BREAST INFECTION

Breast infections affects women aged between 15 and 45 years and can be divided into lactational (breast-feeding) and non lactational infections.

Lactational: Normally seen within 6-8 weeks of breast feeding, although some develop during weaning.

A breast abscess which developed during breast feeding

Non-lactational: can be divided into periareolar (around the nipple) and peripheral (away from the nipple) infections.

Periareolar infections affect young patients. Current evidence links this condition to smoking.. Associated features may include central breast pain, nipple retraction and nipple discharge. This may lead to formation of a discharge abscess which requires surgical excision.

Non-lactating breast abscess due to periductal mastits

Peripheral infections: less common and are often associated with diabetes, rheumatoid arthritis, steroid treatment, granulaomatous lobular mastitis, and trauma. Overall management is along similar plan as other infection however, often conditions such as granulaomatous lobular mastitis, tend to persist to recur.

Neonatal breast infections is most common in first few weeks of life when the breast bud is enlarged. Abscess if develops should be treated with formal drainage by placing the incision as peripherally as possible to avoid damage to breast bud.

Treatment plan of breast abscess (general)

90% of breast abscesses can be managed by repeated aspirations rather than formal surgery.

Inflammatory mass without pus on multiple ultrasound examinations which fails to decrease in size on antibiotics should be fully investigated with biopsies to exclude underlying carcinoma.

All abscesses should be followed clinically as well as with ultrasound till completely resolved.

Interval of assessment will vary in individual patients.