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Breast Abscess

Overview
A breast abscess is a lump that forms in the breast due to congestion and pain. Most abscesses appear just below the skin layer.
Breast abscess is generally experienced by women aged 18 to 50 years, especially by mothers who are breastfeeding. Often breast abscesses can also appear as a complication of mastitis.
Nursing mothers who suffer from breast abscesses are advised to continue breastfeeding their babies. Your doctor may recommend using a breast milk pump to remove milk from the breast affected by breast abscess.

Symptoms
The characteristics of a lump in the case of a breast abscess can be identified by its regular edge pattern and has a smooth texture, and feels solid like a cyst. In addition to pain, the symptoms that also accompany breast abscess are:
  • High fever.
  • Redness
  • The body feels unwell.
  • The lump feels hot.
  • The skin around the abscess also swells.
Cause
Usually breast abscesses will be associated with mastitis, which is an inflammation of the breast that is commonly found in nursing mothers. Mastitis can cause the breast to swell and feel pain. The bacteria that can usually cause mastitis are Staphylococcus aureus, which enters the breast through small cuts or gaps in the nipple. Infection can then occur when bacteria multiply uncontrollably.
The immune system will send white blood cells to infected parts of the body to attack bacteria. This white blood cell attack also results in the body's tissues that are infected with the bacteria dying, resulting in a small hollow bag. Pus that appears is a mixture of dead body tissue, white blood cells, and bacteria. If the infection continues, then the abscess lump can get bigger and more painful.
There are two types of breast abscesses, namely:
  • Breastfeeding abscess (lactation). Formed on the edge of the breast, usually at the top.
  • Non-breastfeeding (non-lactating) abscess. Usually it will appear around the areola (the dark part around the nipple) or the lower part of the breast.
Some factors that can increase a woman's risk of developing a breast abscess are smoking, having had mastitis, having diabetes, being infected with the HIV virus, doing nipple piercing, or undergoing treatment that suppresses the immune system.

Diagnosis
To diagnose a patient suspected of having a breast abscess, the first step that most doctors do is do a physical examination of the lump. If the results of the physical examination still cannot confirm the diagnosis, then an ultrasound examination can be done.

Ultrasound is an examination using high frequency sound waves. From the results of an ultrasound examination, it can be ascertained whether the lump examined is a breast abscess or not, and also obtained information about the number of pus bags in the lump. In addition to ultrasound, doctors can also check mammography, which is X-ray photos of the breast. But this examination is not too comfortable and causes pain, especially if the breast is in an abscess state.

Treatment
Most cases of breast abscess are triggered by mastitis, which is inflammation of the breast. To treat mastitis, most doctors will prescribe antibiotics.
If the inflammation has become an abscess, in addition to treatment with antibiotics, pus fluid will also be released by injecting a needle into a lump guided by an ultrasound, or by making an incision to remove pus from the abscess (incision and drainage).



• Scholefield, J. H., J. L. Duncan, and K. Rogers. “Review of a hospital experience of breast abscesses.” British • Journal of Surgery 74.6 (1987): 469-470. Breast Abscess: A Brief Communication • The Royal Women's Hospital (2012), Mastitis and Breast Abscess • Toomey, A & Bhimji, S S. NCBI (2018). Abscess, Breast. • NHS Choices UK (2017). Health A-Z. Breast Abscess. • Miller, A C. Medscape (2018). Breast Abscesses and Masses. • Boakes, et al. (2018). Breast Infection: A Review of Diagnosis and Management Practices. European Journal of Breast Health, 14(3), pp. 136-143. • Fahrni, et al. (2012). Breast Abscesses: Diagnosis, Treatment and Outcome. Breast Care, 7(1), pp. 32-38. • ABA (2016). Breas Abscess. • My Health Alberta (2017). Patient Care Handouts. Breast Abscess: Care Instruction.
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