Periductal mastitis

What is periductal mastitis?

Periductal mastitis occurs when the ducts under the nipple become inflamed and infected. It’s a benign condition (not cancer), which can affect women of all ages but is more common in younger women.

Symptoms include:
•    the breast becoming tender and hot to the touch
•    the skin may appear reddened
•    discharge from the nipple, which can be bloody or non-bloody
•    an infection in the ducts around the nipple
•    a pulled in (inverted) nipple.

Sometimes, if left untreated, an abscess (collection of pus) or fistula (a tract that develops between a duct and the skin) may also develop.

People who smoke may have an increased risk of being affected by periductal mastitis, because substances in cigarette smoke can damage the ducts behind the nipple. Nipple rings (piercings) can increase the chances of infection and make periductal mastitis more difficult to treat.

How is it diagnosed?

Your GP will refer you to a specialist who can make a definite diagnosis. To do this you will probably have a breast examination, mammogram or ultrasound scan.

If you have discharge from the nipple this may also be tested, especially if it’s bloodstained, to help confirm the diagnosis.

Treatment

Some people may not need any treatment for periductal mastitis as it can clear up by itself. It’s important, though, to go back to your GP if you have any new symptoms as it can come back. Smoking can slow down the healing process, so if you smoke it’s advisable to stop.

If you need treatment, this will usually be with antibiotics. You may also want to take pain relief, such as paracetamol, if your breast is painful.

If you have developed an abscess and/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, or sometimes an opening is made in the skin to allow the pus to be drained. This can be done under either local or general anaesthetic.

If your periductal mastitis doesn’t clear up after taking antibiotics or if it comes back, you may need to have an operation to remove the affected duct or ducts. See our Periductal mastitis leaflet for more information.

After the operation your nipple may be less sensitive than before.

The operation should solve the problem but, if it comes back, more ducts may need to be removed, as finding all the ducts can sometimes be difficult.

What this means for you

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 how soon these occur after your diagnosis of periductal mastitis.


Content last reviewed March 2013; next planned review 2015

Last edited:

10 September 2013