Differential Diagnosis for Breast Swelling and Pain
- Single most likely diagnosis
- Inflammatory breast cancer: This is the most likely diagnosis given the patient's symptoms of diffuse breast warmth, erythema, and thickened skin dimpling, which are characteristic of inflammatory breast cancer. The patient's recent history of mastitis and subsequent worsening of symptoms despite antibiotic treatment also raises suspicion for an underlying malignancy.
- Other Likely diagnoses
- Recurrent mastitis: The patient's history of mastitis and recent completion of antibiotics suggests that the infection may not have been fully eradicated, leading to recurrent symptoms.
- Breast abscess: The patient's symptoms of breast swelling, pain, and erythema could be indicative of a breast abscess, which may have developed as a complication of mastitis.
- Fat necrosis: The patient's history of breastfeeding and subsequent cessation could lead to fat necrosis, which can cause breast swelling, pain, and skin changes.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Necrotizing fasciitis: Although rare, necrotizing fasciitis is a life-threatening condition that can present with similar symptoms to mastitis or breast abscess, and prompt recognition and treatment are crucial to prevent mortality.
- Metastatic infection (e.g., endocarditis): In rare cases, bacterial infections such as endocarditis can metastasize to the breast, causing symptoms similar to mastitis or abscess.
- Rare diagnoses
- Granulomatous mastitis: A rare inflammatory condition that can cause breast swelling, pain, and skin changes, often associated with granulomatous inflammation on histopathology.
- Breast lymphoma: A rare malignancy that can present with breast swelling, pain, and skin changes, often associated with systemic symptoms such as fever and weight loss.