Breast redness and pain

Introduction Breast redness and heat pain is a typical clinical manifestation of inflammation. If there is redness and heat in the breast, it is likely to be an inflammatory disease of the breast, such as acute mastitis, breast duct dilatation syndrome. In addition, you need to be alert to the possibility of inflammatory breast cancer. Acute mastitis is the most common acute suppurative infectious disease in the breast. It often occurs during lactation. There is often a history of nipple cleft palate or milk deposition before the onset of the disease. The breast is red and swollen and hot, the pain is severe, and the systemic symptoms are accompanied by obvious fever. After pus, it can be broken or cut open, and the pus will be red, swollen and painful. The ductal dilatation syndrome is also called plasma cell mastitis. It occurs in non-lactation period, and there is often a history of nipple discharge before onset. Breast mass, followed by local redness and heat pain, the pain is often not very intense, and the systemic symptoms are not obvious, the later mass softens, forming an abscess, often forming a fistula after rupture, the wound does not converge or repeatedly collapse; inflammatory breast cancer It occurs mostly during pregnancy and lactation, the onset is rapid, the disease progresses rapidly, the affected side is red and swollen, and it affects the entire breast in a short time. It is easy to invade the axillary lymph nodes and the contralateral breast. Generally, there is no obvious systemic symptoms, and anti-inflammatory treatment is invalid. Generally, skin ulceration does not occur and the prognosis is dangerous.

Cause

Invasion of bacteria

Most of the pathogenic bacteria of this disease are Staphylococcus aureus, and a few are Streptococcus. Bacteria enter from the rupture of the nipple skin or the areola cleft, spread along the lymphatic vessels to the fat and fibrous tissues of the interlobular lobe and glandular lobules, causing acute suppurative cellulitis of the breast. There are also a few cases of complications of infection in other parts of the postpartum period, and the bacteria spread to the breast through the blood circulation, causing the disease.

2. Milk deposition

Milk is beneficial for the invasion of bacteria. The reasons for milk deposition are:

1 The nipple is too small or invaginated and failed to correct in time before birth, making it difficult for the baby to suck the breast, or even breastfeeding.

2 too much milk, emptying is not complete. The mother does not understand the secretion of milk, and the excess milk cannot be discharged in time and remains in the milk.

3 mammary duct obstruction makes breast drainage difficult, such as inflammation of the milk duct itself, tumor and external compression, can affect normal breastfeeding.

3. nipple splitting

After giving birth, the mother fails to master the correct breastfeeding skills, or the baby's sputum is abnormal, or excessive use of irritants such as soap or ethanol desiccant on the nipple and the disorder of the baby's oral movement function cause the nipple to split and the bacteria along The small nipple invades and forms an infection through the lymphatic vessels to the subcutaneous and interlobular tissues. When the nipple is cleft, the breastfeeding pain is not enough to make the milk fully sucked out, causing the milk to accumulate and creating breeding conditions for the invading bacteria.

an examination

Related inspection

Thoracic B-ultrasound conventional mammography X-ray examination

Breast self-test

1, the mirror self-lighting method: face the mirror, hands on the hips, observe the shape of the breast. Then, raise your arms over your head and carefully observe whether the shape and contour of the breasts on both sides have changed. Whether the breast skin has redness, rash, superficial vein engorgement, skin folds, orange peel-like changes, etc., observe whether the nipples are in the same On the horizontal line, is there any elevation, retraction, depression, whether there is any secretion from the nipple, and whether the color of the areola changes. Finally, put down both arms, hands on the hips, two elbows effort back, make the chest muscles tight, observe whether the breasts on both sides are equal and symmetrical.

2, flat touch method: lying flat, right arm raised above the head, and a small pillow under the right shoulder, so that the right breast flattened. Put the four fingers of your left hand together and use your fingertips to check for any lumps or other changes in the breast.

Use your right hand three fingers (index, middle finger, ring finger) to touch the breast slowly, stably, carefully, and gradually move forward or backward in the left breast, at least three times from the periphery of the breast to the nipple. It can also be checked in the up and down or radial direction, but care should be taken not to miss any parts. At the same time, check the axillary lymph nodes for swelling.

Finally, squeeze the nipple between the thumb and forefinger to see if there is any nipple discharge. Seek medical attention if turbid, yellowish or bloody discharge is found.

3, shower inspection method: when showering, it is easier to find breast problems due to moist skin. The method is to slide slowly with the palm of your finger and carefully check the breast and the armpit for a lump.

Female friends in the breast self-examination, if abnormalities are found, should seek medical advice in time to achieve early detection, early diagnosis, early treatment.

Differential diagnosis

Differential diagnosis of breast redness and heat pain :

1. Breast tenderness: Breast pain caused by physiological or pathological changes in women at different times. Often divided into pathological and physiological.

2, breast tingling: the symptoms of breast hyperplasia are mainly characterized by periodic pain in the breast. At first, it was a painful pain, and the tenderness was obvious in the upper and middle upper parts of the breast. The pain was exacerbated before menstruation every month, and the pain decreased or disappeared after menstruation. In severe cases, persistent pain was observed before and after menstruation. Sometimes the pain radiates to the ankle, shoulders, upper limbs, and the like.

3, breast pain: the symptoms of breast hyperplasia disease is mainly characterized by periodic pain in the breast. At first, it was a painful pain, and the tenderness was obvious in the upper and middle upper parts of the breast. The pain was exacerbated before menstruation every month, and the pain decreased or disappeared after menstruation. In severe cases, persistent pain was observed before and after menstruation. Sometimes the pain radiates to the ankle, shoulders, upper limbs, and the like.

4, breast pain: simple epithelial hyperplasia of mammary glands (also known as breast pain), is an early lesion of mammary gland dysplasia. In 1922, Bloodgood first described that in 1928 Semb noticed that the disease manifested as breast pain and a mass, called simple adenoma. In 1931 Beatle called breast simple epithelial hyperplasia; in 1948 Gescnickter called mastodynia. Has been in use ever since.

diagnosis

History

Lactating women have milk deposits or nipple splits, bad breastfeeding habits, etc.

2. Clinical manifestations

Lactating women have a partial breast pain, red, swollen, hot or lumpy, tender, and even chills, high fever, fatigue, weakness, local fluctuations in the formation of abscesses. Different stages of mastitis have their own characteristics:

(1). Acute simple mastitis

In the early stage, breast pain, high skin temperature, tenderness, stagnant milk, poor return of veins and lymph, and induration of the breast. If this stage is handled correctly, the inflammation can dissipate.

(2). Acute suppurative mastitis

Local skin redness, swelling, heat, pain, induration is obvious, and tenderness is aggravated. The patient has symptoms of systemic poisoning such as chills, high fever, headache, weakness, and fast pulse. The ipsilateral axillary lymph nodes are swollen and painful.

The diagnosis can be determined based on the above medical history and clinical manifestations and auxiliary examinations.

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