1. Abscess

Question 1

How common is it?

Answer 1

Quite - 5-11% of mastitis patients

Question 2

Who does it affect?

Answer 2

Peaks in 4th decade
Lactating women most commonly
Occurs in non-lactating women more commonly in African ethnicities

Question 3

What causes it?

Answer 3

(severe complication of) Mastitis - staph aureus (MRSA)

Question 4

What risk factors are there?

Answer 4

Breast feeding
Obesity, smoking, diabetes
Nipple piercings

Question 5

How does it present?

Answer 5

Tender lump
Pain
Redness, warmth, swelling
Fever, malaise, myalgia

Question 6

What signs may the patient have on examination?

Answer 6

Erythema, tenderness, warmth, induration (hardening)
Nipple / site discharge
Reactive axillary lymphadenopathy

Question 7

Which other conditions might present similarly?

Answer 7

Breast tumour (benign or malignant)
Cellulitis
Inflammatory breast cancer

Question 8

How would you investigate?

Answer 8

USS

Breast milk sample for MCS

Question 9

What treatments are there?

Answer 9

Incision and drainage
Continue to breastfeed where possible
Trimethoprim / doxycycline

Question 10

What are the complications?

Answer 10

Sepsis
Cosmetic deformity
Scarring