Maybe it's not mastitis?

sunshinegal

Hi ladies,

Knowing no one here can diagnose me I wanted to 'reality check' a concern I have. In short, should I be concerned about IBC?

I had a baby 17 days ago. In pregnancy my one remaining breast grew exponentially - far bigger than the HH cup I grew to with my first child (I'm currently wearing a L/M cup size).

When this LO was 8 days old, I woke up with pretty classic mastitis symptoms: chills, aches, low grade fever, and a red, sore, engorged breast. LO had gone almost 5 hours between feedings the night before, plus I had worn the HH-cup bra to bed. All signs pointed to mastitis and I was in bed pretty much all day, feeling horrible.

Home remedies helped some but not enough, so I started an antibiotic two days later. Today, a week into the antibiotics, symptoms have pretty much resolved except for the redness. I'm no longer engorged (cabbage leaves and ice packs helped, along with frequent nursing), and I haven't had a fever since that first day.

But the red color persists: it seems to vary in color day to day although it doesn't seem to be getting worse (it covers most of the 2:00-9:00 position on my breast - the underside and sides that are compressed when I wear a bra). My skin blanches when I touch the red areas. The breast is slightly warm to the touch but that also seems to vary day-to-day. Finally, I have some pores mildly visible all over the breast though it doesn't really look like peau d'orange and I have no skin thickening. Also, no swollen lymph nodes that I can tell.

I'm seeing my midwife on Monday who plans to do a milk culture. But I'm wondering if I should be pro-active and call a breast specialist? On the one hand, it seems so unlikely that it could be IBC given how it started... but on the other hand, I don't want to take any chances, you know?

Thanks for any input!

Kicks

Anyt5hing is possible as you say and no one here can tell you what is going on.  But to me it does not sound like IBC probably.  

There are MANY possible causes/reasons for breast skin redness that have nothing to do with any type of BC.  An appointment with a Dermatologist might be in order.  

Definately find out what is going on - not just for you but for your LO.  You could have some sort of an infection that could be passed on.

sunshinegal

Thanks, Kicks! Midwife thinks it's infection based on the state of my nipple (raw, cracked). We'll know more in 3 days after results from the milk culture come in. I'll update this thread at that time...

sunshinegal

Milk culture came back negative for infection, so midwife suggests I consult a breast surgeon. I will; question is, should I insist on a biopsy no matter what? I'm still getting redness in the breast but like I said before it is variable and it blanches on contact. Doesn't seem likely to be IBC so should I trust the doc to know whether to biopsy it? I've heard people say their symptoms weren't necessarily textbook and they needed to advocate to get a biopsy done...

sunshinegal

Thanks for that link, Bon! I have done most/all of the plugged duct remedies - continuing to nurse, massage, warm compresses, ice packs, cabbage leaves, ibuprofin. They seemed to help somewhat with the engorgement and soreness, but I'm left with the redness.

Today I was noticing that I have a number of broken capillaries on my breast - quite possibly from how I hold it with one hand while breastfeeding. Those same areas are also redder than elsewhere on the breast. I also have thin and fair skin and when my plastic surgeon was discussing reconstruction of my right breast 4 years ago (I had DCIS, not sure why my signature with dx isn't showing up here), he noted that even my DD-cup natural breasts were not well supported by my skin - so my reconstructed breast is a B/C cup. Given that my lactating breast is an L/M cup now, I wonder if all the redness and irritation is from my skin being traumatized?

I have a Tuesday morning appointment with a breast specialist. Hoping to get to the bottom of this quickly

bride

Just a note to wish you well tomorrow. Let us know what you find out, okay?

Thinking of you,

bride

sunshinegal

Thanks for the note, bride.

I saw the breast surgeon this morning. She thinks it is residual mastitis; she did US a lymph node in my armpit that felt enlarged and said it looked like a normal node fighting an ongoing infection. She's going to put me on a different antibiotic and see me again in 10 days. I pointed out that the milk culture last week did not show infection, and she said that that didn't mean much, as mastitis infections don't show up in milk (though an abscess infection would).

She also said that based on the many broken capillaries, the large/heavy size of my breast, and the thinness of my skin, that the redness and visible skin pores could be a result of the stretching/stress that my breast skin is under right now. That seems quite possible to me, particularly since I have to hold/pinch/massage my breast a lot to help my LO nurse and/or to drain the breast. That's a lot of trauma for my poor boob!

For now I think I am satisfied and hope that the new antibiotic helps. There is a small part of me that wonders if I should have insisted on a biopsy today, but since she said that if there's no improvement in 10 days we would talk about a skin biopsy, I feel good that she isn't ignoring the possibility of IBC, just following protocol to rule out other causes.

sunshinegal

The second antibiotic didn't make a difference, so the doc did a skin punch biopsy this morning and has ordered a mammo (which I'm overdue for anyway). She does not really think this is IBC, and said that the skin she biopsied did not show thickening (a good sign). But I'm glad she's taking me seriously on this. I asked about MRI and she said that with me nursing, it's going to light up so much stuff that they will have a hard time telling what's what.

Biopsy results should be available Monday. Fun waiting game til then...

sunshinegal

My biopsy results finally came in today....negative! No cancer whatsoever; instead, a finding of dermatitis. I will still have a mammo, but signs are pointing to this being a dermatology issue of some kind so I will follow up with a skin doc.