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Mastitis and breast abscess

最后审阅: 17 Oct 2025
最后更新: 13 Jun 2024

小结

定义

病史和体格检查

关键诊断因素

  • 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
完整详情

其他诊断因素

  • nipple discharge
  • nipple inversion/retraction
  • lymphadenopathy
  • extra-mammary skin lesions
完整详情

危险因素

  • 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
完整详情

诊断性检查

首要检查

  • 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
完整详情

需考虑的检查

  • pregnancy test
  • blood culture and sensitivity
  • histopathologic examination of biopsy tissue
  • mammogram
  • milk for leukocyte counts and bacteria quantification
  • CBC
完整详情

治疗流程

急症处理

lactational mastitis

nonlactational mastitis

breast abscess

持续性治疗

breast abscess post acute intervention

recurrence of mastitis and/or breast abscess

撰稿人

作者

Jesse Casaubon, DO, FSSO​, FACS

Breast Surgical Oncologist

Baystate Health

Springfield

MA

Раскрытие информации

JC declares that he has no competing interests.

Выражение благодарностей

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.

Раскрытие информации

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

Рецензенты

Edward Sauter, MD, PhD

Program Officer

National Institutes of Health

National Cancer Institute

Rockville

MD

Раскрытие информации

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

Раскрытие информации

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

Раскрытие информации

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.

Список литературы

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.

Основные статьи

World Health Organization. Mastitis: causes and management. 2000 [internet publication].Полный текст

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.Полный текст  Аннотация

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.Полный текст  Аннотация

Статьи, указанные как источники

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
  • 鉴别诊断

    • Breast engorgement
    • Nipple sensitivity
    • Galactocele
    更多 鉴别诊断
  • 指南

    • ABM clinical protocol #36: the mastitis spectrum​​
    • ABM clinical protocol #36: the mastitis spectrum
    更多 指南
  • 患者教育信息

    Mastitis in breastfeeding women

    Mastitis: breastfeeding advice

    更多 患者教育信息
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