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
其他诊断因素
- nipple discharge
- nipple inversion/retraction
- lymphadenopathy
- extra-mammary skin lesions
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
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
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
治疗流程
lactational mastitis
nonlactational mastitis
breast abscess
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
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.

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
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