Breast Care: From Mastitis & Breastfeeding to Recovery After Breast Cancer Treatment
When we talk about breast care, breastfeeding and mastitis often come to mind first.
But breast care can be relevant at many different stages of life.
At Yarra Valley Women's Health, our Mastitis and Breast Care service includes support for breastfeeding-related concerns such as mastitis, breast inflammation and blocked ducts, as well as hands-on care for people experiencing ongoing physical changes after breast cancer treatment.
So when might you book a breast care appointment, and what does treatment actually involve?
Here are some of the questions we are commonly asked.
What can a breast care appointment help with?
There are two main areas where someone may book a breast care appointment.
Breastfeeding and mastitis-related care
This may include:
Mastitis
Breast inflammation
Blocked or “clogged” ducts
Engorgement
Breast pain or tenderness
Recurrent firm or tender areas
Chest wall tension
Musculoskeletal strain associated with feeding
Recurrent mastitis or breast discomfort
Breast care after breast cancer treatment
This may include ongoing physical changes following breast cancer surgery, radiation or other treatment, such as:
Breast or chest wall tightness
Scar tissue restriction
Reduced scar or tissue mobility
Reduced shoulder movement
Chest or upper body stiffness
Pain or discomfort
Swelling
Changes in movement following surgery or treatment
The assessment and treatment will look very different depending on why you're attending.
What is mastitis?
Mastitis is inflammation of the breast, most commonly occurring during breastfeeding.
Symptoms can include breast pain, swelling, warmth or redness, a firm or tender area and sometimes fever, chills, body aches or feeling generally unwell.
Not every painful or firm area means you have a bacterial infection. Breast inflammation can exist along a spectrum, and management will depend on your individual presentation.
What is a blocked or clogged milk duct?
The terms “blocked duct” and “clogged duct” are commonly used to describe a localised firm, tender or painful area of the breast.
However, we now understand that these symptoms don't necessarily mean there is a physical plug of milk that simply needs to be squeezed out.
Inflammation and narrowing within the breast can affect how easily milk moves through an area.
This is important because aggressively trying to massage or squeeze a blockage out may further irritate already inflamed tissue.
Should I massage a blocked duct or mastitis?
Deep, aggressive massage isn't the goal.
When the breast is already tender or inflamed, repeatedly digging into the painful area may further irritate the tissue.
Hands-on breast treatment is generally much gentler and is adapted to how sensitive the breast is at the time.
What happens during a mastitis or breastfeeding breast care appointment?
Your practitioner will first ask about what's been happening, including your symptoms, feeding or expressing patterns, previous episodes of mastitis and anything that may have changed recently.
We may also consider factors such as:
Feeding positions
Feeding or pumping schedule
Clothing or bra pressure
Posture while feeding
Chest wall tension
Musculoskeletal strain
Areas of breast tenderness or inflammation
Treatment may include gentle hands-on techniques to the breast and surrounding tissues, as well as practical advice you can use at home.
Is breast care the same as seeing a lactation consultant?
No — but the two services can work very well together.
Our breast care service focuses on the breast and surrounding musculoskeletal tissues.
An International Board Certified Lactation Consultant (IBCLC) has specialised expertise in breastfeeding and lactation, including latch, feeding mechanics, milk supply and more complex feeding concerns.
Sometimes the best management involves both.
If we believe a feeding or lactation issue is contributing to recurrent breast symptoms, we may recommend working with an IBCLC alongside breast care.
Should I keep breastfeeding if I have mastitis?
In many cases, normal breastfeeding can continue.
It generally isn't necessary to repeatedly feed, pump or express with the aim of completely “emptying” the affected breast.
Excessive milk removal can stimulate further milk production, which may contribute to ongoing inflammation for some people.
Individual circumstances vary, particularly if you're having difficulty feeding, significant pain or concerns about supply.
When does mastitis need medical treatment?
Breast care doesn't replace medical care when it is required.
You should seek appropriate medical assessment if you are significantly unwell, symptoms are severe or rapidly worsening, you have persistent fever or systemic symptoms, or your symptoms aren't improving as expected.
Bacterial mastitis may require antibiotics, and persistent or worsening symptoms can sometimes indicate a breast abscess that requires medical assessment.
Breast Care After Breast Cancer Treatment
Why might I need breast care after breast cancer treatment?
Breast cancer treatment can save lives, but treatment can also leave lasting physical changes.
Following breast surgery, lymph node procedures, radiation or other breast cancer treatments, some people experience changes to the breast, chest, scar tissue, shoulder and surrounding tissues.
These changes may include tightness, pain, swelling, stiffness or reduced movement.
Sometimes these symptoms occur relatively soon after treatment. For others, restrictions or discomfort can persist or become noticeable much later.
Breast care can form one part of helping you regain comfortable movement and confidence in your body after treatment.
Can breast cancer surgery cause scar tissue and tightness?
Yes.
Surgery involves healing and scar formation, and the tissues around the breast and chest can sometimes feel tighter or less mobile afterwards.
Depending on your surgery, this may affect the breast itself, chest wall, underarm or surrounding areas.
Some people describe sensations such as:
Pulling
Tightness
Stiffness
Tenderness
Restriction when lifting their arm
A feeling that the scar or chest doesn't move as freely as it used to
Once the tissues have appropriately healed and treatment is considered safe, gentle hands-on care may be used to work with these restrictions.
Can radiation treatment cause breast or chest tightness?
Radiation can also affect the tissues within the treated area.
For some people, changes to tissue mobility and stiffness can contribute to feelings of tightness or restriction through the breast and chest wall.
Treatment needs to respect your individual medical history, healing and the changes your tissues have been through.
Hands-on care isn't about aggressively trying to “break up” scar tissue. Techniques are adapted to the individual and aim to gently improve movement and comfort.
Can breast care help with shoulder movement after breast cancer treatment?
Reduced shoulder or upper body movement can occur following breast cancer treatment.
For example, someone may notice difficulty comfortably:
Reaching overhead
Putting their arm behind their back
Getting dressed
Reaching into a cupboard
Exercising
Sleeping in certain positions
The breast, chest wall, scars, shoulder and surrounding muscles all interact during upper body movement.
Your appointment may therefore look beyond the breast itself and assess how the chest, shoulder and surrounding tissues are moving together.
What does hands-on treatment after breast cancer involve?
Treatment is individualised depending on the surgery or treatment you've had, your stage of recovery and the symptoms you're experiencing.
It may involve gentle hands-on techniques around appropriately healed scars, the breast, chest wall and surrounding musculoskeletal tissues.
Treatment may focus on improving tissue mobility, reducing feelings of restriction and supporting comfortable shoulder and upper body movement.
Your practitioner may also provide movement or self-management strategies that you can continue at home.
Does treatment directly work over breast cancer scars?
It can, once the area is appropriately healed and it is safe to do so.
Scar treatment doesn't mean aggressively pushing or trying to “break” the scar.
Gentle techniques may be used to assess and work with how the scar and surrounding tissues move.
Your comfort, healing and medical history are always considered before treatment.
What about swelling after breast cancer treatment?
Swelling following breast cancer treatment needs to be assessed appropriately.
Changes to the lymphatic system can occur following breast cancer surgery and lymph node treatment, and new or persistent swelling may require assessment for lymphoedema.
Our breast care service isn't a replacement for specialist lymphoedema management.
If your presentation suggests that specialist assessment is required, we will recommend that you seek appropriate care rather than simply treating the swelling as a musculoskeletal issue.
When can I have breast care after breast cancer surgery?
There isn't one timeframe that applies to everybody.
It depends on the type of surgery or treatment you've had, wound healing, your medical team's recommendations and your individual recovery.
Treatment should only begin when it is appropriate and safe for your stage of healing.
If you're unsure whether you're ready for hands-on treatment, this can be discussed before or during your appointment and medical clearance may be recommended where appropriate.
What if my breast cancer treatment was years ago?
You don't necessarily need to have recently finished treatment.
Some people continue to experience scar restriction, chest wall tightness, shoulder stiffness or discomfort well after their cancer treatment has finished.
If you're experiencing ongoing musculoskeletal or tissue-related symptoms, it may still be worth having them assessed.
Does breast care treat breast cancer?
No.
Breast care at Yarra Valley Women's Health does not treat cancer itself and does not replace your oncology, surgical or medical care.
The purpose of this service is to help manage some of the physical and musculoskeletal effects that may remain following breast cancer treatment, once it is appropriate and safe to do so.
Any new breast lump, unexplained breast change, new nipple change, unexplained swelling or other concerning breast symptom should be medically assessed.
Do I need to have had breast cancer to book breast care?
No.
Our breast care service covers different stages and different concerns.
You may be breastfeeding and experiencing mastitis or breast inflammation.
You may be recovering from breast cancer surgery or treatment.
Or you may be experiencing breast or chest wall symptoms and aren't sure whether breast care is appropriate.
The important part is understanding why you're experiencing your symptoms and whether our service is the right type of care for you.
Mastitis & Breast Care in Healesville and the Yarra Valley
At Yarra Valley Women's Health in Healesville, breast care extends beyond breastfeeding.
Our osteopaths provide gentle hands-on care for mastitis and breastfeeding-related breast concerns, as well as support for people experiencing physical changes after breast cancer treatment, including scar tissue tightness, discomfort and reduced breast, chest wall or shoulder mobility.
Treatment is individualised to your body, symptoms and medical history.
Where your presentation requires additional lactation, medical, oncology or lymphoedema care, we'll also help guide you towards the appropriate support.