Pregnant - Mastitis treatment vs Inflammatory Breast Cancer

[wildrover]

I’m 21 weeks pregnant and have a 3 year old son (who was weaned from exclusively breastfed at 7 months). While breastfeeding my son, I had mastitis, which was resolved by regular feeding and a course of antibiotics.

On 10 September I noticed that my left breast was swollen and red in colour. I thought the changes were probably due to pregnancy and ignored them. But starting from the 18 September, I began to feel ‘bad’ - super tired, needing long naps and headachey.

On 22 September I visited my doctor who said it was possibly mastitis and prescribed a 1 week course of Flucloxacilin 500mg. I took to bed from that point on - I had aches, pains, cramps and felt exhausted. I occasionally had a low fever - never above 37.8.

My ‘flu symptoms’ improved during the course of antibiotics, however my breast symptoms worsened. Now 75% of my left breast is swollen and red. There is discharge from the nipple. I can see a dimple or ridge in the skin on the left breast. I feel that the skin texture has changed a lot - it is pitted in appearance (not quite orange peel, but definitely not my usual fine skin). I can feel a definite ‘mass’ in my breast.

In addition, my right breast has become inflamed - though not to the same extent. There is what looks like mild bruising near the nipple. However, my breasts are not particularly tender or sore.

On 29 September I revisited the doctor who has extended the antibiotics and referred me (under pressure) to a breast clinic (up to 2 week wait). He thinks I ‘just’ have mastitis without abscess. He doesn’t take my concern about the possibility of inflammatory breast cancer seriously.

Today I feel worse again - exhausted, sore throat, aching, terrible headache and am back in bed - I know these are 'good' signs of mastitis. Blood pressure has been fine throughout all this.

I’m treating this as though it is mastitis, but can find little information on what to do during pregnancy. Is there anything I can try beyond bed rest and antibiotics? Obviously I can’t express (which was the single thing that relieved me most last time).

I live in London. Does anyone have any advice? I'd go private to get a second opinion or proper help.

[NK346f2849X127d8bca260]

I developed mastitis ( not linked to bf) that was treated with Flucloxicillian but it didn't clear up although my flu like symtoms/ nipple discharge did ... I was still left with a lump the size of a large marble, my skin also looked mottled.
I attended a breast clinic under the 2 week wait , had all of the tests and needed Augmentin ( another antibiotic) to clear it up.
I also worried myself about IBC also!
I am wondering if your infection has not cleared up. I was told by breast consultant I saw that Flucloxicillian was not so effective on treating mastitis that is not linked to BF.
I suggest going back to your doctors today, especially as you are pregnant.

[wildrover]

Thanks so much for your reply. I'm loath to go back to the doctor as I've been seen three times in one week - first by a female doctor who was no-nonsense and business-like. My last two appointments were with a young male doctor who made me feel like I was just being an over-anxious pregnant lady. Perhaps I will ring and ask for a phone consultation.

How long were you on flucloxicillian before you changed to Augmentin?

[ToadToast]

Call your clinic, you can often self refer certainly you can where I work - not London though.

You could also, reasonably go to a and e where you would be sent straight to the breast clinic for an ultrasound

Get it checked, your treatment isn't working and you risk abscess and blood poisoning if it's not sorted. You can get mastitis in pregnancy and that is probably what you have but it all needs checking and needs good care- today

[wildrover]

One doctor advised me to go to A&E over the weekend if I worsened - he reckoned they might want to try intravenous antibiotics if I didn't respond to the course I'm on. Problem is, yesterday I felt well enough to get out of bed and look after my toddler and so the doctor decided the antibiotics were working. Today I feel dreadful again - but I don't have the type of high fever I think they would find worrying (highest I've seen is 37.8).

I'll try and ring for a phone consultation to see if I get any other advice from my local GP. If I feel worse than this by the evening I will consider A&E (I really hate to bother A&E staff with something I can walk in with).

[ToadToast]

Give over you are pregnant, makes you more vulnerable to infection.makes it more important to be seen. Go, your doctor told you to and was right. It's not a waste I reOurceS

[wildrover]

Waiting on a callback from another doctor in my local surgery then will make a decision. If I do feel much worse today I'll go to A&E. Thanks so much for the advice...makes me feel much better about the need to make a fuss (which I hate doing with all my heart).

[ToadToast]

I can tell you do but anyone with announce of professionalism would be delighted to see you- so much more satisfying than seeing the endless run of belligerent damaged drunks they saw last night...

[wildrover]

A&E does sometimes feel like a party that should've been over hours ago and to which the police might arrive at any moment. I feel for the staff.

[GeorgieB89]

I had a similar problem last year - swelling, redness etc. and saw a number of doctors, as it manifested as IBC. It turned out to be a bacterial infection. The doctor I liked best was Richard Cummins who works out of Parkside (and other hospitals). He was the least alarmist and I liked his manner. He was also the only one to correctly diagnose me. Good luck - obviously feel free to PM if you want any more info. I saw Richard privately, btw.

[wildrover]

I went to A&E last night - it was definitely the right thing to do. Triage sent me straight to the labour ward, which was an oasis of calm compared to A&E. I was examined and prescribed new antibiotics and home again inside 1.5 hours. They've said I need a thorough investigation by the breast clinic as there could be a small abscess or something else. Being examined by someone who knew what she was doing made a huge difference to my anxiety levels. I still feel terrible but I've started the new antibiotics and will wait to see how they work. Thanks so so much for the push to go to A&E - you were right about being taken seriously and treated with kindness. Georgie I'll PM you re: private consultation.

[NK346f2849X127d8bca260]

Glad your getting it sorted , the second breast infection I got turned into an abscess that took weeks to clear up.

[ToadToast]

So glad you were seen though think your ultrasound should be now:) mastitis in pregnancy is always infectious and is much more likely to form abscesses when the abs aren't right- this also makes the abscess grow when there is one.

You are more likely to get it if you have had it before or if you have had a cut or scratch on your hands or arms in the preceding weeks.

It's not that uncommon but gets pushed between maternity/ breast/ gp services sometimes unhelpfully.

Anyway I hope you and your boob feels better soon.

[mintyneb]

so sorry you are going through this rough time wildrover and hope the ABs do their stuff soon.

I can't help with either mastitis or IBC but just wanted to pick up on Georgies comment about Mr Cummins. He is (will be in the new year anyway) my nhs surgeon treating my breast cancer. I'm currently undergoing chemo until Christmas but I have met him a couple of times to discuss treatment.

He has a matter of fact approach, gave me time to explain treatment options and understand them. But just as importantly I thought he had a underlying very caring nature. I feel very confident being looked after him when the time comes.

good luck with everything

[GeorgieB89]

mintyneb, I'm sorry you're meeting Mr Cummins under those circumstances and I wish you well with your surgery and treatment. It's an awful business - as you say, Mr Cummins really does seem to have a caring, thorough manner and not in the least patronising/dismissive. Good luck to you and, of course, to wildrover. Ironically, I've just discovered another large lump in my other breast so I could well be doing the rounds myself (again), sigh.

[wildrover]

mintyneb, I'm sorry to hear you're going through treatment, but it's fantastic you've found someone you have confidence in. Good luck with your chemo treatment and recovery - wishing you all the best.

Georgie, that's too bad re: large lump. I think you know how to navigate the NHS and private breast clinics, but again, wishing you energy and patience for it all.

ToadToast, I agree, a same-day or next-day ultrasound should be on the cards. But I feel I'm walking wounded - not acute enough to be an emergency, and just well enough to stay at home. And once home I'm in bed and can't face getting myself back to doctor/A&E. Waiting for my letter with a date for the breast clinic.

On the bright side, I felt well enough this morning to get up and make myself a bowl of cereal. Have since slumped back to bed, but I feel these antibiotics are beginning to work. Don't mind exhaustion when I can sleep (my wee boy's in nursery all day). Have been told that the Great British Bake-off has some healing properties. Will try anything.