Breast infections (including infectious mastitis and breast abscess) more commonly affect women aged 15-45 years, especially those who are lactating. However, mastitis and breast abscess can occur at any age.
Staphylococcus aureus is the most frequent pathogen isolated.
Prompt and appropriate management of mastitis usually leads to a timely resolution and prevents complications, such as a breast abscess.
Treatment of infectious and non-infectious mastitis includes antibiotic therapy and effective milk removal if lactating.
Breast abscess requires both the removal of pus and antibiotic therapy. Interventions can include aspiration and incision and drainage procedures.
It is imperative to identify and treat any underlying co-existent causes of infection to facilitate resolution and prevent recurrence. It is also necessary to exclude breast carcinoma.
Mastitis is defined as inflammation of the breast with or without infection. Mastitis with infection may be lactational (puerperal) or non-lactational (e.g., duct ectasia). Non-infectious mastitis includes idiopathic granulomatous inflammation and other inflammatory conditions (e.g., foreign body reaction). A breast abscess is a localised area of infection with a walled-off collection of pus. It may or may not be associated with mastitis.
History and exam
- female sex
- women aged >30 years
- poor breastfeeding technique
- milk stasis
- nipple injury
- previous mastitis
- prolonged mastitis (breast abscess)
- prior breast abscess (breast abscess)
- shaving or plucking areola hair
- anatomical breast defect, mammoplasty, or scar
- other underlying breast condition
- nipple piercing
- foreign body
- skin infection
- Staphylococcus aureus carrier
- hospital admission
- breast trauma
- overabundant milk supply
- post-maturity (breast abscess)
- complications of delivery
- maternal fatigue
- tight clothing
- antifungal nipple cream
- fibrocystic breast disease
- cigarette smoking
- vaginal manipulation (breast abscess)
- poor nutrition
- antiretroviral therapy
Assistant Professor of Surgery
University of Massachusetts Medical School - Baystate
HSM is a board member of the American Society of Breast Surgeons Foundation.
Dr Holly S. Mason would like to gratefully acknowledge Dr Jose A. Martagon-Villamil, Dr Daniel Skiest, Dr Gina Berthold, and Dr Liron Pantanowitz, previous contributors to this topic.
National Institutes of Health
National Cancer Institute
ES declares that he has no competing interests.
Consultant Medical Oncologist/Senior Lecturer
Department of Medical Oncology
Imperial College/Imperial Healthcare NHS Trust
Charing Cross Hospital
JS declares that he has no competing interests.
The G. Rainey Williams Professor of Surgical Oncology
University of Oklahoma
WD declares that he has no competing interests.
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