A breast abscess is a localized pus-filled infection in breast tissue, commonly associated with bacterial infections like Staphylococcus aureus and mastitis, particularly during breastfeeding. Symptoms include localized pain, swelling, redness, tenderness, and possible fever, with diagnosis achieved through clinical examination and imaging. Treatment involves antibiotics, abscess drainage, pain management, and ensuring proper hygiene to prevent recurrence.

1. BREAST ABSCESS
MS. SONAM SHARMA
ASST. PROFESSOR

2. Definition
 A breast abscess is a localized collection of
pus within the breast tissue. It typically occurs
as a result of bacterial infection, often in
association with mastitis, a condition
characterized by inflammation of the breast
tissue. Breast abscesses can be painful and
may cause redness, swelling, warmth, and
tenderness in the affected area. Here's a
detailed overview of breast abscess:

3. Causes and risk factor
 Bacterial Infection: Most breast abscesses are caused by
bacterial infections. Staphylococcus aureus is the most
common bacterium responsible for breast abscesses,
although other bacteria can also be involved.
 Mastitis: Breast abscesses often develop in association with
mastitis, which can occur during breastfeeding due to milk
stasis, nipple trauma, or compromised immune defenses.
 Nipple Piercing: In some cases, a breast abscess may
develop as a complication of nipple piercing, particularly if
proper hygiene practices are not followed.
 Compromised Immune System: Conditions or treatments
that weaken the immune system, such as diabetes,
HIV/AIDS, chemotherapy, or immunosuppressive
medications, can impair the body's ability to fight off
bacterial infections, increasing the risk of developing a
breast abscess.

4.  Breast Trauma or Injury: Trauma to the breast tissue,
such as blunt force trauma or injury during physical
activities, can predispose individuals to the development
of a breast abscess.
 Previous History of Breast Abscess: Individuals who
have previously experienced a breast abscess are at an
increased risk of developing recurrent abscesses.
 Breast Surgery or Biopsy: Surgical procedures or
biopsies performed on the breast can disrupt the normal
tissue architecture and increase the risk of infection,
leading to the formation of an abscess.
 Obesity: Obesity is associated with an increased risk of
breast abscess, possibly due to factors such as impaired
lymphatic drainage, increased friction and moisture in
skin folds, and altered immune function.
 Smoking: Smoking is a risk factor for breast abscess, as
it can impair immune function and increase susceptibility
to infections.

5.  Diabetes: Individuals with diabetes are at a higher risk
of developing infections, including breast abscesses, due
to impaired immune function and poor wound healing.
 Hormonal Factors: Fluctuations in hormone levels,
such as those occurring during menstruation, pregnancy,
or menopause, can affect breast tissue and increase the
risk of developing mastitis and subsequent abscess
formation.
 Use of Certain Medications: Medications that affect
hormonal balance or immune function, such as
hormonal contraceptives or corticosteroids, may
increase the risk of breast abscess.
 Poor Breast Hygiene: Inadequate breast hygiene, such
as infrequent washing or wearing tight-fitting clothing
that traps moisture and promotes bacterial growth, can
increase the risk of developing a breast abscess.

6. Pathophysiology
Mastitis Development
Inflammatory Response
Bacterial Invasion(e.g.,Staphylococcus aureus)
Breast Tissue Infection

7. Collection of Pus with in Breast Tissue
Abscess Formation
Proliferation of Bacteria
Milk Stasis and Duct Occlusion

8. Symptoms:
 Localized Pain: Breast abscesses typically cause
localized pain, which may be severe and throbbing
in nature.
 Swelling and Redness: The affected area of the
breast may appear swollen, red, and warm to the
touch.
 Tenderness: The breast tissue surrounding the
abscess is often tender and sensitive to touch.
 Fever: Some individuals with breast abscesses may
develop a fever, along with flu-like symptoms such
as chills and fatigue.
 Pus Drainage: As the abscess matures, it may
develop a fluctuant mass containing pus, which can
sometimes be expressed through the nipple.

9. Diagnosis:
 Clinical Examination: A healthcare provider will perform
a physical examination of the breast to assess for signs of
inflammation, tenderness, and the presence of a palpable
mass.
 Imaging Studies: Imaging tests such as ultrasound or
mammography may be performed to confirm the diagnosis
and to evaluate the size and extent of the abscess.
 Aspiration: If the abscess is fluctuant, a needle aspiration
may be performed to drain the pus and relieve symptoms.
The aspirated fluid may be sent for laboratory analysis to
identify the causative bacteria.
 Biopsy: In some cases, a tissue biopsy may be performed to
rule out other causes of breast lumps, especially if the
diagnosis is uncertain or if there are concerns about
malignancy.

10. Treatment:
 Antibiotic Therapy:
 Antibiotics are usually prescribed to treat the bacterial
infection associated with the breast abscess.
 The choice of antibiotic depends on factors such as the
suspected causative organism and its sensitivity to
antibiotics.
 Commonly used antibiotics for treating breast abscesses
include dicloxacillin, cephalexin, clindamycin, or
amoxicillin-clavulanate.
 Antibiotics may be prescribed orally or intravenously,
depending on the severity of the infection and the
individual's overall health status.

11.  Abscess Drainage:
Drainage of the abscess is essential to relieve pain and
facilitate healing.
There are two main methods of abscess drainage:
 Needle Aspiration: A needle is inserted into the abscess
under local anesthesia, and the pus is withdrawn using a
syringe. This procedure is typically performed under
ultrasound guidance to ensure accurate placement of the
needle.
 Incision and Drainage (I&D): In cases where needle
aspiration is not feasible or effective, surgical incision and
drainage may be necessary. This procedure are performed
under local or general anesthesia and involves making an
incision in the skin overlying the abscess to allow drainage
of the pus.

12.  Pain Management:
 Pain relievers such as acetaminophen (Tylenol) or
ibuprofen (Advil, Motrin) may be recommended to
alleviate discomfort associated with the abscess.
 In some cases, prescription pain medications may be
necessary, especially following surgical drainage.
 Warm Compresses:
 Applying warm compresses to the affected breast can help
reduce pain and inflammation and promote drainage of the
abscess.
 Warm compresses can be applied for 15-20 minutes several
times a day.

13.  Breastfeeding (if applicable):
 If mastitis is the underlying cause of the abscess and the
individual is breastfeeding, continuing to breastfeed on the
affected breast can help clear the infection and promote
healing.
 Emptying the breast regularly through breastfeeding or
pumping can help prevent milk stasis and recurrence of the
abscess.
 Follow-up:
 Regular follow-up appointments with a healthcare provider
are important to monitor the progress of treatment and
ensure complete resolution of the abscess.
 Additional imaging studies or procedures may be
recommended to assess the extent of drainage and evaluate
for any complications.

14.  Lifestyle Modifications:
 Practicing good breast hygiene, such as washing the
breasts regularly and wearing a well-fitting bra, can help
prevent recurrence of breast abscesses.
 If nipple piercing was a contributing factor, avoiding
further trauma to the nipples and practicing proper hygiene
can help reduce the risk of recurrence.

15. Complications:
 Recurrent Infections: Without proper
treatment, breast abscesses can recur or lead to
chronic mastitis.
 Breast Tissue Damage: In severe cases,
untreated abscesses can cause damage to the
surrounding breast tissue, leading to scarring
or deformity.
 Systemic Infection: Rarely, untreated breast
abscesses can spread to the bloodstream,
causing a serious condition known as sepsis.

16. Prevention
 Proper Breastfeeding Techniques
 Ensure Proper Latch: Make sure your baby is
latching on correctly to avoid nipple trauma.
 Frequent Feeding: Feed your baby regularly to
prevent milk stasis, which can lead to mastitis and
abscess formation.
 Alternate Breasts: Ensure both breasts are emptied
regularly by alternating which breast you start
feeding on.

17.  Hygiene and Skin Care
 Nipple Care: Keep nipples clean and dry. Use breast
pads if necessary, and change them frequently to
avoid moisture buildup.
 Moisturize: Use nipple creams or lanolin to prevent
cracked nipples, which can be entry points for
bacteria.
 Avoid Tight Clothing: Wear properly fitting bras
that are not too tight to avoid constriction of milk
ducts.

18.  Prompt Treatment of Mastitis
 Recognize Symptoms Early: Be aware of the signs of
mastitis (pain, redness, warmth, fever) and seek medical
treatment promptly.
 Antibiotics: If prescribed antibiotics for mastitis, complete
the full course to ensure the infection is fully treated.
 Warm Compresses and Massage: Use warm compresses
and gentle breast massage to help relieve blocked ducts.
 Healthy Lifestyle
 Balanced Diet: Maintain a healthy diet to support your
immune system.
 Hydration: Drink plenty of fluids to stay hydrated,
especially if breastfeeding.
 Rest: Ensure you get adequate rest to help your body fight
infections.

19.  Monitoring and Self-Exams
 Regular Self-Exams: Perform regular breast self-exams to
detect any lumps or changes early.
 Medical Check-ups: Attend regular check-ups with your
healthcare provider, especially if you have a history of breast
infections or abscesses.
 Avoid Risk Factors
 Quit Smoking: Smoking can impair your immune system and
affect healing, increasing the risk of infections.
 Manage Chronic Conditions: Keep conditions like diabetes
under control, as they can affect your ability to fight infections.
 When to Seek Help
 Consult a Lactation Specialist: If you have persistent
breastfeeding issues, consult a lactation consultant.
 Medical Attention: Seek immediate medical attention if you
notice signs of an infection or abscess.