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Mastitis and breast abscess

Última revisión: 6 Feb 2026
Última actualización: 13 Jun 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • fever
  • decreased milk outflow
  • breast warmth
  • breast tenderness
  • breast firmness
  • breast swelling
  • breast erythema
  • flu-like symptoms, malaise, and myalgia
  • breast pain
  • breast mass
  • fistula
Todos los datos

Otros factores de diagnóstico

  • nipple discharge
  • nipple inversion/retraction
  • lymphadenopathy
  • extra-mammary skin lesions
Todos los datos

Factores de riesgo

  • female sex
  • poor breast-feeding technique
  • lactation
  • milk stasis
  • nipple injury
  • previous mastitis
  • prolonged mastitis (breast abscess)
  • women aged >30 years (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
  • immunosuppression
  • hospital admission
  • breast trauma
  • primiparity (breast abscess)
  • multiparity
  • overabundant milk supply
  • complications of delivery
  • maternal stress
  • tight clothing
  • antifungal nipple cream
  • fibrocystic breast disease
  • cigarette smoking
  • vaginal manipulation (breast abscess)
  • antiretroviral therapy
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • breast ultrasound
  • diagnostic needle aspiration drainage
  • cytology of nipple discharge or sample from fine-needle aspiration
  • milk, aspirate, discharge, or biopsy tissue for culture and sensitivity
Todos los datos

Pruebas diagnósticas que deben considerarse

  • pregnancy test
  • blood culture and sensitivity
  • histopathologic examination of biopsy tissue
  • mammogram
  • milk for leukocyte counts and bacteria quantification
  • CBC
Todos los datos

Algoritmo de tratamiento

Agudo

lactational mastitis

nonlactational mastitis

breast abscess

En curso

breast abscess post acute intervention

recurrence of mastitis and/or breast abscess

Colaboradores

Autores

Jesse Casaubon, DO, FSSO​, FACS

Breast Surgical Oncologist

Baystate Health

Springfield

MA

Divulgaciones

JC declares that he has no competing interests.

Agradecimientos

Dr Jesse Casaubon would like to gratefully acknowledge Dr Holly S. Mason, Dr Jose A. Martagon-Villamil, Dr Daniel Skiest, Dr Gina Berthold, and Dr Liron Pantanowitz, previous contributors to this topic.

Divulgaciones

HSM, JAMV, DS, and GB declare that they have no competing interests. LP is a co-author of references cited in this topic.

Revisores por pares

Edward Sauter, MD, PhD

Program Officer

National Institutes of Health

National Cancer Institute

Rockville

MD

Disclosures

ES declares that he has no competing interests.

Justin Stebbing, MA, MRCP, MRCPath, PhD

Consultant Medical Oncologist/Senior Lecturer

Department of Medical Oncology

Imperial College/Imperial Healthcare NHS Trust

Charing Cross Hospital

London

UK

Disclosures

JS declares that he has no competing interests.

William C. Dooley, MD

The G. Rainey Williams Professor of Surgical Oncology

University of Oklahoma

Oklahoma City

OK

Disclosures

WD declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

World Health Organization. Mastitis: causes and management. 2000 [internet publication].Full text

Wilson E, Woodd SL, Benova L. Incidence of and risk factors for lactational mastitis: a systematic review. J Hum Lact. 2020 Nov;36(4):673-86.Full text  Abstract

Trop I, Dugas A, David J, et al. Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics. 2011 Oct;31(6):1683-99.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Mastitis and breast abscess images
  • Differentials

    • Breast engorgement
    • Nipple sensitivity
    • Galactocele
    More Differentials
  • Guidelines

    • ABM clinical protocol #36: the mastitis spectrum​​
    • ABM clinical protocol #36: the mastitis spectrum
    More Guidelines
  • Patient information

    Mastitis in breastfeeding women

    Mastitis: breastfeeding advice

    More Patient information
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