f you’ve experienced mastitis, you’ll know just how uncomfortable breast pain, swelling and inflammation can become — and how quickly symptoms can change.
At Yarra Valley Women’s Health in Healesville, we now offer therapeutic ultrasound as part of our Mastitis & Breast Care appointments, giving us another treatment option for women experiencing mastitis and inflammatory breast concerns.
So, what actually is therapeutic ultrasound? And when might we use it?
What is mastitis?
Our understanding of mastitis has changed significantly over recent years.
Mastitis is now understood as a spectrum of inflammatory conditions of the breast, rather than simply being caused by a “blocked milk duct”.
Inflammation and swelling within the breast can contribute to narrowing of the ducts and surrounding tissues. This may result in an area of the breast feeling:
Firm or hard
Swollen
Tender or painful
Warm
Red
Uncomfortable during feeding or expressing
Some women may also experience fever, chills, fatigue or generally feel unwell.
This is also why current approaches to mastitis have moved away from aggressively massaging or trying to “push out” a blockage. When breast tissue is already inflamed and swollen, being overly aggressive with it may cause further irritation.
What is therapeutic ultrasound?
Therapeutic ultrasound is different from the ultrasound used to take an image of your breast during a scan.
Instead, therapeutic ultrasound uses high-frequency sound waves to produce therapeutic effects within the tissues being treated.
Within mastitis care, therapeutic ultrasound may be used to help reduce inflammation and oedema (swelling) within the breast.
During treatment, ultrasound gel is applied to the skin and the ultrasound head is gently moved over the affected area of the breast.
It is non-invasive and can be incorporated into your breast care appointment when appropriate for your presentation.
What breast concerns may therapeutic ultrasound help with?
Therapeutic ultrasound may be considered as part of treatment for several inflammatory breast presentations.
Mastitis
Therapeutic ultrasound may be incorporated into the management of mastitis where there is localised breast pain, inflammation and swelling.
Treatment is always based on your individual presentation, including whether your symptoms suggest inflammatory or bacterial mastitis and whether further medical treatment is required.
Persistent painful or firm areas of the breast
Sometimes the more general symptoms settle, but one particular area of the breast remains firm, tender or uncomfortable.
Where inflammation and swelling are contributing to this area, therapeutic ultrasound may be considered as part of treatment.
Ductal narrowing — or what we used to call a “blocked duct”
You may have previously been told that a painful breast lump is a “blocked duct” that needs to be massaged until the blockage comes out.
Our understanding of this has changed.
These symptoms can occur when inflammation and swelling contribute to narrowing within the ductal system, rather than there necessarily being a solid plug of milk that needs to be pushed out.
This is why treatment now focuses much more on settling inflammation rather than aggressively massaging the breast.
Breast swelling and oedema
Inflammation can cause fluid and swelling within the breast tissue.
Therapeutic ultrasound may be used as one part of management where oedema and inflammation are contributing to breast discomfort.
Engorgement
Engorgement commonly occurs when the breasts become very full, swollen and uncomfortable, particularly during changes in milk production.
Management depends on the cause and severity of the engorgement. In some presentations, therapeutic ultrasound may be considered alongside other appropriate breast and lactation care.
Does therapeutic ultrasound hurt?
Treatment should generally be comfortable.
A layer of ultrasound gel is placed over the breast and the ultrasound head is continuously moved over the treatment area.
If your breast is already particularly inflamed or tender, we will work within your comfort levels throughout your appointment.
Is therapeutic ultrasound the same as a breast ultrasound scan?
No — and this is an important distinction.
Diagnostic ultrasound is imaging. It allows a sonographer or radiologist to look at structures within the breast and may be required when investigating concerns such as a suspected breast abscess or persistent breast lump.
Therapeutic ultrasound is a treatment modality. It does not produce an image and cannot diagnose what is happening inside the breast.
If we are concerned that your symptoms require imaging or further medical assessment, we will recommend that you see the appropriate medical practitioner.
What else happens during a Mastitis & Breast Care appointment?
We don't want to simply put an ultrasound machine over the painful area and send you home.
Understanding why your symptoms have developed is an important part of your appointment.
Depending on your presentation, your appointment may include:
Assessment of the breast and surrounding tissues
Therapeutic ultrasound when clinically appropriate
Gentle hands-on breast care
Advice around managing inflammation and swelling
Discussion around feeding and/or expressing
Identifying factors that may be contributing to recurrent symptoms
Advice around when additional lactation or medical support may be beneficial
Our approach is individualised because mastitis and breast pain can present very differently from person to person.
Do I still need to see my GP if I have mastitis?
Sometimes.
Not every case of mastitis requires antibiotics, particularly when symptoms are predominantly inflammatory. However, bacterial mastitis can occur and some presentations require medical management.
We will recommend further medical assessment when appropriate.
You should seek prompt medical care if you are becoming increasingly unwell, your symptoms are rapidly worsening, you have persistent fever or systemic symptoms, you are concerned about an abscess, or your symptoms are not improving as expected.
A new or persistent breast lump or an unexplained change in your breast should also be medically investigated rather than assumed to be mastitis.
Therapeutic Ultrasound for Mastitis in Healesville
Therapeutic ultrasound is now available as part of our Mastitis & Breast Care appointments at Yarra Valley Women’s Health in Healesville.
It gives our practitioners another treatment option that can be incorporated into breast care when appropriate, particularly where inflammation, swelling, pain or persistent firm and tender areas are present.
If you're experiencing mastitis, recurrent inflammatory breast symptoms, a persistent painful or firm area of the breast, or you're simply unsure what is happening, you can book a Mastitis & Breast Care appointment with our team.