Breast abscess Flashcards
Define breast abscess
Abscess formation in the breast tissues
2 main forms:
lactational
non lactational
Aetiology of breast abscesses
general +3
Caused by INFECTION
Causative organisms based on whether abscess is: Lactational staphylococcus aureus Non-lactational staphylococcus aureus anaerobes
Risk factors for breast abscess
5
Lactation SMOKING Mammary duct ectasia Periductal mastitis Wound infections (e.g. from breast surgery)
Epidemiology of breast abscess
2 kinds
Lactational breast abscesses are COMMON & tend to occur soon after starting breast feeding or weaning
Non-lactational breast abscesses are more common in 30-60 yr old smokers
Presenting symptoms of breast abscess
4
Breast discomfort
Painful swelling
Generally unwell & feverish
Non-lactational tend to present w/ history of infections w/ less pronounced systemic upset
Signs of breast abscess on physical examination
2 groups
Local
Systemic
Signs of breast abscess on physical examination - local
5
Swollen, warm, tender area of breast
Overlying skin may be inflamed
Nipple may be cracked
Non-lactational
scars or tissue distortion from previous episodes
signs of duct ectasia (e.g. nipple retraction)
Signs of breast abscess on physical examination - systemic
2
Pyrexia
Tachycardia
Investigations for breast abscess
2
US
MC&S of pus sample
Management of breast abscess
2 groups
Medical
Surgical
Management of breast abscess - medical
2
Antibiotics
lactational: flucloxacillin
non-lactational: flucloxacillin + metronidazole
Management of breast abscess - surgical
2
Lactational - incision & drainage
Non-lactational - open drainage should be avoided, involved duct system should be excised once infection settled
Complications of breast abscess
2
Mammary fistula
Overlying skin may (rarely) undergo necrosis
Prognosis of breast abscess
2
If untreated, may discharge onto skin surface
Non-lactational abscess tend to recur
