Chapter 5 – The Breast


Mastitis is an inflammatory condition of the breast. The most common type is lactational mastitis. This usually presents in the first few weeks of breastfeeding, with breast pain, swelling, lump or lumps, and redness of the skin overlying the breast infection/ abscess.

Lactational mastitis is a bacterial infection usually caused by Staphylococcus aureus. Poor positioning and poor attachment of the infant during feeding, along with milk stasis, contribute to the establishment of infection.

Lactational mastitis requires prompt treatment with antibiotics usually without investigation provided there is close clinical surveillance with investigation (usually breast ultrasound) if symptoms do not resolve in 24–48 hours. First line antibiotics include:

oral flucloxacillin or dicloxacillin 500 mg four times per day for 10 days, or cephalexin 500 mg four times per day for 10 days(12, 25)

Non-lactational inflammatory breast symptoms should always be investigated as any other breast symptom. Lesions found to be benign on initial assessment should be followed to complete clinical and imaging resolution.(12)

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