Lisa, I am keenly interested in your information that systemic implies that it is in the blood stream and that intraductal and nipple yeast are not of systemic yeast overgrowth. Good comments Pat! I'll try to reply more fully if I get a chance. One definition of systemic candidiasis is "isolation from a normally sterile body site". My usual reference (FC Odds: Candida and Candidosis) says "Systemic forms of candidosis may arise as localised primary disease, with only one organ affected, or as disseminated candidosis (Candida septicaemia) is which Candida is spread by the bloodstream to invade several organs". Perhaps candida in the breast is a "deep candidosis" and could be called "systemic candidosis". We still don't actually have proof. (A biopsy of the breast with invading fungi would be nice - but we're not likely to do this,) The reason I wanted to sound a caution is that I've heard doctors being critical of a diagnosis of systemic candida - because most doctors will feel this only occurs in very ill patients. Also women sometimes feel that thrush is appearing allover (vagina, breasts, bowel) and can feel frightened. I explain the thrush in the breast has got there from the outside, it hasn't spread internally. Hope this helps! Lisa Amir GP / IBCLC in Melbourne, Australia