Women's Health

Breast Care

Breast Disorders

Breast Infection

Breast infections are classified as breast abscesses or as mastitis.

Abscesses

Abscesses are well defined collections of infected material or pus that generally require some form of drainage for management. Symptoms will typically include redness or warmth in the area of the abscess and breast pain. Infections including fever or chills may be present.

Breast abscesses that occur directly behind the nipple are often caused by a condition known as periductal mastitis or duct ectasia. These types of breast abscesses are notorious for their ability to recur even after satisfactory drainage and antibiotic therapy. Multiple recurrences of abscesses behind the nipple may eventually lead to the recommendation to have the diseased ducts surgically removed.

Abscesses that occur further away from the nipple in other quadrants of the breast can be seen in the immediate post-partum period. These abscesses may respond to drainage using a needle-guided approach but occasionally will require surgical drainage in addition to antibiotic therapy.

Breast abscesses in post-menopausal women that occur outside of the nipple area require special consideration. Without an underlying cause such as lactation or periductal mastitis, it is uncommon for post-menopausal women to develop abscesses. It is important to perform a thorough imaging evaluation including mammogram and ultrasound to exclude an underlying breast cancer. Drainage of an abscess in this age group always requires close followup to make sure there is not an underlying breast tumor.

Mastitis

Mastitis refers to an infection in the soft tissue of the breast, but no well-defined collection that requires drainage. This is most commonly seen in women who are lactating and breastfeeding. Most cases of mastitis will respond to antibiotic therapy. Severe cases may require intervenous antibiotics and when symptoms begin to improve, oral antibiotics can be utilized. Women who are beyond childbearing age who develop symptoms of diffuse redness in one breast should be evaluated for inflammatory carcinoma.