Primary breast abscess
- 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. Primary breast abscesses develop when mastitis or cellulitis does not respond to antibiotic treatment. It is an uncommon problem in breastfeeding with a reported incidence of 0.1 percent ; the incidence among women with antibiotic-treated mastitis is 3 percent .
Issues related to primary breast abscess will be reviewed here. Issues related to mastitis, cellulitis, and postoperative complications of breast surgery are discussed separately. (See "Lactational mastitis" and "Nonlactational mastitis in adults" and "Breast cellulitis and other skin disorders of the breast" and "Mastectomy: Indications, types, and concurrent axillary lymph node management", section on 'Complications' and "Breast conserving therapy", section on 'Postoperative Complications'.)
ETIOLOGY AND RISK FACTORS
Primary breast abscesses develop as a complication of mastitis . In a review of 89 patients with primary breast abscesses requiring surgical intervention, 14 percent were complications of lactational mastitis and 86 percent were complications of nonlactational mastitis . The incidence of breast abscesses ranges from 0.4 to 11 percent of lactating mothers . Breast abscesses in nonlactating women occurred more commonly in African Americans, obese patients, and smokers.
Risk factors for development of breast abscess as a complication of lactational mastitis include maternal age >30 years, first pregnancy, gestational age ≥41 weeks, and tobacco use [1,5,6]. Risk factors for a staphylococcal abscess in lactating mothers in one study identified problems with breastfeeding (odds ratio 5.0) and being a mother employed outside her home (odds ratio 2.74) as risk factors .
A breast abscess or infection associated with prior lactation is not a contraindication to subsequent breastfeeding. A prior history of mastitis in previous pregnancies, a blocked duct, cracked nipples, use of creams on nipples (particularly antifungal creams), and using a breast pump all have been reported to significantly increase the likelihood of mastitis [8,9].To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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