Breast Rash

A breast rash can have many different potential causes. Common causes include infections or allergic reactions. In rare instances, it can be a sign of breast cancer, such as Paget’s disease of the nipple or inflammatory breast cancer.

Most skin rashes are caused by medical conditions that can cause rashes elsewhere in the body. However, some rashes only occur on the breast.

Common conditions that can cause rashes all over the body, including the breast, may include:

• Dermatitis and Eczema – conditions that cause inflammation of the skin.
• Heat rash – a skin rash that occurs when sweat glands on the skin are blocked.
• Intertrigo – a rash that usually occurs between the folds of the skin, including the skin under the breast.
• Hives – itchy, slightly raised areas of the skin with many different causes.
• Psoriasis – a long-term skin condition that causes red scaly patches on the skin.
• Infections (such as shingles and scabies)

The rashes due to these common conditions are not specifically associated with the breast and can occur on other parts the body.

Causes of rash that occur only on the breast, may include:

• Mastitis – an inflammation of the breast that can be caused by a blocked milk duct
• Breast abscess – a build-up of pus in the breast caused by an infection
• Mammary duct ectasia – a benign (noncancerous) condition that occurs when a milk duct in the breast widens.
• Inflammatory breast cancer – a rare but often aggressive type of cancer that causes skin changes on the breast.
• Paget’s disease of the nipple – a rare breast cancer that affects the skin around the nipple.

While a rash on your breast is most likely to be caused by an infection or allergic reaction, in rare cases it can also be a symptom of breast cancer, such as inflammatory breast cancer. Unlike other common types of breast cancer, inflammatory breast cancer does not usually cause lumps in the breast.

Because the symptoms between some medical conditions can be very similar, it is important that you speak with your doctor to ensure an accurate diagnosis if you experience a breast rash.

Some breast cancer treatments may also cause a rash as a side effect. Please talk to your treatment team if you experience a rash during or after cancer treatment.

Mastitis is an inflammation of the breast. It is a benign (noncancerous) condition that can be caused by a blocked milk duct or a bacterial infection. It most commonly occurs during breastfeeding. However, it can also occur in women who are not breastfeeding and in men.

Symptoms of mastitis may appear suddenly, and include:

• Breast swelling
• A breast that feels warm and tender to touch
• Breast pain or burning sensation, continuously or while breast feeding
• Generally feeling ill
• Fever

Symptoms of inflammatory breast cancer

Inflammatory breast cancer (IBC) is a rare and often aggressive form of invasive breast cancer. Unlike other common breast cancers, it often does not cause a breast lump. The symptoms of IBC appear when cancer cells block lymph vessels (that are part of the lymphatic system) in the breast.

Symptoms of IBC may include:

• Swelling of the skin of the breast
• A breast that looks red, inflamed or develops a rash
• A breast that becomes swollen or enlarged compared to the other breast
• Dimpling, pitting or thickening of the skin on the breast, so that it looks and feels like an orange peel
• An inverted nipple (nipple that points inwards)

Many of these symptoms are similar to a breast infection or inflammation (such as mastitis). Because these conditions occur more frequently than IBC, your doctor may initially prescribe antibiotics if they suspect that you have an infection. However, if your symptoms do not improve, your doctor may consider other more serious causes, such as IBC, and more tests may be recommended to evaluate your symptoms.

Symptoms of Paget’s disease of the nipple

Paget’s disease of the nipple (also known Paget’s disease of the breast) is a rare form of breast cancer. It can occur in both women and men, but most cases occur in women. Most people who are diagnosed with Paget’s disease of the nipple have tumours in the same breast that are either ductal carcinoma in situ or invasive breast cancer.

The symptoms of Paget’s disease of the nipple can be mistaken for some other noncancerous skin conditions, such as dermatitis or eczema. The main symptom of Paget’s disease of the nipple is a change in the nipple and/or the areola (the darker skin surrounding the nipple).

Symptoms of Paget’s disease of the nipple may include:

• Flaky, scaly or crusty skin on or around the nipple.
• Itching or redness in the nipple and/or areola
• A flat or inverted nipple (nipple pointing inwards)
• Discharge or bleeding from the nipple
• There may be a lump in the same breast

Common skin rashes

Treatments recommended depend on the specific medical condition, and its severity and responsiveness to previous treatment. For skin diseases, treatment may involve prescribed topical creams and ointments, oral medications and/or other therapies. Treatment for rashes causes by viruses (such as shingles) may involve anti-viral medications.

Mastitis

Your doctor may prescribe antibiotics to treat mastitis. However, if your symptoms do not improve after taking antibiotics, please follow up with your doctor. Your doctor may also recommend an over-the-counter pain reliever (such as ibuprofen or paracetamol) if needed.

Inflammatory breast cancer

Most people diagnosed with inflammatory breast cancer will have a combination of different therapies. Treatment options include chemotherapy, breast surgery, radiotherapy, targeted therapies and hormonal therapies. The order in which the treatments are given may vary, and the treatment plan may be adjusted depending on how the cancer responds.

Paget’s disease of the nipple

The treatments recommended for Paget’s disease of the nipple will depend on how much of the nipple, areola or breast is involved. Surgery is one of the main treatment options for this disease. Radiotherapy may also be recommended. If invasive breast cancer is found, further treatments such as chemotherapy, targeted therapy and/or hormonal therapy may be needed. Treatment options vary depending on individual circumstances.