Materiały źródłowe

• #1 Mastitis and breast abscesses – Health New Zealand | Te Whatu Ora

  https://www.tewhatuora.govt.nz/for-health-professionals/clinical-guidance/specific-life-stage-health-information/maternal-health/breastfeeding/breastfeeding-problems/mastitis-and-breast-abscesses

  Approximately 3 to 11% of cases of acute mastitis develop into a breast abscess (Mitchell et al., 2022). […] If all the appropriate treatment for mastitis has been given and an area of the breastfeeding person’s breast remains hard, reddened and painful an abscess may have formed or be forming. […] A breast ultrasound may identify the abscess area. […] Appropriate initial treatment is likely to be needle aspiration with fluid culture which may require repeating. […] If there are multiple abscesses or if the abscess is large or unresponsive to repeated aspiration treatments, surgical drainage is necessary.

• #2 Lactation breast abscess treated with Gualou Xiaoyong decoction and painless lactation manipulation: A case report and review of literature

  https://www.wjgnet.com/2307-8960/full/v11/i8/1847.htm

  Breast abscess during lactation is a severe complication of acute mastitis, which can lead to discomfort, high fever, breast fistula, sepsis, septic shock, breast damage, disease persistence and frequent hospitalization. […] The predominant pathogenic bacteria are Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus. […] The incidence of breastfeeding abscesses in breastfeeding women ranges between 4.0% and 11.0%. […] In cases of breast abscess, the rate of cessation of lactation is 41.0%. […] Furthermore, 50.0% of women with breast abscesses must be hospitalized and treated with intravenous antibiotics. […] Treatment includes antibiotics, abscess puncture and surgical incision and drainage. […] Consequently, it is crucial to discover an adequate cure. […] In treating breast abscesses during breastfeeding, the combination of Gualou Xiaoyong decoction and painless lactation provides a positive therapeutic impact.

• #3 Lactation breast abscess treated with Gualou Xiaoyong decoction and painless lactation manipulation: A case report and review of literature

  https://www.wjgnet.com/2307-8960/full/v11/i8/1847.htm

  Breast abscess during lactation is a severe complication of acute mastitis, which can lead to discomfort, high fever, breast fistula, sepsis, septic shock, breast damage, disease persistence and frequent hospitalization. […] The predominant pathogenic bacteria are Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus. […] The incidence of breastfeeding abscesses in breastfeeding women ranges between 4.0% and 11.0%. […] In cases of breast abscess, the rate of cessation of lactation is 41.0%. […] Furthermore, 50.0% of women with breast abscesses must be hospitalized and treated with intravenous antibiotics. […] Treatment includes antibiotics, abscess puncture and surgical incision and drainage. […] Consequently, it is crucial to discover an adequate cure. […] In treating breast abscesses during breastfeeding, the combination of Gualou Xiaoyong decoction and painless lactation provides a positive therapeutic impact.

• #4 Breast Abscess – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459122/

  Breast abscesses are a common problem, especially in lactating women. […] However, when a non-lactating patient presents with a breast abscess, a more nefarious etiology such as an inflammatory carcinoma should be considered. […] It is important to rule out more serious pathology like breast cancer when a non-lactational patient presents with signs and symptoms of breast abscess. […] The cornerstone of diagnosis of a breast abscess is the physical exam. […] If there is any frank drainage, cultures can be obtained to help guide antibiotic treatment. […] A breast ultrasound may be obtained if there is a question of cellulitis versus abscess, to evaluate for a drainable fluid collection. […] In some cases, to confirm the presence of a breast abscess, needle aspiration is done and the fluid analyzed.

• #5 How To Spot a Breast Abscess

  https://health.clevelandclinic.org/breastfeeding-that-hot-hard-painful-lump-in-your-breast-might-be-an-abscess

  A breast abscess feels like a hot, hard and painful lump seek support from a healthcare provider at first signs of an infection. […] A breast abscess is a walled-off collection of pus thats extremely painful, Dr. Brant explains. Fortunately, its treatable. […] If you have a breast abscess, youll likely be able to feel it with your hand. It will feel like a hard, red, fluid-filled mass on your breast that is very painful. It may also be warm (even hot) to the touch. […] Remember that breast abscesses start as mastitis. So, before you can feel the abscess, youll probably have symptoms of mastitis, like redness and tenderness in your breast. […] Breast infections are easiest to treat when caught early. So, seek treatment quickly for signs of mastitis. […] At the first sign of mastitis, contact a healthcare professional to let them know whats going on, Dr. Brant advises. Depending on how severe your symptoms are, your doctor may want you to start on antibiotics.

• #6 What is Breast Abscess and is it Serious? – Dr Jesse Hu

  https://drjessehu.com.sg/what-is-breast-abscess-and-is-it-serious/

  Patients with breast abscess usually present with pain, swelling and redness in the breast. Sometimes, this is accompanied by fever, chills and a general feeling of being unwell. […] After a thorough history and examination, an ultrasound is required to confirm the presence of an abscess. The beast abscess usually appear as ill-defined masses with central hypoechoic areas and may display internal septations, debris, posterior enhancement, eccentrically thickened walls, and increased Doppler flow in the walls and surrounding tissue with lack of internal colour Doppler flow. […] After confirming the diagnosis of a breast abscess, treatment in the form of antibiotics is required. Some of the smaller breast abscesses can resolve with antibiotics alone and do not need further treatment. However, most breast abscess will require some form of drainage procedure to remove the pus. This can be either by ultrasound guided needle aspiration or surgical drainage whereby a cut is made on the skin of the breast to allow the pus to be drained. The cut is not stitched up to allow continual drainage of the pus. Hence, for cosmetic purposes, most breast abscesses are treated with needle aspiration. However, some patients require repeated aspirations and some with very thick pus are not amenable to needle aspirations and will require surgery.

• #7 How To Spot a Breast Abscess

  https://health.clevelandclinic.org/breastfeeding-that-hot-hard-painful-lump-in-your-breast-might-be-an-abscess

  A breast abscess feels like a hot, hard and painful lump seek support from a healthcare provider at first signs of an infection. […] A breast abscess is a walled-off collection of pus thats extremely painful, Dr. Brant explains. Fortunately, its treatable. […] If you have a breast abscess, youll likely be able to feel it with your hand. It will feel like a hard, red, fluid-filled mass on your breast that is very painful. It may also be warm (even hot) to the touch. […] Remember that breast abscesses start as mastitis. So, before you can feel the abscess, youll probably have symptoms of mastitis, like redness and tenderness in your breast. […] Breast infections are easiest to treat when caught early. So, seek treatment quickly for signs of mastitis. […] At the first sign of mastitis, contact a healthcare professional to let them know whats going on, Dr. Brant advises. Depending on how severe your symptoms are, your doctor may want you to start on antibiotics.

• #8 Abscess/infections/periareolar mastitis – Pesce – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6764/html

  Breast infections can be considered lactational or nonlactational, and the guiding principle in treating breast infection is to give antibiotics as early as possible to stop abscess formation. […] A breast abscess develops as a complication of mastitis in 5-11% of cases. An abscess presents as a fluctuant mass with overlying skin erythema, and patients can have fever, tachycardia, and leukocytosis. Differentiating between mastitis and abscess can be challenging, and therefore when there is suspicion for abscess, ultrasound should be performed. […] The diagnosis of abscess requires identification of a hypoechoic collection, often with a thick echogenic periphery. […] A combination of repeated aspiration and oral antibiotics is usually effective at resolving local abscess formation and is the current treatment of choice for most breast abscesses.

• #9 What is Breast Abscess and is it Serious? – Dr Jesse Hu

  https://drjessehu.com.sg/what-is-breast-abscess-and-is-it-serious/

  Patients with breast abscess usually present with pain, swelling and redness in the breast. Sometimes, this is accompanied by fever, chills and a general feeling of being unwell. […] After a thorough history and examination, an ultrasound is required to confirm the presence of an abscess. The beast abscess usually appear as ill-defined masses with central hypoechoic areas and may display internal septations, debris, posterior enhancement, eccentrically thickened walls, and increased Doppler flow in the walls and surrounding tissue with lack of internal colour Doppler flow. […] After confirming the diagnosis of a breast abscess, treatment in the form of antibiotics is required. Some of the smaller breast abscesses can resolve with antibiotics alone and do not need further treatment. However, most breast abscess will require some form of drainage procedure to remove the pus. This can be either by ultrasound guided needle aspiration or surgical drainage whereby a cut is made on the skin of the breast to allow the pus to be drained. The cut is not stitched up to allow continual drainage of the pus. Hence, for cosmetic purposes, most breast abscesses are treated with needle aspiration. However, some patients require repeated aspirations and some with very thick pus are not amenable to needle aspirations and will require surgery.

• #10 Breast Abscess – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459122/

  Breast abscesses are a common problem, especially in lactating women. […] However, when a non-lactating patient presents with a breast abscess, a more nefarious etiology such as an inflammatory carcinoma should be considered. […] It is important to rule out more serious pathology like breast cancer when a non-lactational patient presents with signs and symptoms of breast abscess. […] The cornerstone of diagnosis of a breast abscess is the physical exam. […] If there is any frank drainage, cultures can be obtained to help guide antibiotic treatment. […] A breast ultrasound may be obtained if there is a question of cellulitis versus abscess, to evaluate for a drainable fluid collection. […] In some cases, to confirm the presence of a breast abscess, needle aspiration is done and the fluid analyzed.

• #11 Breast Infection (Mastitis): Symptoms, Causes, Treatments

  https://www.webmd.com/women/breast-infection

  Mastitis Diagnosis […] The diagnosis of mastitis and a breast abscess can usually be made based on a physical exam. […] If it’s unclear whether a mass is due to a fluid-filled abscess or to a solid mass such as a tumor, you may get a test such as an ultrasound. An ultrasound may also tell whether you have simple mastitis, or an abscess deep in the breast. This noninvasive test allows your doctor to see the abscess by placing an ultrasound probe over your breast to get an image. If an abscess is confirmed, aspiration or surgical drainage, and IV antibiotics, are often required. […] A nurse or lab tech may take a sample (culture) either of breast milk or of material from an abscess through a syringe, to find out the type of organism causing the infection. This information can help your doctor decide what kind of antibiotic to use. […] Non-breastfeeding women with mastitis, or those who do not respond to treatment, may have a mammogram or breast biopsy. This is a precaution because a rare type of breast cancer can produce symptoms of mastitis.

• #12 Breast Abscess – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459122/

  Incision and drainage are the standard of care for breast abscesses. […] If there is a recurrence of an abscess after needle aspiration, incision and drainage should be performed. […] A course of antibiotics may be given before or following drainage of breast abscesses. […] Patients with large breast abscesses or signs of sepsis should be considered for admission to the hospital. […] The majority of isolated cases of breast abscess have good outcomes, but it can lead to pain, scarring, and a poor quality of life in women with recurrent infections. […] Any patient that continues to have features of mastitis after 5 weeks should be evaluated for malignancy or infection. […] The majority of breast abscess tend to occur in the postpartum period, and if it is seen in a nonlactating female, the onus is on the clinician to rule out inflammatory breast cancer, new-onset diabetes, or infection with mycobacterium.

• #13 Breast abscess | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/breast-abscess?lang=us

  A breast abscess is a relatively rare but significant complication of mastitis that may occur during breastfeeding, particularly in primiparous women. The clinical context is a key to diagnosis as imaging appearances (particularly ultrasound) can mimic many other entities such as breast carcinoma. […] Ultrasound is considered the most useful initial imaging modality when a breast abscess is suspected. It is also the imaging method of choice to monitor progress, response to therapy and to ensure resolution. For the purpose of follow up the three dimensional measurement of the abscess and the volume of the contents should be given. […] On ultrasound a breast abscess can easily mimic other entities such as a breast malignancy or a breast hematoma on imaging grounds alone. In practice, the most difficult differentiation is from a galactocele.

• #14 Breast Abscesses and Masses Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/781116-workup

  In patients suspected of having a breast abscess, a CBC count with differential may be helpful. Send an aerobic and anaerobic culture during surgical drainage. […] Ultrasonography is used to distinguish solid from cystic structures and to direct needle aspiration for abscess drainage. […] The addition of elastography and color Doppler ultrasonography to B-mode ultrasonography has been reported to increase the positive predictive value (PPV) of screening ultrasonography in women with dense breasts while reducing the number of false-positive findings without missing cancers. […] It should be noted that although bedside ultrasound performed in the emergency department (ED) by trained emergency medicine providers may effectively identify an abscess, patient selection is important. […] Schedule an outpatient mammography to further characterize the suspected breast mass.

• #15 Understanding Breast Abscess: Symptoms, Causes & Treatment | Medanta

  https://www.medanta.org/patient-education-blog/battling-breast-abscess-understanding-treatment-and-recovery

  A breast abscess can usually be diagnosed based on a physical exam and a review of your medical history and symptoms. […] If a breast abscess is suspected, the healthcare provider may order additional tests to confirm the diagnosis and assess the extent of the infection. These tests may include a breast ultrasound or a breast MRI, which can help identify the location and size of the abscess as well as any underlying cysts or masses. […] A breast abscess can sometimes be mistaken for other conditions that affect the breast tissue, such as mastitis or a cyst. […] To help distinguish a breast abscess from other conditions, the healthcare provider may order additional tests, such as an ultrasound or MRI, to identify the location and extent of the infection. […] The treatment for a breast abscess typically involves draining the abscess to remove the pus and relieve pressure on the breast tissue. […] If you suspect that you have a breast abscess, it’s important to see a healthcare provider for an evaluation and treatment. With prompt and appropriate treatment, most cases of breast abscesses can be successfully treated, and the patient can recover fully with minimal complications.

• #16 Breast abscess | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/breast-abscess?lang=us

  A breast abscess is a relatively rare but significant complication of mastitis that may occur during breastfeeding, particularly in primiparous women. The clinical context is a key to diagnosis as imaging appearances (particularly ultrasound) can mimic many other entities such as breast carcinoma. […] Ultrasound is considered the most useful initial imaging modality when a breast abscess is suspected. It is also the imaging method of choice to monitor progress, response to therapy and to ensure resolution. For the purpose of follow up the three dimensional measurement of the abscess and the volume of the contents should be given. […] On ultrasound a breast abscess can easily mimic other entities such as a breast malignancy or a breast hematoma on imaging grounds alone. In practice, the most difficult differentiation is from a galactocele.

• #17 Breast Abscesses: Diagnosis, Treatment and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3335354/

  The aim of our study was to analyze diagnostic results, different treatment modalities, and the outcome of patients with breast abscesses treated at our institution in a multi-modality breast team, to determine whether minimally invasive treatments are successful. […] Abscesses were diagnosed using ultrasonography (US), and the material obtained using US-guided fine needle aspiration (FNA) was further examined. […] US-guided FNA as a minimally invasive therapy in combination with antibiotics was found to successfully treat most breast abscesses and, in cases where a larger volume of pus was involved, the placement of an additional drainage catheter was effective. […] Breast abscesses are more frequently observed in non-puerperal mastitis than in puerperal mastitis, and can be a particularly difficult condition due to the intense discomfort and tendency for recurrence. When an abscess is small and located deep within the breast, it can be clinically difficult to detect and differentiate from mastitis; therefore, ultrasonography (US) is the method of choice for diagnosis.

• #18 Management of Breast Abscess during Breastfeeding

  https://www.mdpi.com/1660-4601/19/9/5762

  (1) Background: Breast abscess (BA) is a condition leading in the majority of cases to breastfeeding interruption. […] The diagnosis of breast abscess is clinical and is confirmed by ultrasound. […] Ultrasonography is the baseline radiologic technique to diagnose a BA, which results in a hypoechoic or anechoic mass surrounded by a hyperechoic area due to edema. […] The clinical picture was associated with an ultrasound finding of a localised area of infection with a walled-off collection of pus. […] A timely diagnosis and adequate treatment are essential, as mastitis and abscess represent one of the main reasons that lead to early weaning, with the loss of the benefits that derive from this practice for mother and child. […] In our experience, treatment with needle aspiration is a cost-effective method. Unlike drainage, it is an outpatient procedure, easily repeatable, with no cosmetic damage. […] Following our results, regardless of size and clinical features of BA, we suggest a conservative and multidisciplinary approach with antibiotic therapy based on the MRSA prevalence and needle aspiration, if necessary.

• #19 What is Breast Abscess and is it Serious? – Dr Jesse Hu

  https://drjessehu.com.sg/what-is-breast-abscess-and-is-it-serious/

  Patients with breast abscess usually present with pain, swelling and redness in the breast. Sometimes, this is accompanied by fever, chills and a general feeling of being unwell. […] After a thorough history and examination, an ultrasound is required to confirm the presence of an abscess. The beast abscess usually appear as ill-defined masses with central hypoechoic areas and may display internal septations, debris, posterior enhancement, eccentrically thickened walls, and increased Doppler flow in the walls and surrounding tissue with lack of internal colour Doppler flow. […] After confirming the diagnosis of a breast abscess, treatment in the form of antibiotics is required. Some of the smaller breast abscesses can resolve with antibiotics alone and do not need further treatment. However, most breast abscess will require some form of drainage procedure to remove the pus. This can be either by ultrasound guided needle aspiration or surgical drainage whereby a cut is made on the skin of the breast to allow the pus to be drained. The cut is not stitched up to allow continual drainage of the pus. Hence, for cosmetic purposes, most breast abscesses are treated with needle aspiration. However, some patients require repeated aspirations and some with very thick pus are not amenable to needle aspirations and will require surgery.

• #20 Breast Abscesses and Masses Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/781116-workup

  In patients suspected of having a breast abscess, a CBC count with differential may be helpful. Send an aerobic and anaerobic culture during surgical drainage. […] Ultrasonography is used to distinguish solid from cystic structures and to direct needle aspiration for abscess drainage. […] The addition of elastography and color Doppler ultrasonography to B-mode ultrasonography has been reported to increase the positive predictive value (PPV) of screening ultrasonography in women with dense breasts while reducing the number of false-positive findings without missing cancers. […] It should be noted that although bedside ultrasound performed in the emergency department (ED) by trained emergency medicine providers may effectively identify an abscess, patient selection is important. […] Schedule an outpatient mammography to further characterize the suspected breast mass.

• #21 Breast Infection (Mastitis): Symptoms, Causes, Treatments

  https://www.webmd.com/women/breast-infection

  Mastitis Diagnosis […] The diagnosis of mastitis and a breast abscess can usually be made based on a physical exam. […] If it’s unclear whether a mass is due to a fluid-filled abscess or to a solid mass such as a tumor, you may get a test such as an ultrasound. An ultrasound may also tell whether you have simple mastitis, or an abscess deep in the breast. This noninvasive test allows your doctor to see the abscess by placing an ultrasound probe over your breast to get an image. If an abscess is confirmed, aspiration or surgical drainage, and IV antibiotics, are often required. […] A nurse or lab tech may take a sample (culture) either of breast milk or of material from an abscess through a syringe, to find out the type of organism causing the infection. This information can help your doctor decide what kind of antibiotic to use. […] Non-breastfeeding women with mastitis, or those who do not respond to treatment, may have a mammogram or breast biopsy. This is a precaution because a rare type of breast cancer can produce symptoms of mastitis.

• #22 Breast Abscesses and Masses Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/781116-workup

  In patients suspected of having a breast abscess, a CBC count with differential may be helpful. Send an aerobic and anaerobic culture during surgical drainage. […] Ultrasonography is used to distinguish solid from cystic structures and to direct needle aspiration for abscess drainage. […] The addition of elastography and color Doppler ultrasonography to B-mode ultrasonography has been reported to increase the positive predictive value (PPV) of screening ultrasonography in women with dense breasts while reducing the number of false-positive findings without missing cancers. […] It should be noted that although bedside ultrasound performed in the emergency department (ED) by trained emergency medicine providers may effectively identify an abscess, patient selection is important. […] Schedule an outpatient mammography to further characterize the suspected breast mass.

• #23 Mastitis and breast abscess – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/1084

  Breast abscess requires both the removal of pus and antibiotic therapy. Interventions can include aspiration and incision and drainage procedures. […] It is imperative to identify and treat any underlying co-existent causes of infection to facilitate resolution and prevent recurrence. It is also necessary to exclude breast carcinoma. […] 1st investigations to order include breast ultrasound, diagnostic needle aspiration drainage, cytology of nipple discharge or sample from fine-needle aspiration, and milk, aspirate, discharge, or biopsy tissue for culture and sensitivity. […] Investigations to consider include pregnancy test, blood culture and sensitivity, histopathological examination of biopsy tissue, mammogram, milk for leukocyte counts and bacteria quantification, and FBC.

• #24 Breast Abscesses and Masses Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/781116-workup

  In patients suspected of having a breast abscess, a CBC count with differential may be helpful. Send an aerobic and anaerobic culture during surgical drainage. […] Ultrasonography is used to distinguish solid from cystic structures and to direct needle aspiration for abscess drainage. […] The addition of elastography and color Doppler ultrasonography to B-mode ultrasonography has been reported to increase the positive predictive value (PPV) of screening ultrasonography in women with dense breasts while reducing the number of false-positive findings without missing cancers. […] It should be noted that although bedside ultrasound performed in the emergency department (ED) by trained emergency medicine providers may effectively identify an abscess, patient selection is important. […] Schedule an outpatient mammography to further characterize the suspected breast mass.

• #25 Managing a Breast Abscess – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/breast-abscess

  Breast abscesses are diagnosed by means of a physical examination. […] The health care provider may in some cases consult a general surgeon to cut, drain, and perform a biopsy of the area. […] In a biopsy, a small piece of breast tissue is taken for study under the microscope. […] Pus can be studied to identify the bacteria, which helps the health care provider select the right antibiotic for treatment.

• #26 Mastitis and breast abscess – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/1084

  Breast abscess requires both the removal of pus and antibiotic therapy. Interventions can include aspiration and incision and drainage procedures. […] It is imperative to identify and treat any underlying co-existent causes of infection to facilitate resolution and prevent recurrence. It is also necessary to exclude breast carcinoma. […] 1st investigations to order include breast ultrasound, diagnostic needle aspiration drainage, cytology of nipple discharge or sample from fine-needle aspiration, and milk, aspirate, discharge, or biopsy tissue for culture and sensitivity. […] Investigations to consider include pregnancy test, blood culture and sensitivity, histopathological examination of biopsy tissue, mammogram, milk for leukocyte counts and bacteria quantification, and FBC.

• #27 Lactation breast abscess treated with Gualou Xiaoyong decoction and painless lactation manipulation: A case report and review of literature

  https://www.wjgnet.com/2307-8960/full/v11/i8/1847.htm

  It is usually caused by Staphylococcus infection caused by pathogenic bacteria such as Streptococcus and/or Corynebacterium. […] Breastfeeding discontinuation (41.0%), breast fistula (11.1%) and readmission (50.0%) are prevalent among patients with the disease. […] Breast abscess during lactation is often treated with antibiotics administered orally or intravenously, percutaneous aspiration and surgical incision and drainage. […] However, these procedures have limitations. […] Therefore, the development of traditional Chinese medicine and traditional Chinese medicine therapy is recommended. […] In this instance, the combination of Gualou Xiaoyong decoction and painless breast opening manipulation resulted in favorable clinical outcomes for the treatment of breast abscess in lactation.

• #28

  https://www.ijsurgery.com/index.php/isj/article/view/1538

  Breast abscess develops as a complication of lactational mastitis. […] The aim of the study was to analyse the microbial flora in the lactational and non-lactational breast abscess in the ED and to elucidate the susceptibility of flora to different antibiotics. […] This is a retrospective cohort study of breast abscess patients registered in the ED over two years. […] The culture was grown in 92% of the patient pus specimens. Staphylococcus aureus (83%) was common organisms cultured in lactational breast abscess. Mixed Flora including Staphylococcus aureus and Group B Streptococci were grown in non-lactational breast abscess. […] Appropriate antibiotic choices are of immense importance in the management of breast abscess. Mixed flora is common in non – lactational breast abscess when compared with a lactational breast abscess. Staphylococcus Aureus is the most common isolate in both groups.

• #29 Breast Abscesses: Diagnosis, Treatment and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3335354/

  The aim of our study was to analyze diagnostic results, different treatment modalities, and the outcome of patients with breast abscesses treated at our institution in a multi-modality breast team, to determine whether minimally invasive treatments are successful. […] Abscesses were diagnosed using ultrasonography (US), and the material obtained using US-guided fine needle aspiration (FNA) was further examined. […] US-guided FNA as a minimally invasive therapy in combination with antibiotics was found to successfully treat most breast abscesses and, in cases where a larger volume of pus was involved, the placement of an additional drainage catheter was effective. […] Breast abscesses are more frequently observed in non-puerperal mastitis than in puerperal mastitis, and can be a particularly difficult condition due to the intense discomfort and tendency for recurrence. When an abscess is small and located deep within the breast, it can be clinically difficult to detect and differentiate from mastitis; therefore, ultrasonography (US) is the method of choice for diagnosis.

• #30 Breast abscess – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/breast-abscess/

  A breast abscess is an encapsulated accumulation of pus within the breast tissue that most commonly results from puerperal mastitis. […] The diagnosis is primarily clinical, but imaging and aspiration are often required for confirmation and to guide management. […] Although abscess is often diagnosed clinically, imaging and aspiration are used to confirm the diagnosis and guide management. […] Fine needle aspiration can be diagnostic and therapeutic. Aspirate should be sent for cultures.

• #31 Breast Infection (Mastitis): Symptoms, Causes, Treatments

  https://www.webmd.com/women/breast-infection

  Mastitis Diagnosis […] The diagnosis of mastitis and a breast abscess can usually be made based on a physical exam. […] If it’s unclear whether a mass is due to a fluid-filled abscess or to a solid mass such as a tumor, you may get a test such as an ultrasound. An ultrasound may also tell whether you have simple mastitis, or an abscess deep in the breast. This noninvasive test allows your doctor to see the abscess by placing an ultrasound probe over your breast to get an image. If an abscess is confirmed, aspiration or surgical drainage, and IV antibiotics, are often required. […] A nurse or lab tech may take a sample (culture) either of breast milk or of material from an abscess through a syringe, to find out the type of organism causing the infection. This information can help your doctor decide what kind of antibiotic to use. […] Non-breastfeeding women with mastitis, or those who do not respond to treatment, may have a mammogram or breast biopsy. This is a precaution because a rare type of breast cancer can produce symptoms of mastitis.

• #32 Breast abscess in lactating women resolved with ultrasound-based detection, treatment | AuntMinnie

  https://www.auntminnie.com/resources/conference/rsna/article/15564077/breast-abscess-in-lactating-women-resolved-with-ultrasound-based-detection-treatment

  Swedish researchers report positive results using ultrasound for the diagnosis and treatment of breast abscesses in lactating women. […] „If ultrasound showed evidence of an abscess, diagnosis was confirmed by needle puncture and the abscess was treated by ultrasound-guided drainage,” he added. […] „The lesion was punctured not only to confirm the diagnosis, but to obtain material for culture and to determine puss viscosity. Once needle puncture confirmed the diagnosis, ultrasound-guided drainage was performed in one of two ways determined by size.” […] „After generous local anesthetic, a pigtail catheter, 6-8 French, was placed using the Trocar technique. Catheter size was based on puss viscosity.” […] „Ultrasound detection and ultrasound-guided treatment is now standard protocol at Danderyds Hospital, Ulitzsch wrote in an e-mail to AuntMinnie.com.” […] „No surgical incision or surgical operation in puerperal abscesses has been performed for at least 5 years,” he wrote. […] „The main costs beside salary is the price of the catheter (about $80-$90 U.S.),” he wrote.

• #33 Breast Abscess – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459122/

  Breast abscesses are a common problem, especially in lactating women. […] However, when a non-lactating patient presents with a breast abscess, a more nefarious etiology such as an inflammatory carcinoma should be considered. […] It is important to rule out more serious pathology like breast cancer when a non-lactational patient presents with signs and symptoms of breast abscess. […] The cornerstone of diagnosis of a breast abscess is the physical exam. […] If there is any frank drainage, cultures can be obtained to help guide antibiotic treatment. […] A breast ultrasound may be obtained if there is a question of cellulitis versus abscess, to evaluate for a drainable fluid collection. […] In some cases, to confirm the presence of a breast abscess, needle aspiration is done and the fluid analyzed.

• #34 Breast Abscesses: Diagnosis, Treatment and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3335354/

  However, this treatment strategy can interfere with lactation and potentially yields poor cosmetic results. More recently, the use of US-guided needle aspiration, or drainage with a catheter, has been shown to successfully treat breast abscesses. […] The following data were analyzed: (1) patient clinical history, including risk factors and diagnostic clarifications (i.e. radiological imaging, microbiology and cytopathology assay data); (2) types of therapy administered (conservative, minimally invasive, and primary surgery); (3) treatment outcome. […] Minimally invasive treatment of breast abscesses was performed using US-guided fine needle aspiration (FNA), or by US-guided percutaneous drainage placement. […] For US-guided FNA, superficial disinfection and local anesthesia were administered before a 20-gauge needle, or a 22-gauge needle with a mandrin, was used to aspirate the center of the abscess.

• #35 Breast abscess differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Breast_abscess_differential_diagnosis

  Breast abscess should be differentiated from other diseases that cause swelling in the breast skin. […] Breast abscess must also be differentiated from the following conditions: […] Breast abscess: evidence based management recommendations. […] Breast abscess is a complication of lactational mastitis in 14% of cases. […] Breast abscess resolves after drainage/antibiotic therapy. […] Ultrasound shows fluid collection in breast abscess.

• #36 Breast Infection (Mastitis): Symptoms, Causes, Treatments

  https://www.webmd.com/women/breast-infection

  Mastitis Diagnosis […] The diagnosis of mastitis and a breast abscess can usually be made based on a physical exam. […] If it’s unclear whether a mass is due to a fluid-filled abscess or to a solid mass such as a tumor, you may get a test such as an ultrasound. An ultrasound may also tell whether you have simple mastitis, or an abscess deep in the breast. This noninvasive test allows your doctor to see the abscess by placing an ultrasound probe over your breast to get an image. If an abscess is confirmed, aspiration or surgical drainage, and IV antibiotics, are often required. […] A nurse or lab tech may take a sample (culture) either of breast milk or of material from an abscess through a syringe, to find out the type of organism causing the infection. This information can help your doctor decide what kind of antibiotic to use. […] Non-breastfeeding women with mastitis, or those who do not respond to treatment, may have a mammogram or breast biopsy. This is a precaution because a rare type of breast cancer can produce symptoms of mastitis.

• #37 Breast Abscesses: Diagnosis, Treatment and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3335354/

  The aim of our study was to analyze diagnostic results, different treatment modalities, and the outcome of patients with breast abscesses treated at our institution in a multi-modality breast team, to determine whether minimally invasive treatments are successful. […] Abscesses were diagnosed using ultrasonography (US), and the material obtained using US-guided fine needle aspiration (FNA) was further examined. […] US-guided FNA as a minimally invasive therapy in combination with antibiotics was found to successfully treat most breast abscesses and, in cases where a larger volume of pus was involved, the placement of an additional drainage catheter was effective. […] Breast abscesses are more frequently observed in non-puerperal mastitis than in puerperal mastitis, and can be a particularly difficult condition due to the intense discomfort and tendency for recurrence. When an abscess is small and located deep within the breast, it can be clinically difficult to detect and differentiate from mastitis; therefore, ultrasonography (US) is the method of choice for diagnosis.

• #38 Abscess/infections/periareolar mastitis – Pesce – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6764/html

  Breast infections can be considered lactational or nonlactational, and the guiding principle in treating breast infection is to give antibiotics as early as possible to stop abscess formation. […] A breast abscess develops as a complication of mastitis in 5-11% of cases. An abscess presents as a fluctuant mass with overlying skin erythema, and patients can have fever, tachycardia, and leukocytosis. Differentiating between mastitis and abscess can be challenging, and therefore when there is suspicion for abscess, ultrasound should be performed. […] The diagnosis of abscess requires identification of a hypoechoic collection, often with a thick echogenic periphery. […] A combination of repeated aspiration and oral antibiotics is usually effective at resolving local abscess formation and is the current treatment of choice for most breast abscesses.

• #39 Breast Abscess – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459122/

  Incision and drainage are the standard of care for breast abscesses. […] If there is a recurrence of an abscess after needle aspiration, incision and drainage should be performed. […] A course of antibiotics may be given before or following drainage of breast abscesses. […] Patients with large breast abscesses or signs of sepsis should be considered for admission to the hospital. […] The majority of isolated cases of breast abscess have good outcomes, but it can lead to pain, scarring, and a poor quality of life in women with recurrent infections. […] Any patient that continues to have features of mastitis after 5 weeks should be evaluated for malignancy or infection. […] The majority of breast abscess tend to occur in the postpartum period, and if it is seen in a nonlactating female, the onus is on the clinician to rule out inflammatory breast cancer, new-onset diabetes, or infection with mycobacterium.

• #40 Breast Infection (Mastitis): Symptoms, Causes, Treatments

  https://www.webmd.com/women/breast-infection

  Mastitis Diagnosis […] The diagnosis of mastitis and a breast abscess can usually be made based on a physical exam. […] If it’s unclear whether a mass is due to a fluid-filled abscess or to a solid mass such as a tumor, you may get a test such as an ultrasound. An ultrasound may also tell whether you have simple mastitis, or an abscess deep in the breast. This noninvasive test allows your doctor to see the abscess by placing an ultrasound probe over your breast to get an image. If an abscess is confirmed, aspiration or surgical drainage, and IV antibiotics, are often required. […] A nurse or lab tech may take a sample (culture) either of breast milk or of material from an abscess through a syringe, to find out the type of organism causing the infection. This information can help your doctor decide what kind of antibiotic to use. […] Non-breastfeeding women with mastitis, or those who do not respond to treatment, may have a mammogram or breast biopsy. This is a precaution because a rare type of breast cancer can produce symptoms of mastitis.

• #41 Breast abscess | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/breast-abscess?lang=us

  A breast abscess is a relatively rare but significant complication of mastitis that may occur during breastfeeding, particularly in primiparous women. The clinical context is a key to diagnosis as imaging appearances (particularly ultrasound) can mimic many other entities such as breast carcinoma. […] Ultrasound is considered the most useful initial imaging modality when a breast abscess is suspected. It is also the imaging method of choice to monitor progress, response to therapy and to ensure resolution. For the purpose of follow up the three dimensional measurement of the abscess and the volume of the contents should be given. […] On ultrasound a breast abscess can easily mimic other entities such as a breast malignancy or a breast hematoma on imaging grounds alone. In practice, the most difficult differentiation is from a galactocele.

• #42 Breast abscess | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/breast-abscess?lang=us

  A breast abscess is a relatively rare but significant complication of mastitis that may occur during breastfeeding, particularly in primiparous women. The clinical context is a key to diagnosis as imaging appearances (particularly ultrasound) can mimic many other entities such as breast carcinoma. […] Ultrasound is considered the most useful initial imaging modality when a breast abscess is suspected. It is also the imaging method of choice to monitor progress, response to therapy and to ensure resolution. For the purpose of follow up the three dimensional measurement of the abscess and the volume of the contents should be given. […] On ultrasound a breast abscess can easily mimic other entities such as a breast malignancy or a breast hematoma on imaging grounds alone. In practice, the most difficult differentiation is from a galactocele.

• #43 Breast abscess | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/breast-abscess?lang=us

  A breast abscess is a relatively rare but significant complication of mastitis that may occur during breastfeeding, particularly in primiparous women. The clinical context is a key to diagnosis as imaging appearances (particularly ultrasound) can mimic many other entities such as breast carcinoma. […] Ultrasound is considered the most useful initial imaging modality when a breast abscess is suspected. It is also the imaging method of choice to monitor progress, response to therapy and to ensure resolution. For the purpose of follow up the three dimensional measurement of the abscess and the volume of the contents should be given. […] On ultrasound a breast abscess can easily mimic other entities such as a breast malignancy or a breast hematoma on imaging grounds alone. In practice, the most difficult differentiation is from a galactocele.

• #44 Breast abscess differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Breast_abscess_differential_diagnosis

  Breast abscess should be differentiated from other diseases that cause swelling in the breast skin. […] Breast abscess must also be differentiated from the following conditions: […] Breast abscess: evidence based management recommendations. […] Breast abscess is a complication of lactational mastitis in 14% of cases. […] Breast abscess resolves after drainage/antibiotic therapy. […] Ultrasound shows fluid collection in breast abscess.

• #45 Ambiguity in Diagnosis of Extra-Pulmonary Breast Tuberculosis as Breast Abscess/Duct Ectasia

  https://clinmedjournals.org/articles/ijpcr/international-journal-of-pathology-and-clinical-research-ijpcr-4-073.php?jid=ijpcr

  Tubercular mastitis is a great masquerader and is an extremely rare entity as extra-pulmonary tuberculosis even in endemic countries like India and incidence accounts for 4% of breast lesions. […] FNAC diagnosis of tubercular mastitis is a useful tool for the proper management and treatment of patient thus avoiding unnecessary surgery. […] The aim of this case is to highlight the importance of FNAC as the first investigation of choice in diagnosing breast tuberculosis, especially in older female presenting with retraction of the nipple and also saving the patient from other invasive diagnostic procedures. […] Diagnosis is ideally by demonstration of AFB in the breast tissue by ZN stain or culture. […] In cytology, the presence of granulomatous inflammation with caseation necrosis and the demonstration of the acid-fast bacilli by ZN staining is suggestive of tubercular mastitis. However, the confirmation has to be done if only granulomatous inflammation is reported in cytology. Identifying acid-fast bacilli is particularly difficult in tubercular mastitis due to the low bacilli load in such tissues. […] Tuberculous mastitis is uncommon even in countries where tuberculosis is highly endemic. It can mimic breast abscess or cancers clinically so FNAC acts as a first-line screening modality may lead to proper diagnosis and treatment of the patient.

• #46 Breast Abscess – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459122/

  Incision and drainage are the standard of care for breast abscesses. […] If there is a recurrence of an abscess after needle aspiration, incision and drainage should be performed. […] A course of antibiotics may be given before or following drainage of breast abscesses. […] Patients with large breast abscesses or signs of sepsis should be considered for admission to the hospital. […] The majority of isolated cases of breast abscess have good outcomes, but it can lead to pain, scarring, and a poor quality of life in women with recurrent infections. […] Any patient that continues to have features of mastitis after 5 weeks should be evaluated for malignancy or infection. […] The majority of breast abscess tend to occur in the postpartum period, and if it is seen in a nonlactating female, the onus is on the clinician to rule out inflammatory breast cancer, new-onset diabetes, or infection with mycobacterium.

• #47 Breast Abscess – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459122/

  Incision and drainage are the standard of care for breast abscesses. […] If there is a recurrence of an abscess after needle aspiration, incision and drainage should be performed. […] A course of antibiotics may be given before or following drainage of breast abscesses. […] Patients with large breast abscesses or signs of sepsis should be considered for admission to the hospital. […] The majority of isolated cases of breast abscess have good outcomes, but it can lead to pain, scarring, and a poor quality of life in women with recurrent infections. […] Any patient that continues to have features of mastitis after 5 weeks should be evaluated for malignancy or infection. […] The majority of breast abscess tend to occur in the postpartum period, and if it is seen in a nonlactating female, the onus is on the clinician to rule out inflammatory breast cancer, new-onset diabetes, or infection with mycobacterium.

• #48 Primary breast abscess – UpToDate

  https://www.uptodate.com/contents/primary-breast-abscess

  Primary breast abscesses develop as a complication of mastitis. […] A review of over 1300 patients with mastitis and breast abscesses showed 42 percent had lactational abscesses, and 47 percent had periductal (nonlactating) abscesses. […] The incidence of breast abscesses ranges from 0.4 to 11 percent of lactating parents. […] Risk factors for development of breast abscess as a complication of lactational mastitis include maternal age >30 years, first pregnancy, gestational age ≥41 weeks, and tobacco use. […] In a retrospective study of 68 patients all with breast abscess, smoking was a significant risk factor for the development of an abscess. […] The majority of patients who developed recurrent abscesses were smokers. […] Smoking was the only factor significantly associated with abscess recurrence.

• #49 Abscess/infections/periareolar mastitis – Pesce – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6764/html

  If the overlying skin is thinned and pus is visible then after application of the local anesthetic a small incision is made and the pus is drained. […] Women should be encouraged to continue breastfeeding in order to promote drainage of the breast and prevent ductal engorgement. […] The underlying cause of recurrent infections is obstructed lactiferous ducts by keratin plugs, and therefore a subareolar abscess will continue to recur unless these ducts are excised. […] The only effective long-term treatment for these women is removal of all the affected ducts by total duct excision. […] Treatment requires aspiration of the abscess, sending fluid to microbiology for aerobic and anaerobic culture, and tailoring antimicrobial therapy based on culture and susceptibility results. […] For women older than 35 years old and/or at risk for breast cancer, management of breast infections should not forgo recommended screening, and patients require appropriate breast imaging to evaluate for abnormalities after resolution of their abscess.

• #50 Ambiguity in Diagnosis of Extra-Pulmonary Breast Tuberculosis as Breast Abscess/Duct Ectasia

  https://clinmedjournals.org/articles/ijpcr/international-journal-of-pathology-and-clinical-research-ijpcr-4-073.php?jid=ijpcr

  Tubercular mastitis is a great masquerader and is an extremely rare entity as extra-pulmonary tuberculosis even in endemic countries like India and incidence accounts for 4% of breast lesions. […] FNAC diagnosis of tubercular mastitis is a useful tool for the proper management and treatment of patient thus avoiding unnecessary surgery. […] The aim of this case is to highlight the importance of FNAC as the first investigation of choice in diagnosing breast tuberculosis, especially in older female presenting with retraction of the nipple and also saving the patient from other invasive diagnostic procedures. […] Diagnosis is ideally by demonstration of AFB in the breast tissue by ZN stain or culture. […] In cytology, the presence of granulomatous inflammation with caseation necrosis and the demonstration of the acid-fast bacilli by ZN staining is suggestive of tubercular mastitis. However, the confirmation has to be done if only granulomatous inflammation is reported in cytology. Identifying acid-fast bacilli is particularly difficult in tubercular mastitis due to the low bacilli load in such tissues. […] Tuberculous mastitis is uncommon even in countries where tuberculosis is highly endemic. It can mimic breast abscess or cancers clinically so FNAC acts as a first-line screening modality may lead to proper diagnosis and treatment of the patient.

• #51 Breast Abscess – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459122/

  Breast abscesses are a common problem, especially in lactating women. […] However, when a non-lactating patient presents with a breast abscess, a more nefarious etiology such as an inflammatory carcinoma should be considered. […] It is important to rule out more serious pathology like breast cancer when a non-lactational patient presents with signs and symptoms of breast abscess. […] The cornerstone of diagnosis of a breast abscess is the physical exam. […] If there is any frank drainage, cultures can be obtained to help guide antibiotic treatment. […] A breast ultrasound may be obtained if there is a question of cellulitis versus abscess, to evaluate for a drainable fluid collection. […] In some cases, to confirm the presence of a breast abscess, needle aspiration is done and the fluid analyzed.

• #52 Breast abscess | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/breast-abscess?lang=us

  A breast abscess is a relatively rare but significant complication of mastitis that may occur during breastfeeding, particularly in primiparous women. The clinical context is a key to diagnosis as imaging appearances (particularly ultrasound) can mimic many other entities such as breast carcinoma. […] Ultrasound is considered the most useful initial imaging modality when a breast abscess is suspected. It is also the imaging method of choice to monitor progress, response to therapy and to ensure resolution. For the purpose of follow up the three dimensional measurement of the abscess and the volume of the contents should be given. […] On ultrasound a breast abscess can easily mimic other entities such as a breast malignancy or a breast hematoma on imaging grounds alone. In practice, the most difficult differentiation is from a galactocele.

• #53 Breast Abscesses: Diagnosis, Treatment and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3335354/

  The aim of our study was to analyze diagnostic results, different treatment modalities, and the outcome of patients with breast abscesses treated at our institution in a multi-modality breast team, to determine whether minimally invasive treatments are successful. […] Abscesses were diagnosed using ultrasonography (US), and the material obtained using US-guided fine needle aspiration (FNA) was further examined. […] US-guided FNA as a minimally invasive therapy in combination with antibiotics was found to successfully treat most breast abscesses and, in cases where a larger volume of pus was involved, the placement of an additional drainage catheter was effective. […] Breast abscesses are more frequently observed in non-puerperal mastitis than in puerperal mastitis, and can be a particularly difficult condition due to the intense discomfort and tendency for recurrence. When an abscess is small and located deep within the breast, it can be clinically difficult to detect and differentiate from mastitis; therefore, ultrasonography (US) is the method of choice for diagnosis.

• #54 Mastitis and breast abscess – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/1084

  Breast abscess requires both the removal of pus and antibiotic therapy. Interventions can include aspiration and incision and drainage procedures. […] It is imperative to identify and treat any underlying co-existent causes of infection to facilitate resolution and prevent recurrence. It is also necessary to exclude breast carcinoma. […] 1st investigations to order include breast ultrasound, diagnostic needle aspiration drainage, cytology of nipple discharge or sample from fine-needle aspiration, and milk, aspirate, discharge, or biopsy tissue for culture and sensitivity. […] Investigations to consider include pregnancy test, blood culture and sensitivity, histopathological examination of biopsy tissue, mammogram, milk for leukocyte counts and bacteria quantification, and FBC.

• #55 Abscess/infections/periareolar mastitis – Pesce – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6764/html

  If the overlying skin is thinned and pus is visible then after application of the local anesthetic a small incision is made and the pus is drained. […] Women should be encouraged to continue breastfeeding in order to promote drainage of the breast and prevent ductal engorgement. […] The underlying cause of recurrent infections is obstructed lactiferous ducts by keratin plugs, and therefore a subareolar abscess will continue to recur unless these ducts are excised. […] The only effective long-term treatment for these women is removal of all the affected ducts by total duct excision. […] Treatment requires aspiration of the abscess, sending fluid to microbiology for aerobic and anaerobic culture, and tailoring antimicrobial therapy based on culture and susceptibility results. […] For women older than 35 years old and/or at risk for breast cancer, management of breast infections should not forgo recommended screening, and patients require appropriate breast imaging to evaluate for abnormalities after resolution of their abscess.

• #56 What is Breast Abscess and is it Serious? – Dr Jesse Hu

  https://drjessehu.com.sg/what-is-breast-abscess-and-is-it-serious/

  Patients with breast abscess usually present with pain, swelling and redness in the breast. Sometimes, this is accompanied by fever, chills and a general feeling of being unwell. […] After a thorough history and examination, an ultrasound is required to confirm the presence of an abscess. The beast abscess usually appear as ill-defined masses with central hypoechoic areas and may display internal septations, debris, posterior enhancement, eccentrically thickened walls, and increased Doppler flow in the walls and surrounding tissue with lack of internal colour Doppler flow. […] After confirming the diagnosis of a breast abscess, treatment in the form of antibiotics is required. Some of the smaller breast abscesses can resolve with antibiotics alone and do not need further treatment. However, most breast abscess will require some form of drainage procedure to remove the pus. This can be either by ultrasound guided needle aspiration or surgical drainage whereby a cut is made on the skin of the breast to allow the pus to be drained. The cut is not stitched up to allow continual drainage of the pus. Hence, for cosmetic purposes, most breast abscesses are treated with needle aspiration. However, some patients require repeated aspirations and some with very thick pus are not amenable to needle aspirations and will require surgery.

• #57 Abscess/infections/periareolar mastitis – Pesce – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6764/html

  If the overlying skin is thinned and pus is visible then after application of the local anesthetic a small incision is made and the pus is drained. […] Women should be encouraged to continue breastfeeding in order to promote drainage of the breast and prevent ductal engorgement. […] The underlying cause of recurrent infections is obstructed lactiferous ducts by keratin plugs, and therefore a subareolar abscess will continue to recur unless these ducts are excised. […] The only effective long-term treatment for these women is removal of all the affected ducts by total duct excision. […] Treatment requires aspiration of the abscess, sending fluid to microbiology for aerobic and anaerobic culture, and tailoring antimicrobial therapy based on culture and susceptibility results. […] For women older than 35 years old and/or at risk for breast cancer, management of breast infections should not forgo recommended screening, and patients require appropriate breast imaging to evaluate for abnormalities after resolution of their abscess.

• #58 Breast Abscesses: Diagnosis, Treatment and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3335354/

  The aim of our study was to analyze diagnostic results, different treatment modalities, and the outcome of patients with breast abscesses treated at our institution in a multi-modality breast team, to determine whether minimally invasive treatments are successful. […] Abscesses were diagnosed using ultrasonography (US), and the material obtained using US-guided fine needle aspiration (FNA) was further examined. […] US-guided FNA as a minimally invasive therapy in combination with antibiotics was found to successfully treat most breast abscesses and, in cases where a larger volume of pus was involved, the placement of an additional drainage catheter was effective. […] Breast abscesses are more frequently observed in non-puerperal mastitis than in puerperal mastitis, and can be a particularly difficult condition due to the intense discomfort and tendency for recurrence. When an abscess is small and located deep within the breast, it can be clinically difficult to detect and differentiate from mastitis; therefore, ultrasonography (US) is the method of choice for diagnosis.

• #59 Management of Breast Abscess during Breastfeeding

  https://www.mdpi.com/1660-4601/19/9/5762

  (1) Background: Breast abscess (BA) is a condition leading in the majority of cases to breastfeeding interruption. […] The diagnosis of breast abscess is clinical and is confirmed by ultrasound. […] Ultrasonography is the baseline radiologic technique to diagnose a BA, which results in a hypoechoic or anechoic mass surrounded by a hyperechoic area due to edema. […] The clinical picture was associated with an ultrasound finding of a localised area of infection with a walled-off collection of pus. […] A timely diagnosis and adequate treatment are essential, as mastitis and abscess represent one of the main reasons that lead to early weaning, with the loss of the benefits that derive from this practice for mother and child. […] In our experience, treatment with needle aspiration is a cost-effective method. Unlike drainage, it is an outpatient procedure, easily repeatable, with no cosmetic damage. […] Following our results, regardless of size and clinical features of BA, we suggest a conservative and multidisciplinary approach with antibiotic therapy based on the MRSA prevalence and needle aspiration, if necessary.

• #60 Breast Infection (Mastitis): Symptoms, Causes, Treatments

  https://www.webmd.com/women/breast-infection

  Mastitis Diagnosis […] The diagnosis of mastitis and a breast abscess can usually be made based on a physical exam. […] If it’s unclear whether a mass is due to a fluid-filled abscess or to a solid mass such as a tumor, you may get a test such as an ultrasound. An ultrasound may also tell whether you have simple mastitis, or an abscess deep in the breast. This noninvasive test allows your doctor to see the abscess by placing an ultrasound probe over your breast to get an image. If an abscess is confirmed, aspiration or surgical drainage, and IV antibiotics, are often required. […] A nurse or lab tech may take a sample (culture) either of breast milk or of material from an abscess through a syringe, to find out the type of organism causing the infection. This information can help your doctor decide what kind of antibiotic to use. […] Non-breastfeeding women with mastitis, or those who do not respond to treatment, may have a mammogram or breast biopsy. This is a precaution because a rare type of breast cancer can produce symptoms of mastitis.

• #61 A Comparative Study of Drainage of Breast Abscesses by Conventional Incision and Drainage vs Ultrasound-Guided Needle Aspiration/Re-Aspiration in A Tertiary Health Care Centre – European Journal of Breast Health

  https://eurjbreasthealth.com/articles/a-comparative-study-of-drainage-of-breast-abscesses-by-conventional-incision-and-drainage-vs-ultrasound-guided-needle-aspirationre-aspiration-in-a-tertiary-health-care-centre/doi/ejbh.galenos.2024.2024-3-2

  Breast abscesses are localized purulent collections, often arising from bacterial mastitis, and pose significant health risks, especially for lactating women. The aim of this study was to compare the efficacy and outcomes of two different treatment approaches: Traditional incision and drainage (ID) versus ultrasound (USG)-guided aspiration in breast abscess management. […] The study found that USG-guided aspiration was associated with several advantages over ID. Patients in group B experienced shorter healing times (5 days vs. 13 days, p = 0.001), lower rates of residual abscesses (12% vs. 36%, p = 0.047), and no recurrence after two weeks vs. 28% in group A (p = 0.012). […] These results highlight that USG-guided aspiration offers a minimally invasive and effective method for managing breast abscesses, leading to quicker recovery, better cosmetic outcomes, and higher patient satisfaction compared to the traditional ID approach. Early diagnosis and intervention with USG-guided aspiration can prevent complications and reduce the need for open surgery.

• #62 A Comparative Study of Drainage of Breast Abscesses by Conventional Incision and Drainage vs Ultrasound-Guided Needle Aspiration/Re-Aspiration in A Tertiary Health Care Centre – European Journal of Breast Health

  https://eurjbreasthealth.com/articles/a-comparative-study-of-drainage-of-breast-abscesses-by-conventional-incision-and-drainage-vs-ultrasound-guided-needle-aspirationre-aspiration-in-a-tertiary-health-care-centre/doi/ejbh.galenos.2024.2024-3-2

  The study underscores the clinical implications of adopting ultrasound-guided aspiration as a minimally invasive and effective method for managing breast abscesses. […] The conventional approach to treating breast abscesses has been incision and drainage (ID) with antibiotic coverage, primarily after initial unsuccessful needle aspiration. However, non-operative techniques such as percutaneous drainage using ultrasound (USG) have gained popularity, even in large abscesses that were once considered indications for ID. […] In group B, none of the patients failed to respond to needle aspiration. The mean healing time was significantly longer in group A than in group B and fewer patients in group A were able to resume lactation following open surgery. […] There was a significant difference between group A and group B in terms of post-operative outcome and patient satisfaction, favoring group B. USG-guided guided aspiration/re-aspiration is a technically feasible and easy method of management when done under aseptic precautions and under antibiotic cover with good cosmetic and functional results for the patient and quick recovery. […] Our findings unequivocally support the superiority of percutaneous USG-guided aspiration over conventional ID. The USG-guided approach demonstrated notable advantages, including faster healing times, improved cosmetic outcomes, and quicker resumption of lactation.

• #63 Breast abscess | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/breast-abscess?lang=us

  A breast abscess is a relatively rare but significant complication of mastitis that may occur during breastfeeding, particularly in primiparous women. The clinical context is a key to diagnosis as imaging appearances (particularly ultrasound) can mimic many other entities such as breast carcinoma. […] Ultrasound is considered the most useful initial imaging modality when a breast abscess is suspected. It is also the imaging method of choice to monitor progress, response to therapy and to ensure resolution. For the purpose of follow up the three dimensional measurement of the abscess and the volume of the contents should be given. […] On ultrasound a breast abscess can easily mimic other entities such as a breast malignancy or a breast hematoma on imaging grounds alone. In practice, the most difficult differentiation is from a galactocele.

• #64 Breast Abscesses: Diagnosis, Treatment and Outcome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3335354/

  The aim of our study was to analyze diagnostic results, different treatment modalities, and the outcome of patients with breast abscesses treated at our institution in a multi-modality breast team, to determine whether minimally invasive treatments are successful. […] Abscesses were diagnosed using ultrasonography (US), and the material obtained using US-guided fine needle aspiration (FNA) was further examined. […] US-guided FNA as a minimally invasive therapy in combination with antibiotics was found to successfully treat most breast abscesses and, in cases where a larger volume of pus was involved, the placement of an additional drainage catheter was effective. […] Breast abscesses are more frequently observed in non-puerperal mastitis than in puerperal mastitis, and can be a particularly difficult condition due to the intense discomfort and tendency for recurrence. When an abscess is small and located deep within the breast, it can be clinically difficult to detect and differentiate from mastitis; therefore, ultrasonography (US) is the method of choice for diagnosis.

• #65 Abscess/infections/periareolar mastitis – Pesce – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6764/html

  If the overlying skin is thinned and pus is visible then after application of the local anesthetic a small incision is made and the pus is drained. […] Women should be encouraged to continue breastfeeding in order to promote drainage of the breast and prevent ductal engorgement. […] The underlying cause of recurrent infections is obstructed lactiferous ducts by keratin plugs, and therefore a subareolar abscess will continue to recur unless these ducts are excised. […] The only effective long-term treatment for these women is removal of all the affected ducts by total duct excision. […] Treatment requires aspiration of the abscess, sending fluid to microbiology for aerobic and anaerobic culture, and tailoring antimicrobial therapy based on culture and susceptibility results. […] For women older than 35 years old and/or at risk for breast cancer, management of breast infections should not forgo recommended screening, and patients require appropriate breast imaging to evaluate for abnormalities after resolution of their abscess.

• #66 Breast abscess | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/breast-abscess?lang=us

  A breast abscess is a relatively rare but significant complication of mastitis that may occur during breastfeeding, particularly in primiparous women. The clinical context is a key to diagnosis as imaging appearances (particularly ultrasound) can mimic many other entities such as breast carcinoma. […] Ultrasound is considered the most useful initial imaging modality when a breast abscess is suspected. It is also the imaging method of choice to monitor progress, response to therapy and to ensure resolution. For the purpose of follow up the three dimensional measurement of the abscess and the volume of the contents should be given. […] On ultrasound a breast abscess can easily mimic other entities such as a breast malignancy or a breast hematoma on imaging grounds alone. In practice, the most difficult differentiation is from a galactocele.

• #67 Breast Abscess – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459122/

  Incision and drainage are the standard of care for breast abscesses. […] If there is a recurrence of an abscess after needle aspiration, incision and drainage should be performed. […] A course of antibiotics may be given before or following drainage of breast abscesses. […] Patients with large breast abscesses or signs of sepsis should be considered for admission to the hospital. […] The majority of isolated cases of breast abscess have good outcomes, but it can lead to pain, scarring, and a poor quality of life in women with recurrent infections. […] Any patient that continues to have features of mastitis after 5 weeks should be evaluated for malignancy or infection. […] The majority of breast abscess tend to occur in the postpartum period, and if it is seen in a nonlactating female, the onus is on the clinician to rule out inflammatory breast cancer, new-onset diabetes, or infection with mycobacterium.

• #68 A Comparative Study of Drainage of Breast Abscesses by Conventional Incision and Drainage vs Ultrasound-Guided Needle Aspiration/Re-Aspiration in A Tertiary Health Care Centre – European Journal of Breast Health

  https://eurjbreasthealth.com/articles/a-comparative-study-of-drainage-of-breast-abscesses-by-conventional-incision-and-drainage-vs-ultrasound-guided-needle-aspirationre-aspiration-in-a-tertiary-health-care-centre/doi/ejbh.galenos.2024.2024-3-2

  Breast abscesses are localized purulent collections, often arising from bacterial mastitis, and pose significant health risks, especially for lactating women. The aim of this study was to compare the efficacy and outcomes of two different treatment approaches: Traditional incision and drainage (ID) versus ultrasound (USG)-guided aspiration in breast abscess management. […] The study found that USG-guided aspiration was associated with several advantages over ID. Patients in group B experienced shorter healing times (5 days vs. 13 days, p = 0.001), lower rates of residual abscesses (12% vs. 36%, p = 0.047), and no recurrence after two weeks vs. 28% in group A (p = 0.012). […] These results highlight that USG-guided aspiration offers a minimally invasive and effective method for managing breast abscesses, leading to quicker recovery, better cosmetic outcomes, and higher patient satisfaction compared to the traditional ID approach. Early diagnosis and intervention with USG-guided aspiration can prevent complications and reduce the need for open surgery.

• #69 A Comparative Study of Drainage of Breast Abscesses by Conventional Incision and Drainage vs Ultrasound-Guided Needle Aspiration/Re-Aspiration in A Tertiary Health Care Centre – European Journal of Breast Health

  https://eurjbreasthealth.com/articles/a-comparative-study-of-drainage-of-breast-abscesses-by-conventional-incision-and-drainage-vs-ultrasound-guided-needle-aspirationre-aspiration-in-a-tertiary-health-care-centre/doi/ejbh.galenos.2024.2024-3-2

  The study underscores the clinical implications of adopting ultrasound-guided aspiration as a minimally invasive and effective method for managing breast abscesses. […] The conventional approach to treating breast abscesses has been incision and drainage (ID) with antibiotic coverage, primarily after initial unsuccessful needle aspiration. However, non-operative techniques such as percutaneous drainage using ultrasound (USG) have gained popularity, even in large abscesses that were once considered indications for ID. […] In group B, none of the patients failed to respond to needle aspiration. The mean healing time was significantly longer in group A than in group B and fewer patients in group A were able to resume lactation following open surgery. […] There was a significant difference between group A and group B in terms of post-operative outcome and patient satisfaction, favoring group B. USG-guided guided aspiration/re-aspiration is a technically feasible and easy method of management when done under aseptic precautions and under antibiotic cover with good cosmetic and functional results for the patient and quick recovery. […] Our findings unequivocally support the superiority of percutaneous USG-guided aspiration over conventional ID. The USG-guided approach demonstrated notable advantages, including faster healing times, improved cosmetic outcomes, and quicker resumption of lactation.

• #70 Breast Abscess – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459122/

  Because of the heterogeneity in management methods of breast abscess, there is, in fact, not enough data to state if needle aspiration is a better option than incision and drainage for a breast abscess. […] However, with all three methods, recurrence of breast abscess is common. […] Thus, it is highly recommended that a standardized interprofessional approach be developed to manage breast abscess, lower the rates of recurrence, and improve outcomes.

Zobacz więcej