- J Michael Dixon, MD
J Michael Dixon, MD
- Professor of Surgery and Consultant Surgeon
- Edinburgh University
- Section Editors
- Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
- Section Editor — Breast Surgery
- Associate Professor, Department of Surgery
- Yale University School of Medicine
- Daniel J Sexton, MD
Daniel J Sexton, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine
- Duke University Medical Center
A breast abscess is a localized collection of pus in the breast tissue.
Breast abscesses develop as a complication of mastitis (figure 1) . In a review of 89 patients with breast abscesses requiring surgical intervention, 14 percent were lactational and 86 percent were nonlactational . Breast abscesses were more common in African Americans, obese patients and smokers than in the general population.
Lactational abscess — Risk factors for lactational breast abscess formation include maternal age over 30 years of age, first pregnancies, gestational age ≥41 weeks gestation, and mastitis [3,4]. It is relatively uncommon for lactating women to develop a breast abscess as a complication of mastitis [3,5]. (See "Lactational mastitis".)
Nonlactational abscesses — Nonlactational abscesses can be classified as central, peripheral or skin associated. Patients with nonlactational abscesses, diabetics and smokers are likely to develop recurrent infections .
●Central (periareolar) nonlactational abscesses are usually due to periductal mastitis. (See "Mastitis and other skin disorders of the breast in adults".)
- Dixon JM, Khan LR. Treatment of breast infection. BMJ 2011; 342:d396.
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- Berens PD. Prenatal, intrapartum, and postpartum support of the lactating mother. Pediatr Clin North Am 2001; 48:365.
- Kvist LJ, Rydhstroem H. Factors related to breast abscess after delivery: a population-based study. BJOG 2005; 112:1070.
- Dener C, Inan A. Breast abscesses in lactating women. World J Surg 2003; 27:130.
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- Renz DM, Baltzer PA, Böttcher J, et al. Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis. A comparative study. Eur Radiol 2008; 18:2370.
- Dixon JM. Breast abscess. Br J Hosp Med (Lond) 2007; 68:315.
- Branch-Elliman W, Golen TH, Gold HS, et al. Risk factors for Staphylococcus aureus postpartum breast abscess. Clin Infect Dis 2012; 54:71.
- Leach RD, Eykyn SJ, Phillips I, Corrin B. Anaerobic subareolar breast abscess. Lancet 1979; 1:35.
- Dixon JM. Breast infection. In: ABC of Breast Diseases, Dixon JM (Ed), Blackwell Publishing, Oxford 2006. p.19.
- Dixon JM, Bundred NJ. Management of disorders of the ductal system and infections. In: Diseases of the Breast, Harris JR, Lippman ME, Morrow M, Osborne CK (Eds), Lippincott Williams & Wilkins, Philadelphia 2004. p.47.
- Hughes LE, Mansel RE, Webster DJT. Miscellaneous conditions. In: Benign Disorders and Diseases of the Breast: Current Concepts and Clinical Management, Hughes LE, Mansel RE, Webster DJT (Eds), Edward Arnold, London 2000. p.231.
- Dixon JM. Repeated aspiration of breast abscesses in lactating women. BMJ 1988; 297:1517.
- Schwarz RJ, Shrestha R. Needle aspiration of breast abscesses. Am J Surg 2001; 182:117.
- Hansen PB, Axelsson CK. [Treatment of breast abscess. An analysis of patient material and implementation of recommendations]. Ugeskr Laeger 2003; 165:128.
- Eryilmaz R, Sahin M, Hakan Tekelioglu M, Daldal E. Management of lactational breast abscesses. Breast 2005; 14:375.
- Karstrup S, Solvig J, Nolsøe CP, et al. Acute puerperal breast abscesses: US-guided drainage. Radiology 1993; 188:807.
- O'Hara RJ, Dexter SP, Fox JN. Conservative management of infective mastitis and breast abscesses after ultrasonographic assessment. Br J Surg 1996; 83:1413.
- Christensen AF, Al-Suliman N, Nielsen KR, et al. Ultrasound-guided drainage of breast abscesses: results in 151 patients. Br J Radiol 2005; 78:186.
- Berna-Serna JD, Madrigal M, Berna-Serna JD. Percutaneous management of breast abscesses. An experience of 39 cases. Ultrasound Med Biol 2004; 30:1.
- Ozseker B, Ozcan UA, Rasa K, Cizmeli OM. Treatment of breast abscesses with ultrasound-guided aspiration and irrigation in the emergency setting. Emerg Radiol 2008; 15:105.
- Department of child and adolescent healtlh and development. Mastitis: Causes and management. World Health Organization 2000; http://whqlibdoc.who.int/hq/2000/WHO_FCH_CAH_00.13.pdf (Accessed August 17, 2009).
- Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician 2008; 78:727.
- Jahanfar S, Ng CJ, Teng CL. Antibiotics for mastitis in breastfeeding women. Cochrane Database Syst Rev 2009; :CD005458.
- Thomsen AC, Espersen T, Maigaard S. Course and treatment of milk stasis, noninfectious inflammation of the breast, and infectious mastitis in nursing women. Am J Obstet Gynecol 1984; 149:492.
- ATKINS HJ. Mammillary fistula. Br Med J 1955; 2:1473.
- Dixon JM, Ravisekar O, Chetty U, Anderson TJ. Periductal mastitis and duct ectasia: different conditions with different aetiologies. Br J Surg 1996; 83:820.
- Dixon JM, Thompson AM. Effective surgical treatment for mammary duct fistula. Br J Surg 1991; 78:1185.
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- Schackmuth EM, Harlow CL, Norton LW. Milk fistula: a complication after core breast biopsy. AJR Am J Roentgenol 1993; 161:961.
- Lactational abscess
- Nonlactational abscesses
- CLINICAL MANIFESTATIONS AND DIAGNOSIS
- Differential diagnosis
- Ultrasound guided aspiration
- Surgical drainage
- ROLE OF BREASTFEEDING
- Poor cosmetic outcome
- Mammary duct fistula
- Milk fistula
- SUMMARY AND RECOMMENDATIONS