1. What is periductal mastitis?
Periductal mastitis occurs when the ducts (tubes) under the nipple become inflamed and infected.
Periductal mastitis is a benign (not cancer) breast condition and does not increase your risk of developing breast cancer.
2. What are the symptoms of periductal mastitis?
Symptoms of periductal mastitis may include:
- A tender, hot or reddened breast
- Liquid (discharge) from the nipple that is either bloody or non-bloody
- A lump that can be felt behind the nipple
- The nipple becomes pulled in
- Occasionally, a collection of pus (abscess) or an abnormal connection between a duct and the skin (fistula)
3. Who does it affect?
Periductal mastitis can affect people of any age, though it is much more common in younger women.
Men can also get periductal mastitis, but this is very rare.
People who smoke have an increased risk of periductal mastitis because substances in cigarette smoke can damage the ducts behind the nipple. Smoking can also slow down the healing process after treatment. Nipple piercings can increase the chances of infection and may make periductal mastitis more difficult to treat. Periductal mastitis is also common in women who are breastfeeding or have recently given birth.
4. How is periductal mastitis diagnosed?
What happens at a breast clinic appointment?
After a breast examination your GP is likely to refer you to a breast clinic where you’ll be seen by specialist doctors or nurses.
At the breast clinic most people have a breast examination followed by one or more of the following tests:
If you have discharge from the nipple, a sample may be sent to a laboratory to be looked at under a microscope to confirm the diagnosis. This is more likely if the discharge is bloody.
5. How is periductal mastitis treated?
Most cases of periductal mastitis will be treated with antibiotics. However, some people may not need any treatment and it will clear up by itself. Go back to your GP if your symptoms return or if you have any new symptoms, as it can come back.
If your breast is painful, you may want to take pain relief such as paracetamol.
If you develop an abscess or a fistula, your specialist will decide the best way to treat it. This may involve using a fine needle and a syringe to draw off (aspirate) the pus using an ultrasound scan for guidance. This may need to be repeated over a period of time until all the pus has been removed. Sometimes an opening is made in the skin to allow the pus to be drained. This can be done under local or general anaesthetic.
If periductal mastitis doesn’t get better after taking antibiotics, or if it comes back, you may need to have an operation to remove the affected area. This operation is usually done under a general anaesthetic, and you’ll be in hospital for the day or overnight. If your breast is painful after the operation you can take pain relief like paracetamol. The operation will leave a small scar but this will fade in time. After the operation your nipple may be less sensitive than before.
Sometimes it can be difficult for the surgeon to find all the affected ducts during the operation. This is because they are very small. If periductal mastitis comes back after an operation, more ducts may need to be removed.
6. Can periductal mastitis increase my risk of breast cancer?
Having periductal mastitis does not increase your risk of breast cancer. However, it’s still important to be breast aware and go back to your GP if you notice any further changes in your breasts regardless of how soon these occur after having periductal mastitis.
7. Further support
If you have any questions about periductal mastitis or just want to talk things through, you can call our free helpline, below.