(B)- Breast Abscess

Question 1

What is a breast abscess?

Answer 1

Collection of pus caused by bacterial infection

Question 2

What are the types of breast abscess?

Answer 2

Lactational and non-lactational abscesses

Question 3

What is pus caused by?

Answer 3

Produced by inflammation, contains dead WBCs and waste from infection

Question 4

How does an abscess form?

Answer 4

Pus gets trapped in specific area and cannot drain

Question 5

What happens in lactational mastitis?

Answer 5

Bacteria enter nipple and back-track to ducts from baby’s mouth causing infection

Can lead to development of an abscess

Question 6

What is a key risk factor for breast abscess development?

Answer 6

• Smoking
• Nipple damage (e.g. piercings, eczema)
• Underlying breast disease

Question 7

What are the most common causative bacteria for breast abscesses?

Answer 7

Staphylococcus aureus
Streptococcal species
Enterococcal species
Anaerobic bacteria

Question 8

How do breast abscesses present?

Answer 8

• Acutely
• Nipple change
• Purulent nipple discharge
• Pain and tenderness
• Warmth and erythema
• Hardening
• Swelling
• May have generalised infection symptoms

Question 9

How is lactational and non-lactational mastitis managed?

Answer 9

Lactational mastitis

• Conservatively with continued breastfeeding, expressing milk and breast massage
• Flucloxacillin
• Erythromycin if penicillin allergy

Non-lactational mastitis

• Analgesia
• Antibiotics
• Treat underlying cause (e.g. eczema or candida infection)

Question 10

What antibiotics are used in non-lactational mastitis?

Answer 10

Must be broad-spectrum

Co-amoxiclav

or

Erythromycin + Metronidazole (for anaerobes)

Question 11

How are breast abscesses managed?

Answer 11

• Referral to on-call surgical team
• Antibiotics
• USS
• Drainage
• Microscopy, culture and sensitives

Question 12

How are breast abscesses managed in breastfeeding women?

Answer 12

Continue breastfeeding

Regularly express milk if feeding is too painful, resume feeding when possible

Not harmful to baby