Periductal mastitis pathology: what should you know?

A duct beneath the nipple may become widened, narrowed, or blocked. Secretions can escape into surrounding tissue and trigger an inflammatory response. Immune cells gather there, and the area may later develop scar-like repair tissue. If infection is present, bacteria and pus may contribute to an abscess.

These microscopic descriptions help explain a painful lump, redness, nipple retraction, or discharge, but symptoms alone cannot establish the tissue diagnosis. Breast pain and painful breastfeeding also have other possible causes.

A clinician begins with the breast and nipple examination, then may use ultrasound or other imaging to look for a collection or a persistent mass. If findings are unusual, recurrent, or do not settle, a sample of fluid or tissue may be taken for laboratory assessment. The result is interpreted alongside the examination and imaging rather than in isolation.

Do not squeeze a lump or repeatedly manipulate the nipple. If breastfeeding, obtain feeding support for latch and milk transfer while following the medical plan for inflammation or infection.

Seek prompt assessment for a new painful lump with fever, spreading redness, pus-like discharge, or worsening swelling. Arrange follow-up for a lump, discharge, nipple inversion, or skin change that persists after treatment. Urgent care is appropriate if severe illness, faintness, or rapidly increasing breast swelling develops.

Ask what the examination and imaging show, whether an abscess or another process is possible, and whether sampling is needed. Ask how results will be explained, when follow-up should occur, and how to feed or express comfortably if relevant.