Breast abscess Flashcards
What is the definition of a breast abscess?
Localised collection of pus within the breast
What is the epidemiology of breast abscesses?
Breast abscesses develop in 3–11% of women with mastitis
What is the pathology of breast abscesses?
• Most commonly staphylococcus aureus
• Lactiferous duct lining undergoes epidermalisation and keratin production = plugging
(see image on notes)
What are the risk factors/aetiology of breast abscesses?
- Mastitis – inflammation of the breast
- Breastfeeding
- Sore/cracked nipples
- Nipple piercing
- Milk statis
- Periductal mastitis – subareolar ducts are damaged/infected
- Duct ectasia – harmless, age related breast change
- Diabetes (immunosuppression)
- HIV (immunosuppression)
- Rheumatoid arthritis
- Trauma
- Corticosteriod treatment
- Granulomatous lobular mastitis (GLM) – autoimmune reaction to substances secreted from mammary ducts
- Poor socio-economical status
- Poor hygiene
What are the signs/symptoms of breast abscesses?
- Painful, swollen lump in the breast – redness, hot, swelling of overlying skin
- Fever
- Flu like symptoms
- Malaise
What diseases present similarly to breast abscesses?
- Breast cancer
* Fibrocytic disease
What investigations would be carried out for suspected breast abscesses?
- Breast examination
- US
- Culture of fluid from abscess
- Breast milk culture
What are the surgical treatments for breast abscesses?
• Drainage via ultrasound guided needle aspiration/surgical drainage
What are the pharmacological treatments for breast abscesses?
- Antibiotics
* Analgesia
What are the non pharmacological treatments for breast abscesses?
- Continue breast feeding if possible
- Improve milk removal via breast feeding technique
- Do not wear a bra at night