Mastitis + Breast Abscess Flashcards
Definition of mastitis?
Inflammation of the breast
What can mastitis lead to if left untreated?
Breast abscess
What is a breast abscess?
Collection of pus in the breast tissue due to infection
What are the types of mastitis and how is it caused?
Lactational or non-lactational
- milk stasis/over-production
Epidemiology and risk factors for mastitis?
15-45y/o
Breast-feeding
>30y/o smokers
What is the most common pathogen causing mastitis and how does it do so?
Staphylococcus aureus
- enters through cracked skin e.g. nipple (e.g. after microtrauma from breast-feeding)
Using SCTF method, what are the features of mastitis?
S - generalised swelling of the breast, inflamed overlying skin (nipple may be cracked)
C - redness, firm
T - very tender and uncomfortable, warm to touch
F - flu-like symptoms: fever, aches, chills, generally unwell
How does non-lactational tend to present different to lactational?
With a Hx of previous infections
- with less pronounced systemic upset
Investigations if a breast abscess if suspected?
USS
FNA + cytology of aspirate/nipple discharge
FBC + blood cultures (if evidence of systemic infection)
Management of breast abscess?
Surgery + IV/oral ABx that act against methicillin-sensitive staph
Investigations of mastitis?
Breast US
FNA
Cytology of aspirate/milk/nipple discharge
Management of mastitis?
Lactational
- milk removal (breast-feeding)
- ABx + milk removal if severe/systemic symptoms
Non-lactational
- empiric ABx
- if MRSA detected, non-beta lactam antibiotic
Supportive care in all, may include analgesia
Complications of breast abscess?
Mammary fistula
Overlying skin may undergo necrosis (rare)
Prognosis of breast abscess?
Untreated - breast abscess may discharge onto skin surface
Non-lactational breast abscesses tend to re-occur
