Non-Lactational Mastitis Not Better with Antibiotics

mamabear10

Background: I am 30 y/o, two pregnancies, breastfed both for 1.5 years (it has been well over a year since I last breastfed), my mom was diagnosed with breast cancer at 35. I started having pretty severe left breast pain from the 6 o'clock to 10 o'clock position 10 days ago, thick yellow nipple discharge, swelling and warmth. I saw the doctor Tuesday and she ordered a diagnostic mammogram and u/s but did not feel it was an infection. The pain worsened and I went to the ER Thursday and was prescribed a 10 day of Clindamycin. Day 5 and I am not having any relief. I went back today and the doctor switched my antibiotics to Augmentin for 10 days. I pushed to have her put in a consult to see a breast surgeon (I get my care at the VA and nothing happens quickly). The pain is severe at times that it makes me want to vomit.

How can you tell if the mastitis is now an abscess that needs to be drained vs failure to respond to antibiotics and potentially IBC. I know that IBC is very rare but with my mom's history, breast cancer is always at the back of my mind. Just looking to see if anyone else had experience with non lactational mastitis and how the course of treatment was.