Differential Diagnosis for Sudden Swelling of Right Breast with Nipple Retraction

• Single most likely diagnosis
  • Breast abscess: This is a common cause of sudden breast swelling, especially when accompanied by nipple retraction. The abscess can cause the breast tissue to become inflamed, leading to swelling and retraction of the nipple.
• Other Likely diagnoses
  • Mastitis: An infection of the breast tissue, mastitis can cause sudden swelling, redness, and warmth of the breast, along with nipple retraction. It is often seen in lactating women but can occur in non-lactating women as well.
  • Fat necrosis: This condition occurs when the fatty tissue in the breast becomes damaged, leading to inflammation and scarring. It can cause a sudden swelling of the breast and nipple retraction, often without other symptoms.
  • Seroma or hematoma: A collection of fluid (seroma) or blood (hematoma) in the breast tissue can cause sudden swelling and may lead to nipple retraction if it is large enough.
• Do Not Miss diagnoses
  • Breast cancer: Although less likely, breast cancer can cause a sudden swelling of the breast, especially if it is an inflammatory type. Nipple retraction is also a common symptom of breast cancer. It is crucial to rule out cancer due to its severe implications.
  • Infectious mastitis due to tuberculosis or other unusual pathogens: These infections can present with similar symptoms and are important to consider, especially in endemic areas or in individuals with specific risk factors.
• Rare diagnoses
  • Galactocele: A milk-filled cyst that can occur in lactating women, causing a swelling of the breast. Nipple retraction can occur if the cyst is large or becomes infected.
  • Breast lymphangioma or lymphangiosarcoma: These are rare tumors of the lymphatic vessels in the breast and can cause swelling and nipple retraction, although they are much less common than other diagnoses listed here.
  • Mondor's disease: A rare condition characterized by thrombophlebitis of the superficial veins of the breast, which can cause swelling, pain, and nipple retraction.