Benign Breast Conditions

Question 1

Periareolar Abscess Recurrent Subareolar Abscesses Characteristics (6)

Answer 1

1. Young women
2. Underlying problem is periductal mastitis
3. Presents as inflammation +/- mass, abscess or mammary duct fistula
4. Aerobic and anaerobic organisms
5. Nearly always associated with cigarette smoking
6. Hx of recurring problems and prior abx or incision and drainage; up to 50% recurrent

Question 2

Definition periductal mastitis

Answer 2

1. squamous metaplasia
2. obstruction of duct

Question 3

Treatment initial episode periareolar abscess

Answer 3

1. Antibiotics (broad spectrum aerobic and anaerobic coverage)
2. Aspiration if needed
3. QUIT smoking

Question 4

Definitive management of RECURRENT subareolar abscess

Answer 4

1. surgical excision of subareolar ducts after acute infection is controlled

Question 5

Treatment mammary duct fistula

Answer 5

1. excise tract and affected duct(s)

Question 6

Lactational Mastitis characteristics

1. Timing
2. Microbes
3. Symptoms

Answer 6

1. generally within 1st 6 weeks of breast feeding
2. Staph aureus or Staph epidermidis
3. Pain, erythema, swelling, tenderness, systemic symptoms

Question 7

Antibiotic therapy choices

Answer 7

1. flucloxacillin
2. amoxicillin-clavulanate
3. erythromycin