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By Mayo Clinic staffYour doctor diagnoses mastitis based on a physical examination, taking into account signs and symptoms of fever, chills and a painful area in the breast. Another clear sign is a wedge-shaped area on the breast that points toward the nipple and is tender to the touch. As part of the examination, your doctor will make sure you don't have a breast abscess — a complication that can occur when mastitis isn't treated promptly.