Brenda Spriggs, MD, MPH, MBA
Red blotches on the breast can indicate a range of conditions, including hives, rash or dermatitis. Sometimes red blotches are caused by cancer. You may experience symptoms of itch or pain, or none at all. Other reasons for blotches include mastitis, mammary duct ectasia, Paget’s disease of the breast or inflammatory breast cancer.
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A red, warm, swollen and/or painful breast -- complete with chills or fever -- indicates a breast infection. Mastitis mostly affects women in the first few months of delivering a baby or while she is breastfeeding.
The Mayo Clinic website states it is not necessary to stop breastfeeding due to mastitis, but warns it may affect your energy levels, and therefore temporary interfere with your ability to care for the baby.
Mammary Duct Ectasia
When a milk duct dilates, that duct’s walls may thicken and it may fill with fluid. Mammary duct estasia is more likely to affect women between the ages 40 and 60. For some, the skin below the nipple may become red or sensitive, for others it may cause a discharge from the nipple and for others there may be no symptoms. Often, this condition clears on its own. Other times, antibiotics or even surgery is required.
This form of breast cancer is rare, according to the Mayo Clinic website and is visible in the areola -- the pigmented skin surrounding the nipple and the nipple itself. It bears no relationship to a metabolic bone disease that bears the same name. Of the women diagnosed with Paget’s disease of the breast, most are 50 years and older and also have ductal breast cancer.
Inflammatory Breast Cancer
Inflammatory breast cancer is more aggressive -- and less obvious to detect -- than any other breast cancers. Instead of making itself known as a lump that is found in self examination, clinical exam or a mammogram, IBC causes your breast to redden, swell and become warm. According to the Dr. Susan Love Research Foundation, the skin on the breast may develop dimples like the peel of an orange and the nipple might retract. Lymph nodes in the arm pit and below may swell.
Those symptoms resemble mastitis -- and because IBC represents only 6 percent of breast cancers diagnosed -- Love says it is reasonable for a doctor to treat the symptoms with antibiotics before ordering a biopsy.
Talk to Your Doctor
If your breast displays anything out of the ordinary, make an appointment with your health care provider for a check-up. In the interim, the Mayo Clinic website advises a few self-care measures: don’t scratch, spread a fragrance-free moisturizer or add warmth to the area and avoid stress.