Breast abscess

A breast abscess is a painful collection of pus that forms in the breast. Most abscesses develop just under the skin and are caused by a bacterial infection.

Key Information

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What should I do?

If you think you have this condition you should see a doctor within 48 hours.

How is it diagnosed?

Your doctor might suspect a breast abscess based on your symptoms and physical examination findings. An ultrasound scan is needed to confirm the diagnosis.

What is the treatment?

The breast abscess will need to be drained using a needle and syringe after applying some local anaesthetic to numb the skin. You might need to take a course of antibiotics after drainage.

Introduction

A breast abscess is a painful collection of pus that forms in the breast.

Most abscesses develop just under the skin and are caused by a bacterial infection.

Breast abscesses are painful, swollen lumps that may also:

  • be red
  • feel hot
  • cause the surrounding skin to swell
  • cause a high temperature (fever)

What causes a breast abscess?

Breast abscesses are often linked to mastitis, a condition that causes breast pain and inflammation, and usually affects women who are [breastfeeding].

During breastfeeding, infections can occur if bacteria enter your breast tissue, or if the milk ducts (tiny tubes that carry milk) become blocked. This can cause mastitis which, left untreated, can result in an abscess forming.

Sometimes, non-breastfeeding women can also develop mastitis if bacteria enter the milk ducts through a sore or cracked nipple, or a nipple piercing.

White blood cells are sent to attack the infection which causes tissue at the site of the infection to die. This creates a small, hollow area that fills with pus (an abscess).

Read more about what causes breast abscesses.

When to visit your doctor

See your doctor if your breast is red and sore. If you have mastitis, you may be prescribed antibiotics to treat the infection.

If your symptoms persist after taking antibiotics, your doctor may refer you for an ultrasound scan which will confirm whether you have a breast abscess. This type of scan uses high-frequency sound waves to create an image of the inside of your body.

Treating a breast abscess

If you have a breast abscess, it will need to be drained. Small breast abscesses can be drained using a needle and syringe. For larger abscesses, a small incision may be needed to drain the pus.

For both procedures, a local anaesthetic will usually be given to numb the skin around the abscess so you do not feel pain or discomfort.

Read more about how breast abscesses are treated.

Causes

Most breast abscesses occur as a complication of mastitis, a bacterial infection that causes the breast to become red and inflamed.

Mastitis usually affects breastfeeding women, but it can sometimes occur in women who are not breastfeeding.

Women who smoke cigarettes have an increased risk of developing non-breastfeeding mastitis. This condition is known as periductal mastitis.

Bacterial infection

Most abscesses are caused by a bacterial infection. The bacteria usually enter the breast through small cracks or breaks in the skin of the nipple, which can sometimes develop during breastfeeding.

Infections can also be caused by an overgrowth of bacteria that usually exist quite harmlessly within the milk ducts (the tiny tubes inside the breast that carry milk). An overgrowth of bacteria can occur if stagnant milk collects in a blocked milk duct.

When bacteria enter your body, your immune system (the body’s natural defence) tries to fight them off by sending white blood cells to the affected area. As the white blood cells attack the bacteria, some of the tissue at the site of the infection dies, creating a small, hollow pocket.

The pocket starts to fill with pus, forming an abscess. The pus contains a mixture of dead tissue, white blood cells and bacteria. As the infection progresses, the abscess may get bigger and more painful as more pus is produced.

Treatment

You should visit your doctor if your breast is red and painful.

A breast abscess is usually a complication of mastitis (inflammation of the breast).

If you have mastitis, you may be prescribed antibiotics to treat the infection. If your symptoms do not improve, you should return to your doctor.

If your breast is still hard, red and painful after taking antibiotics, your doctor may refer you to a specialist breast unit to confirm the diagnosis of a breast abscess.

A diagnosis will usually be confirmed using an ultrasound scan. This type of scan uses high-frequency sound waves to create an image of the inside of your body.

Draining breast abscesses

If a breast abscess is confirmed, it can usually be successfully treated by draining it.

Small abscesses can be drained using a needle and syringe. Ultrasound may be used to guide the needle into place.

For larger breast abscesses, a small incision can be made in the abscess so the pus can be drained.

During both procedures, a local anaesthetic may be used to numb the area of skin surrounding the infected breast tissue. General anaesthetic is not usually needed unless the abscess is particularly deep.

Diagnosing breast problems

Always visit your doctor if you notice any changes to your breasts, such as a breast lump or discharge (leaking fluid) from your nipples. In some cases, such symptoms could be a sign of breast cancer.

If you have a lump on your breast, you will be referred to a breast clinic for an assessment which may include an ultrasound scan and a mammogram (breast X-ray).

Common questions about breast abscess

Content produced by Your.MD

What does a breast abscess look like?

A breast abscess is a painful build-up of pus in the breast due to an infection. It often looks like a lump or swelling in your breast. Your breast may also be painful, red, and warm if you have an abscess.

What does a breast abscess feel like?

A breast abscess can feel painful, swollen and hot to the touch. You may also feel more than one lump.

Can a breast abscess go away on its own?

If you think you have a breast abscess, you should see a doctor. The pus in the abscess will need to be drained and the infection treated with antibiotics for the abscess to get better.

When would you need breast abscess surgery?

If your doctor confirms that you have a breast abscess, you will usually need a small procedure to drain the pus in it.

Small abscesses can be drained using a needle and syringe (sometimes with an ultrasound scan to guide the needle into place), while larger breast abscesses may need a small operation to cut open the skin and drain the pus. You may need a local anaesthetic to numb the area around the abscess before it is drained.

What is the recovery time for breast abscess surgery?

A drained breast abscess usually heals completely within a few days or weeks after surgery.

Can breastfeeding cause a breast abscess?

Breastfeeding itself may not directly cause a breast abscess. However, it can cause a breast infection (called mastitis) and this infection can lead to an abscess if it is not treated quickly.

Breastfeeding can lead to mastitis if milk builds up inside the breast and becomes infected by bacteria. Bacteria can enter the breast and cause infection via small cracks or sores in and around the nipple.

Can I breastfeed with a breast abscess?

Yes. If you have a breast abscess, one of the best things you can do is to carry on breastfeeding. Continuing to breast-feed can help to empty the affected breast and keep the milk flowing.

Breastfeeding from an infected breast is unlikely to harm your baby as the acid in your baby’s stomach will kill any bacteria that may be swallowed from your breast.

Feed from the affected breast first, usually for the next two or three feeds. This ensures it will empty well. You can also express milk from the affected side to make sure the breast is empty. Also, feed from the unaffected side to prevent a build-up of milk that could cause mastitis (breast inflammation) in that breast.

What antibiotics treat a breast abscess?

A breast abscess is usually treated with a small procedure to drain the pus. After drainage your doctor may prescribe antibiotics, such as dicloxacillin, cephalexin, trimethoprim-sulfamethoxazole and clindamycin.

The most effective length of antibiotic treatment for a breast abscess is currently unknown, but your doctor is likely to recommend 10 to 14 days of antibiotics after your abscess has been drained.

Can you treat a breast abscess at home?

If you suspect you have a breast abscess, you should contact a doctor immediately. The pus in the abscess will need to be drained for it to get better. You may also need antibiotic treatment.

Can a breast abscess cause cancer?

The cause of breast cancer is not fully understood. However, there are certain factors that are known to increase a person’s risk of developing breast cancer. At present, a breast abscess is not recognised as a cause of or risk factor for breast cancer.

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