Differential Diagnosis for Breast Pain after Pumping

• Single most likely diagnosis
  • Mastitis: This is an inflammation of the breast tissue, which can be caused by milk stasis or infection, common in lactating women who are breastfeeding or pumping. The pain, especially if localized to one breast, could indicate mastitis, which is a common issue in women who are pumping.
• Other Likely diagnoses
  • Plugged duct: A plugged duct can cause pain, swelling, and redness in the affected breast. It occurs when milk flow is blocked in one of the ducts, which can happen due to improper latching, infrequent feeding or pumping, or pressure on the breast.
  • Breast engorgement: This condition occurs when the breast becomes overly full of milk, leading to swelling, pain, and discomfort. It's common in the early days of breastfeeding or pumping but can occur at any time, especially if there's a sudden change in feeding or pumping schedule.
  • Nipple trauma: Incorrect use of the breast pump or poor fit of the pump flanges can lead to nipple soreness or trauma, causing pain during and after pumping.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Breast abscess: Although less common, a breast abscess is a serious condition that requires prompt medical attention. It's an infection that has led to a collection of pus in the breast tissue, which can cause severe pain, swelling, and fever.
  • Inflammatory breast cancer: This is a rare but aggressive form of breast cancer that can cause pain, swelling, and redness of the breast. It's crucial to rule out cancer in cases of persistent or severe breast pain.
• Rare diagnoses
  • Ductal ectasia: This condition involves the widening of a milk duct in the breast, which can cause pain, nipple discharge, and sometimes a lump. It's more common in women who are nearing menopause but can occur in lactating women.
  • Breast cysts: While breast cysts are common, they are less likely to cause pain specifically related to pumping. However, if a cyst becomes large or ruptures, it could cause discomfort or pain.