Breast Abscess – Symptoms, Causes, and Management

A breast abscess is a painful lump, filled with pus which lies under the skin. It is more common in females who are lactating or breastfeeding. The pain caused by an abscess is usually localized unless it involves surrounding structures, which may cause the pain to radiate to arm, axilla, or chest wall.

Symptoms of breast abscess

  • Tenderness at the point of inflammation
  • Redness of the skin
  • The temperature is slightly hotter than the surrounding skin
  • Fever
  • Swelling of surrounding structures
  • Decreased production of milk
  • Pus-filled lumps in the breast
  • Discharge from the nipples
  • Nausea and vomiting
  • Lethargy.

Causes of breast abscess

  • Lactating women are more prone to getting infected via the pores in the nipples that carry bacteria into the breast tissue through the milk ducts. This bacteria has favorable breeding conditions once the duct gets blocked or there is stasis of milk, in case of infrequent feeding. This infection of breast tissue is known as mastitis and if left untreated can complicate into an abscess.
  • White blood cells in the body are sent by the immune system to fight against infection, these cells cause tissue necrosis and accumulation of inflammatory mediators. Breast pain caused by an abscess results from an accumulation of inflammatory mediators in the tissue in the form of pus.
  • The causative agent for abscess formation in lactating females is staphylococcus aureus. Whereas, in nonlactating cases, which is quite rare, staphylococcus aureus, streptococcus, and some anaerobic bacteria are involved.

Risk factors

  • Breastfeeding or lactating women
  • Infrequent feed
  • Ongoing mastitis that is not being treated
  • Nipple piercing or breast implants
  • Nipple thrush all cracked skin.

Complications of breast abscess

Following are the probable complications of breast abscess if not properly treated:

  • Formation of a fistula.
  • Disfigurement of the breast.
  • Scaring of the area.
  • The breast abscess can burst, contaminating the surrounding tissues.

Management of breast abscess

Diagnosis

A breast abscess is diagnosed chiefly based on the previous history of mastitis with poor recovery and compliance of the patient. Other than that, your doctor might go on to perform a clinical breast examination and an ultrasound to confirm the diagnosis. A biopsy of the fluid will also be done in a suspected case.

Medical treatment

  • Painkillers for excessive pain
  • Antibiotics for ongoing infection
  • Antipyretics for high fever
  • Symptomatic treatment for other ongoing symptoms can also be given.

Surgical treatment

  • Needle aspiration of the fluid from a lump smaller than 3 cm in women who are lactating
  • Incision and drainage of the abscess is done in case of a mass larger than 3cm
  • If a non-lactating person develops an abscess, there are higher chances of reoccurrence, and more than one extraction and drainage will be required.

Prevention 

It can be easily prevented by taking a few measures:

  • Lactating mothers should take long breaks between feeding 
  • Do not keep the breasts full for too long, mothers who are not breastfeeding should use a breast pump to empty the breasts frequently 
  • Avoid wearing tight-fitted clothes 
  • Make sure the baby attaches properly while feeding.

Home remedies

  • Apply moisturizer avoid the nipples from cracking
  • Avoid taking long breaks between feeds
  • Empty out the breast frequently by using breast pumps
  • Do not stop breastfeeding at any point
  • Warm compresses to ease inflammation
  • Properly fitted bra to support the breast properly.

When to consult a doctor?

Following are some conditions when a breast abscess requires medical attention:

  • If you have an infection in both breasts
  • Discharge from nipples
  • High fever and vomiting
  • Red streaks on the skin over the abscess.

FAQ

Does a breast infection always complicate into an abscess?

No, only if the breast infection/mastitis is left untreated for very long, is when it complicates and develops an abscess.

Why do I need to take antibiotics for a breast abscess?

A breast abscess develops due to an ongoing infection. To fight the bacteria an antibiotic is required.

Can a breast abscess burst?

Yes, if excessive pressure is applied and the abscess is large enough, it can also burst to contaminate the surrounding tissues. This requires active management.

Last medically reviewed on September 20, 2022.