Mastitis is one of the most common inflammatory diseases. Its essence lies in the development of infectious inflammation in the tissues of the mammary gland, which tends to spread and can cause purulent destruction directly both in the gland itself and in the tissues surrounding it.
Most often, mastitis develops in women in the postpartum period. It accounts for more than ninety percent of cases. It is worth noting that women are more susceptible to this pathological process in the first month after the birth of a child. According to statistics, about seven percent of females develop this disease after childbirth. However, in some cases, inflammation of the breast may not be associated with the postpartum period. The age of these women varies from fifteen to sixty years.
To summarize, the classification of mastitis includes the lactation form and the non-lactation form. The lactation form, respectively, develops in the postpartum period, and the non-lactation form is in no way associated with childbirth. In both cases, the main cause of this disease is the infectious flora. The most common causative agent is Staphylococcus aureus.
There are a number of predisposing factors for the occurrence of mastitis. First of all, this is the presence of benign neoplasms in the tissues of the mammary gland. In this case, we mean mastopathy. In addition, severe mastopathy or cicatricial changes remaining after the operation for this reason can also provoke the formation of an inflammatory process. Congenital anomalies in the development of the mammary gland, a general decrease in immunity against the background of hypothermia, past infectious pathologies, as well as microtrauma in the area of the mammary gland — all this often leads to inflammation. If we talk about the lactation form of this disease, then the main predisposing factors here are the complicated course of pregnancy and childbirth.
Mastitis, depending on the nature of morphological changes in the mammary gland, is divided into five varieties:
- Serous variety
It is characterized by the initial development of the inflammatory process. The main clinical manifestations in this case are a feeling of heaviness and swelling in the affected breast, as well as moderate pain when expressing milk. At the same time, there is no intoxication syndrome, and the woman feels fine. However, in some cases, this variety may have a more rapid course with an increase in body temperature and a sharp pain syndrome in the process of expressing milk;
- Infiltrative variety
In this case, local manifestations are more pronounced. In the affected mammary gland, a painful compaction without clear boundaries is palpated. The gland itself at the same time moderately increases in size. General intoxication of the body may or may not be present;
- Abscessing variety
It is accompanied by the formation of cavities inside the mammary gland, inside of which there is pus. Palpation may reveal an area of tissue softening with concomitant fluctuation. Without fail, there are symptoms such as fever, general weakness and malaise. In this case, the affected gland swells and turns red;
- Phlegmonous variety
It implies the spread of a purulent inflammatory process throughout all breast tissues. The affected breast becomes sharply enlarged in size due to increasing edema and significantly hyperemic. A fever develops, which reaches febrile values. In some cases, nipple retraction may be detected;
- Gangrenous variety
is the most unfavorable. As a rule, the mechanism of its development is that inflammation captures the vessels passing into the mammary gland, as a result of which thrombotic masses are formed in them. As a result, areas of necrosis are formed in this organ.
Symptoms of this pathology
As we have already said, first of all, the symptoms of this disease begin to appear with a feeling of heaviness and swelling in the chest. Against this background, the process of expressing milk becomes painful. At the beginning of the inflammatory process, after a woman expresses milk, her condition improves, but then it stops helping.
Local signs of this disease are characterized by the presence of edema, hyperemia of the mammary gland and a local increase in body temperature. On palpation, areas of compaction or softening may be detected. The important point is that over time, blood and pus begin to be present in the secreted milk.
In most cases, mastitis is accompanied by a general intoxication syndrome. In this case, fever, headaches and general weakness are present. The more pronounced the inflammation, the stronger the intoxication of the body.
Diagnosis of mastitis
Initially, it is possible to suspect this disease based on its symptoms. However, an ultrasound examination of the breast is recommended to confirm the diagnosis. In the case of a questionable ultrasound picture, doctors may resort to using a fine needle biopsy.
Treatment and prevention of this disease
In the event that the developed inflammation is not purulent, conservative therapy can be dispensed with. To do this, prescribe antibacterial agents and detoxification measures. When pus appears in the mammary gland, it is necessary to perform a surgical intervention, which consists in opening the purulent focus and draining it.
The principles of prevention of mastitis consist of the prevention of stagnation of milk in the breast. To do this, you need to regularly feed the baby, followed by decanting the remaining milk. The non-lactation form of this pathology can be avoided by treating existing infectious diseases, increasing the level of the body’s immune defenses.
Obstetrics / Ed. Savelieva G.M. — 2000
general surgery / Petrov S.V. — 2012