Intraductal mastitis or galactophoritis is an inflammatory process that develops in the milk ducts of the mammary gland. Most often, this disease is caused by an infectious flora in the presence of predisposing factors. Such a pathology is dangerous due to the fact that with a long course it can lead to degeneration of breast tissue and its various deformities.
Most often, intraductal mastitis occurs in females aged forty-five to forty-seven years. In the event that this pathological process develops in a younger age group, it is mainly associated with lactation, as well as with the post-lactation period. After thirty-five years, such inflammation most often occurs against the background of existing mastopathy. Mastopathy is detected in about forty percent of women who are faced with this pathology.
As we have already said, in the overwhelming majority of cases, the formation of intraductal mastitis is based on the excessive reproduction of pathogenic flora in the milk ducts, as well as in the tissues that surround them. At the same time, staphylococci play the largest role among all bacteria. However, in some cases, streptococci, E. coli, Proteus, and some varieties of fungi can lead to the occurrence of an inflammatory process.
For the development of intraductal mastitis, the presence of predisposing factors is mandatory. First of all, such factors include lactation, or rather the stagnation of milk in the milk ducts. Stagnant milk is a favorable environment for the active reproduction of pathogenic microorganisms. As a result of the presence of cysts in the mammary gland, fibroadenomas, or with nodular mastopathy, the milk ducts can be compressed, which contributes to the stagnation of secreted secretions in them. In some cases, this inflammation is associated with too tortuous or long milk ducts. It is worth noting that the pathogenic flora is able to actively multiply not only in breast milk, but also in any other types of secretion, for example, in serous or colostrum-like secretions.
Other predisposing factors include chronic infectious foci in the body and a decrease in the level of immune protection. Foci of chronic infection are most relevant for intraductal mastitis not associated with lactation. In this case, the bacterial flora spreads into the milk ducts with the blood or lymph flow.
Intraductal mastitis is divided into two main varieties: lactational and non-lactational. The lactational variety is established if the inflammatory process has formed during the period of breastfeeding. As a rule, it has an acute character and is accompanied by an intensely pronounced clinical picture. The non-lactation variety implies the occurrence of the disease without any connection with lactation. In this case, the pathology is prone to a chronic and protracted course. Moreover, it is this variety that most often leads to various morphological changes in the tissues of the mammary gland.
Symptoms of intraductal mastitis
With a lactational variety of this disease, the symptoms increase suddenly and rapidly. A sick woman complains of a sudden increase in body temperature to thirty-eight degrees and above. There is a pronounced pain syndrome from the affected mammary gland. Moreover, the more the inflammatory process progresses, the stronger the pain becomes. On examination, redness of the mammary gland is detected, but edema is usually absent. During a palpation examination, it is possible to detect the presence of a compacted element that has a round or cylindrical shape, as well as a sharp pain.
We have said before that the non-lactation variety is accompanied by much milder symptoms. As the main manifestation in this disease are various discharges from the nipple. Most often they are yellowish in color. However, with some concomitant pathologies, the nature of the secret may change. As an example, we can say that with mastopathy it is greenish, and with cysts or malignant tumors — brown. At the same time, such secretions can appear both with pressure and on their own.
In addition, the clinical picture is supplemented by symptoms such as local pain and subfebrile fever. The pain syndrome, as a rule, is not expressed intensely. Due to the long course of the pathology, there is a high risk of foci of atypical proliferation in the chest. In turn, this significantly increases the likelihood of further malignancy of the pathological process.
Diagnosis and treatment of inflammation
For the diagnosis of intraductal mastitis, the clinical picture alone is not enough. This is due to the fact that there are no specific manifestations in this disease. In order to confirm the diagnosis, it is necessary to conduct cytological and microbiological studies of the secretion of the mammary gland, as well as ductography. If there are indications, an ultrasound diagnostic method, mammography and biopsy can be prescribed, followed by a histological analysis of the material obtained.
Treatment of such inflammation is carried out with the help of antibacterial drugs, selected on the basis of the sensitivity of the isolated flora, and non-steroidal anti-inflammatory drugs. After stopping the acute inflammatory process, various physiotherapeutic procedures are indicated.
In the absence of the effect of conservative therapy, surgery may be performed.
Prevention of intraductal mastitis
To prevent this condition, it is recommended to follow all the rules when breastfeeding a child, to express milk, to maintain a high level of personal hygiene, and to treat existing infectious foci in the body in a timely manner.
The use of oxytocin in combination with antibiotics in the treatment of patients with lactational mastitis / Kurlaev P.P., Zak V.I. // Surgery. Journal them. N.I. Pirogov — 1988 — T. 64 No. 4