Breast Abscess

Question 1

what is a breast abscess

Answer 1

abscess formation in breast tissue

Question 2

what are the two main forms of breast abscesses

Answer 2

lactational, non-lactational

Question 3

aetiology/ causes of breast abscess

Answer 3

caused by infection

Question 4

what is causative agent of non-lactational abscess

Answer 4

Staphylococcus aureus OR

Anaerobes

Question 5

what is causative agent of lactational abscess

Answer 5

Staphylococcus aureus

Question 6

risk factors

Answer 6

lactation

smoking

mammary duct ectasia

wound infections

Question 7

epidemiology

Answer 7

Lactational breast abscess are COMMON and tend to occur soon after starting breast feeding or weaning

Non-lactational breast abscesses are more common in 30-60 yo smokers

Question 8

presenting symptoms of breast abscess

Answer 8

Breast discomfort

Painful swelling

Generally unwell and feverish

Non-lactational - tend to present with a history of previous infections with less pronounced systemic upset

Question 9

signs of local breast abscess

Answer 9

Swollen, warm and tender area of the breast

Overlying skin may be inflamed

The nipple may be cracked

Non-Lactational

Scars or tissue distortion from previous episodes

Signs of duct ectasia (e.g. nipple retraction)

Question 10

signs of systemic breast abscess

Answer 10

pyrexia (high temp) and tachycardia

Question 11

investigations for a breast abscess

Answer 11

ultrasound

microscopy, cultures and sensitivity (MC&S) of pus samples

Question 12

management of a breast abscess

Answer 12

medical and surgical treatments

Question 13

medical treatment of breast abscess

Answer 13

antibiotics

Question 14

antibiotics to treat lactational breast abscess

Answer 14

flucloxacillin

Question 15

antibiotics to treat non-lactational breast abscess

Answer 15

flucloxacillin and metronidazole

Question 16

why use metronidazole for non-lactational breast abscess

Answer 16

treats anaerobe bacteria which are causative organisms of a breast abscess

Question 17

surgical treatment/ management of a breast abscess

Answer 17

Lactational: Incision and drainage

Non-Lactational: open drainage should be avoided. The involved duct system should be excised once the infection has settled

Question 18

possible complications of a breast abscess

Answer 18

mammary fistula and overlying skin may (rarely) undergo necrosis

Question 19

prognosis of an untreated breast abscess

Answer 19

pus may leak onto the skin

Question 20

prognosis of non-lactational breast abscesses

Answer 20

may recur