A breast abscess is a localised collection of pus in the breast tissue. It is usually caused by a bacterial infection. Breast infections, including mastitis and breast abscesses, are most often seen in women aged 15 to 45 years.
The signs and symptoms of breast abscesses are:
- a tender swelling or lump in an area of the breast;
- pain in the affected breast;
- redness, warmth, swelling, and tenderness in an area of the breast;
- muscles aches; and
- feeling generally unwell.
What causes breast abscesses?
Breast abscesses are usually caused by a bacterial infection, which often occurs when a woman is breast feeding.
Mastitis (inflammation of the breast) is a common problem associated with breast feeding. Symptoms of mastitis include:
- a tender, swollen breast;
- breast pain;
- red, warm skin overlying the breast (often in a wedge-shaped pattern);
- fever; and
- feeling generally unwell.
Bacteria can enter the breast through the nipple during breast-feeding, or through cracks in the nipple or areola (the darkened area around the nipple). Blocked milk ducts can also lead to mastitis. Mastitis can progress to a breast abscess if it is not treated promptly.
Breast abscesses can also develop in women who are not breast feeding. Risk factors can include:
- injury to the breast;
- cracked nipples;
- having diabetes or problems with your immune system;
- nipple piercing; and
- breast implant surgery.
It is rare for breast cancer to cause pain and inflammation. However, inflammatory breast cancer is a rare type of breast cancer that can cause symptoms similar to breast abscess symptoms.
Tests and diagnosis
Your doctor will ask about your symptoms and perform a physical examination.
If a breast abscess is suspected, your doctor may recommend having an ultrasound scan of your breast. Breast abscesses can often be drained with a needle at the time of the scan, and the drained fluid can be tested for bacterial infection or other problems.
Consult your doctor at the first sign of breast infection.
Treatment for breast abscesses includes antibiotics, surgical removal of pus and self-care measures.
Antibiotics are usually needed to treat the infection that caused the breast abscess. The most common type of bacteria causing breast abscesses is Staphylococcus aureus.
The pus in the breast abscess usually needs to be drained.
Most breast abscesses can be drained using a needle. Local anaesthetic is used to numb the skin before the needle is inserted. Drainage with a needle may be done with the help of an ultrasound scan, to locate the position of the abscess and guide the needle to the right area.
Large abscesses may need to be treated with a small surgical cut (incision) and drainage.
In addition to resting as much as possible and drinking plenty of fluids, there are several other self-care measures that can help.
Take simple painkillers such as paracetamol or a non-steroidal anti-inflammatory medicine (NSAID). If you are breast feeding, check with your doctor before taking any medicines.
Cold compresses can also be used to help reduce pain.
Can I still breast feed with an abscess or mastitis?
If you have mastitis, it is usually safe to continue to breast-feed your baby as normal from both breasts. Breast feeding will help to clear the milk ducts in the affected breast, relieve symptoms and help prevent a breast abscess.
Gentle breast massage and a warm compress can help milk flow if there is a blocked milk duct. When breast feeding, offer your baby the breast with the blocked duct first and let the baby feed until it is completely drained.
If you have a breast abscess breast feeding may be painful or difficult. Breast feeding can continue from the affected breast as long as any drainage procedure does not interfere with breastfeeding. It may be recommended that you express breast milk using a breast pump.
Your doctor or a breast feeding nurse (lactation consultant) will be able to advise you on the approach you should take. They can also offer general breast feeding advice to help prevent mastitis in the future.
Preventing mastitis and breast abscesses when breast feeding
- Make sure that your baby is latching on properly when breast feeding.
- Make sure that your bra and clothing is not too tight.
- Try to encourage your baby to empty your breasts of milk as much as possible when breast feeding. Alternate the breast you offer first to the baby at each feed, and allow the baby to feed until the first breast is completely drained.
- Keep your breasts clean by washing them daily with mild soap and water. Wipe off dried secretions and gently dry the breast thoroughly with a clean towel.
- After breast-feeding, wipe the nipples and areolae with sterilised cotton dipped in boiled, cooled water or some breast milk.
- At the end of a feed, allow your breasts to dry naturally in the air.
- Apply lanolin cream daily to the nipples and areolae to prevent them from cracking.