Mastitis and breast abscess

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.

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 purulence. It may or may not be associated with mastitis.

This topic covers mastitis in adults. Neonates and infants with suspected mastitis should be referred to a paediatric consultant for evaluation and management.