A breast abscess is a localized aggregation of painful, pus-filled lesions in the breast parenchyma secondary to persistent bacterial infection in the breast tissue – referred to as mastitis.

A breast abscess is prevalent among women of childbearing age while mastitis is more commonly reported in the age group of 18 – 50 years.

Read on to find out more about mastitis and the ensuing complications including breast abscess to help identify when to see a Gynecologist in Lahore before it becomes troublesome for you.

THE ONSET: WHAT MAKES IT OCCUR?

Staphylococcus aureus, a gram-positive bacteria, is the most common infective agent attributable to causing breast tissue infection and inflammation. The abscess formation is preceded by a cascade of inflammatory reactions, enzymatic participation, toxin-mediated events, and neutrophilic infiltration that leads to necrosis.

It can stem from direct injury by an infant while feeding in lactating women or natural cracking in the non-lactating subset of women. The disruption in the continuity of breast skin permits the entry of bacteria into the parenchyma via the infant’s nose where S aureus is colonized. If the abscess is left untreated, it can lead to fibrosis, scarring, and nipple retraction.

RISK FACTORS

Women of childbearing age, especially the subset of lactating women, recent delivery, and menopause are most likely to develop mastitis and breast abscess formation. Women with diabetes, chronic diseases, AIDS, or compromised immunity tend to be more susceptible.

CLINICAL FEATURES

Its presentation is characterized by low milk production. Pain, erythema, and tenderness on the overlying skin of the affected tissue are a more pronounced set of symptoms. You might also see a nipple discharge that is suggestive of breast engorgement.

Some clinical features of breast abscess are non-specific such as nausea, vomiting, headache, flu-like symptoms, fatigue, and high-grade fever.

The lesion/mass tends to be painful and mobile upon palpation. The mass usually possesses irregular contours and retracts after breastfeeding. A draining abscess suggests a severe infection.

TREATMENT

Breast abscess can be cured with various therapeutic approaches; both conservative and surgical. In case of pain during breastfeeding, over-the-counter analgesics such as acetaminophen and ibuprofen can be taken. Alternatively, alternating between a hot or cold pack periodically can also relieve pain. An antibiotic course is necessary to resolve the infection. For chronic and recurrent infections, the dosage can be tailored according to the body’s requirements.

The doctors advise the patient to breastfeed from the unaffected side as the recurring emptying of the infected breast tissue can exacerbate mastitis. A breast pump can be used to relieve the pressure while it is highly recommended to avoid the notion of breastfeeding in the state of breast abscess.

Maintaining a healthy, balanced diet while keeping the hydration levels at their best contributes greatly to the general well-being of the patient.

An abscess is usually managed by mildly invasive techniques. A superficially located abscess can be drained by a standard incision and drainage procedure or a fine needle aspiration (FNA) technique. While a deep-set abscess has to be surgically operated, and then drained. However, the surgical method has been associated with cosmetic defects and lactational complications hence an ultrasound-guided needle aspiration or drainage using a catheter is being promoted with increasingly effective outcomes.

Learn to overcome the preventable risk factors or else, you must set up an appointment with a Gynecologist in Karachi for consultation if you find yourself relating to any of the symptoms above.