelling, skin thickening, breast enlargement, warmth, or an inverted nipple and ask how quickly the symptoms developed.
If inflammatory breast cancer is suspected, diagnostic imaging may include a mammogram, breast ultrasound, or breast MRI. These tests can help identify abnormalities within the breast, evaluate nearby lymph nodes, and determine the extent of concerning changes. However, imaging alone cannot diagnose inflammatory breast cancer. Because IBC may not form a distinct lump and can sometimes be difficult to detect on a mammogram, persistent or unexplained breast changes may require further evaluation.
A breast biopsy is necessary to confirm that cancer is present. A core needle biopsy may be performed on an abnormal area of breast tissue identified through imaging or examination.
Mastitis vs. Inflammatory Breast Cancer: Why the Difference Matters
The similarities between these conditions can make it difficult to distinguish them based on symptoms alone. Mastitis often occurs in the setting of breastfeeding and may improve with appropriate treatment. Inflammatory breast cancer is not an infection and will not resolve with antibiotics.
If breast redness, swelling, warmth, or other changes persist despite treatment for presumed mastitis, it is important to follow up with a healthcare professional rather than continuing to assume that the symptoms are related to an infection.
It is also important to remember that most breast changes are not cancer. Redness, swelling, breast pain, and other changes can have many benign causes, from bug bites to pimples or eczema. However, any new or persistent breast change deserves appropriate evaluation.
Frequently Asked Questions
Can I still breastfeed if I have mastitis?
Yes. In most cases, it is safe to continue breastfeeding when you have mastitis. Continuing to breastfeed or express milk can help maintain normal milk removal, and mastitis itself does not typically make breast milk unsafe for your baby. Your healthcare provider can recommend the best approach based on your symptoms and whether an infection is suspected.
Can mastitis turn into breast cancer?
No, mastitis does not turn into breast cancer. Mastitis is inflammation of the breast tissue, most often caused by a bacterial infection. Breast cancer is a completely different process, driven by abnormal cell growth. One condition does not evolve into the other.
Can mastitis happen more than once?
Yes. Some people may experience mastitis more than once, particularly during breastfeeding. If mastitis keeps coming back or symptoms persist despite treatment, it is important to speak with a healthcare provider to determine why it is recurring and whether further evaluation is needed.
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