Abscesses have the shape of a smaller or bigger lump or mass, which may be palpated by the patient themselves or the physician; however, in the majority of the cases this is rendered impossible due to the inflammation. The typical manifestations of mastitis include swelling and redness of breast skin, elevated breast temperature and a painful sensation described by the patient. As any other inflammation, mastitis may be accompanied by fever and nausea, with the patient reporting the exudation of pus from an obvious mass or the nipple.
Mastitis and subsequent breast abscesses cause a clinically evident breast inflammation, which can be diagnosed based solely on clinical manifestations. Any patients with a medical history of breast infection, and swollen, red breasts are candidates for mastitis.
Cultures of breast milk, if a patient lactates, or of the pus produced from the abscess may be required in order to detect the specific pathogen responsible for the condition and arrange the proper antibiotic scheme.
If the diagnosis of a breast abscess cannot be substantiated with clinical observations, ultrasonography can be applied to differentiate between a abscess and a potential tumor. Women who are under antimicrobial treatment for a breast abscess and show no signs of symptom relief despite the medications and women who do not breastfeed should also undergo investigation for the existence of a potential tumor.
Ultrasonography is a useful tool to distinguish an abscess from a malignant formation and also aids the physician in the follow-up stage, allowing for the accurate evaluation of response to therapeutic regimes. Findings that ascertain the existence of an abscess include a hypoechoic collection encased in an echogenic border, lack of vascularization and acoustic enhancement.
Mammography can also be used to eliminate the potential existence of a carcinoma, but is not often performed, as the findings, such as a non-symmetric distortion or density, are not pathognomonic. A mammography is more often carried out in women who have passed the age of thirty, who present with non-bacterial mastitis or remain unresponsive to treatment for long periods of time. Even though the mass cannot be diagnosed accurately via mammography, the latter is the optimal tool for detecting other anomalies consistent with breast cancer, such as calcifications. A biopsy specimen can then be retrieved to confirm.
The key point in order to prevent the development of an abscess is to successfully treat the initial mastitis. In this way, the inflammation will be reversed at an early stage and the complication of an abscess will be avoided. Otherwise healthy women are treated with oral antibiotics for 7-10 days. Should the woman be lactating, a physician will prescribe antibiotics that do not cause any additional harm to the infant.
If an abscess has already built up, it is surgically drained by needle with the aid of local anesthesia. Ultrasonographic guidance may be required to prevent damage to nearby healthy tissue. Larger abscesses may need the skin to be incised first, in order for the pus to be drained. While all surgical drainage processes are performed with local anesthesia, general anesthesia may be mandatory if the abscess has reached a considerable depth within the tissue.
Breast abscesses form due to mastitis. This term is used to comprehensively describe the inflammation of the breast, regardless of its cause. More specifically, mastitis may be a result of bacterial infection, but may also be caused by non-bacterial causes.
The most typical bacterium leading to an abscess-accompanied mastitis is S. aureus, which is one of the pathogens found amongst the skin's natural flora. Almost all staphylococci isolated from abscesses are methicillin-resistant . The second most common pathogen responsible for a mastitis case is coagulase-negative staphylococcus, followed by a plethora of other aerobes, such as Streptococcus, Enterobacteriae, Escherichia coli etc.
Anaerobic bacteria may also be the culprits behind the infection. Lactobacillus, Clostridium, Veillonella, Bacteroides and other pathogens  are responsible for causing a mastitis; it is believed that people with smoking habits tend to be more frequently infected by anaerobes, rather than aerobes, when compared to non-smokers . It has also been estimated that a considerable number of abscesses are formed due to an infection with a combination of different pathogens, both anaerobes and aerobes.
Rarely, mastitis may be a result of microorganisms including fungi, parasites, Bartonella henselae or Brucella, which many times may trigger suspicion of an underlying immunodeficiency and the existence of an HIV infection must be investigated .
Lastly, as far as non-bacterial mastitis is concerned, it can occur as a result of foreign material in breast tissue, such as breast implants or piercing, or due to duct ectasia . Idiopathic causes are also possible, as in the case of lobular mastitis .
At a rate of 3-11%, breast abscesses form in patients with underlying mastitis and more specifically, only in a 0.1-3% of lactating women . As for lobular mastitis, whose causes are still unknown, its prevalence is insignificant, as it is an extremely uncommon disorder .
Women who lactate develop bacterial mastitis due to two reasons : excessive production of milk which does not flow when the baby is not feeding and a higher risk of cracks and injuries of the nipples, which constitute a breach of the breast skin barrier, allowing for the entrance of skin bacteria. Bacteria can originate from the patient's own skin flora, or from the infant's oral cavity, which harbors a plethora of potential pathogens.
Abscesses that occur due to the process of lactation are usually located distally, as the nipples and the adjacent skin are the points of bacterial entrance. In non-lactating women, abscesses are usually observed in the region beneath the nipple's areola. Generally, irrespective of their causes, abscesses that rupture may lead to the formation of a draining canal and subsequently to a fistula, that is expected to drain pus to the skin region unless treated.
The condition known as duct ectasia involves the dilation of the milk ducts, which is accompanied by a clinically evident inflammation. It is typically linked to squamous metaplasia of the milk ducts, which leads to the obstruction of the ducts themselves and potential rupture. The inflammation causes the ducts to be more susceptible to bacterial pathogens, which complicate the condition by causing an infection . Damaged tissue and annihilated pathogens lead to the formation of pus, which build up to form a breast abscess.
One of the crucial factors that should be addressed upon the diagnosis of mastitis is the importance of milk flow. Milk that remains in the breast in a static condition is susceptible to inflammation. Therefore, mothers are advised to breastfeed even if they notice symptoms of inflammation, since it will rid the breast of the contaminated milk and they baby will remain healthy, as the bacteria will be eradicated by the stomach's gastric acid.
Should breastfeeding cause excessive pain, a breast pump can be used to extract the infected milk. A warm compress placed over the inflamed breast fro a quarter of an hour prior to breastfeeding can also enhance the milk's flow and help avoid the formation of an abscess.
Breast abscesses are collections of pus that have built up beneath breast skin. They are caused by a bacterial infection; activated white blood cells target the pathogen, which is exterminated alongside dead body tissue and pus is produced.
Abscesses are associated with clinically evident inflammation and are by definition painful. Staphylococcus aureus, commonly found in the skin, is the microorganism usually responsible for such an inflammation. It can bypass the skin barrier through any breach of continuity (wounds, cracks etc.) and cause inflammation of the underlying fat and milk ducts, which is defined as mastitis. The annihilation process carried out by components of the immune system destroys S. aureus and the damaged milk ducts and pus is formed, which concentrates in a cavity, thus forming an abscess.
A breast abscess is the collection of pus in a cavity of breast tissue, which develops as a result of infection with various bacteria. A breast abscess will produce symptoms that are essentially easy to recognize by any individual: the infected breast is painful or tender, swollen and red. The patient may also have a fever.
An abscess is a result of infection. A person's skin is naturally endowed with various bacteria (flora), which cause no harm as long as they remain on the outer surface of the skin. If someone sustains a cut, abrasion or crack, these bacteria can bypass the skin and enter tissues, which are not protected against them. This results to inflammation, which, if not treated early, leads to the formation of pus. Pus consists of exterminated bacteria and dead body tissue. Women who breastfeed run a high risk of developing a breast infection, since breastfeeding causes more cracks and injuries to the breast's skin than usual.
If you start feeling symptoms that resemble an inflammation of the breasts, whether you lactate or not, consult your doctor. They are responsible for diagnosing an abscess and can illustrate the therapy plan. You may need oral antibiotics and the abscess may be drained with a needle under local anesthesia.
If you are breastfeeding, in order to prevent an abscess from forming, make sure that you wash the breasts daily and remove remaining secretions. Use sterilized cotton or compresses sprayed with boiled water to clean the breasts after feeding your baby and allow them to dry in the air. Apply moisturizing solutions and creams to the breasts to avoid being injured during this period.