Materiały źródłowe

• #1 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. Breast abscesses in nonlactating women occurred more commonly in African Americans, those with obesity, and smokers. […] 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. Risk factors for a staphylococcal abscess in lactating parents in one study identified problems with breastfeeding (odds ratio 5.0) and being a lactating parent employed outside their home (odds ratio 2.74) as risk factors.

• #1 Breast Abscesses and Masses: Background, Pathophysiology, Epidemiology

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

  Breast infections occur in as many as 10%-33% of lactating women. […] Lactational mastitis is seen in approximately 2%-3% of lactating women, and breast abscess may develop in 5%-11% of women with mastitis. […] Approximately 2.1%-3.6% of women die of breast cancer. […] Abscess formation complicates postpartum mastitis in fewer than 10% of cases. […] Development of mastitis has been correlated with an increased risk of developing breast cancer. […] African-American women have been variably reported to have an increased incidence of developing a primary breast abscess. […] Recurrent or chronic infections, pain, and scarring are causes of morbidity. […] The recurrence rate of breast abscess is high (39%-50%) when treated with standard incision and drainage, and studies have shown even higher recurrence rates in women undergoing fine-needle aspiration. […] Nonpuerperal abscesses recur more frequently, especially when associated with non-staphylococcal species (50% recurrence rate).

• #1 Breast Abscess – StatPearls – NCBI Bookshelf

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

  Lactation is the most common association with breast infections, present in 10% to 33% of these women. Lactational mastitis is present in 2% to 3% of lactating women, and 5% to 11% of these patients may develop an abscess. This is most common in women of childbearing age, with a mean age of 32 years. Nonlactating breast abscesses have a wider age range, with a peak incidence in the fourth decade of life. There is a strong association between diabetes and smoking with non-lactational breast abscesses. Obese patients and African Americans have a greater incidence of breast abscess. Nipple piercings have also been associated with subareolar breast abscesses in the nonlactating population.[6] […] 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. In addition, it is not known if an antibiotic should always be administered to women undergoing incision and drainage or aspiration. The few case series available reveal that the outcome for most women is excellent with any of these methods, but it is not known which is superior. 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.

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

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

  Breast infections (including infectious mastitis and breast abscess) more commonly affect women aged 15-45 years, especially those who are lactating. However, mastitis and breast abscess can occur at any age. […] 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. […] Risk factors include female sex, poor breastfeeding technique, lactation, milk stasis, nipple injury, previous mastitis, prolonged mastitis (breast abscess), women aged 30 years (breast abscess), prior breast abscess (breast abscess), and Staphylococcus aureus carrier.

• #1 Breast Abscess | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617645/all/Breast_Abscess?q=Breastfeeding

  311% of women with breastfeeding mastitis develop a breast abscess. […] Affects primarily infants (peak age 1 to 6 weeks) and adolescents. […] Bilateral abscesses, seen among neonates, are rare. […] Male-to-female ratio is 1:2 in neonates.

• #1 Primary breast abscess – UpToDate

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

  In a retrospective study of 68 patients all with breast abscess, smoking was a significant risk factor for the development of an abscess (odds ratio 8.0, 95% CI 3.4-19.4). Of the 68 cases, over half (54 percent) needed multiple surgical treatments and 22 of these were heavy smokers. Five patients developed fistulas and all were heavy smokers. In another retrospective study of 89 patients with any type of breast abscess, 39 patients (43 percent) were heavy smokers. The majority of patients who developed recurrent abscesses were smokers (77 percent). Smoking was the only factor significantly associated with abscess recurrence.

• #1 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. […] Periareolar abscesses are common in young women and smokers, and up to half of patients experience recurrent episodes of infection. […] 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 by total duct excision. […] Periareolar infections are most common among young women who smoke cigarettes. […] The underlying pathologic process is periductal mastitis. […] Periareolar infections are the most difficult breast infections to treat, and up to half of patients experience recurrent episodes of infection.

• #1 [Breast abscess: epidemiological, diagnostic and therapeutic features in patients hospitalized in the Main Hospital in Dakar] – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33062118/

  Breast abscesses are neoformed collections of purulent matter occupying the mammary gland and the periglandular tissue. The purpose of our study was to describe the epidemiological, diagnostic and therapeutic features of breast abscesses in patients hospitalized in the Division of General Surgery at the main hospital in Dakar. We conducted a retrospective, descriptive study involving all patients treated for breast abscess over a 4-year period. The main risk factor was mastitis during lactation (27%). Staphylococcus aureus was the most commonly isolated germ (79.5%). The average length of stay in hospital was 7 days and operative morbidity was 31.7%. Mortality was zero. Prevention of abscesses during lactation is based on improving breastfeeding practices and on early antibiotic treatment in patients with mastitis.

• #1 Staphylococcus aureus in breast abscess-major culprit besides others – Indian Journal of Medical Sciences

  https://ijmsweb.com/staphylococcus-aureus-in-breast-abscess-major-culprit-besides-others/

  Breast abscess is a significant cause of morbidity especially in young women of childbearing age. […] Lactation was a risk factor in almost two-third of all cases. Others were diabetes mellitus, extremes of age, immunocompromised conditions, and tuberculosis. […] The most common bacterial isolate was Staphylococcus aureus (83.3%), almost half being methicillin-resistant S. aureus (MRSA). […] The treatment of all such microorganisms is different, signifying that microbial diagnosis plays a pivotal role in management of such abscesses. […] The present article addresses the microbiological profile of breast abscess and elucidates antimicrobial susceptibility of isolates, with main focus on methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MRSA and MSSA). […] In our study, we found diabetes mellitus, extremes of age, breastfeeding, immunocompromised conditions, and tuberculosis as risk factors for breast abscess.

• #1

  https://link.springer.com/article/10.1007/s11739-012-0813-x

  Cellulitis, mastitis, and breast abscesses exist along a continuum, with breast abscesses occurring in 5-11% of lactating women with infectious mastitis. […] Most breast abscesses develop secondarily to skin contamination with S. aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Peptostreptococcus, or Bacteroides. […] Ultrasonography is the imaging modality of choice due to its availability, painless use, ability to conduct repeat examinations during the course of therapy, and its ability to guide percutaneous drainage. […] According to recently published 2011 algorithm, a trial of ultrasound guided drainage is recommended for all fluid collections suggesting an abscess, regardless of size, which occur during the breast-feeding period, are caused by S. aureus, and lack a multiloculated structure.

• #1

  https://link.springer.com/article/10.1007/s11739-012-0813-x

  The greatest success is achieved with abscesses that are 3 cm in diameter. […] Abscesses that are multiloculated or larger than 3 cm in diameter may fail ultrasound-guided drainage; thus, in such instances, early surgical evaluation for incision and drainage is strongly recommended. […] In addition to ultrasound-guided drainage, all suspected breast abscesses should be managed with antibiotics including cloxacillin 500 mg four times daily, clindamycin 300 mg four times daily, erythromycin 500 mg three times daily, or cefazolin 500 mg four times daily for a total of 7-10 days. […] In the rare cases in which breast abscess is clinically suspected, but initial ultrasound fails to demonstrate a defined fluid collection, evaluation for inflammatory carcinoma should be completed with mammography or breast biopsy.

• #1 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. Breast abscesses may also lead the mother to discontinue breastfeeding, thereby harming the infants health. 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%. In instances of breast fistula, the rate of cessation of lactation is very high (66.7%). 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. The patients suffer from stress, pain and easily induced breast scarring; the diseases progression is prolonged and recurrent, interfering with infant feeding. Consequently, it is crucial to discover an adequate cure.

• #1 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

  A severe complication of acute mastitis during breastfeeding is breast abscess. The disease is associated with patient fatigue, pressure, blockage of the mammary duct, inadequate feeding times, oral abnormalities of infants (such as cleft lip or palate), local milk stasis, malnutrition of mothers, use of a manual breast suction device, community-acquired infection, breast injury and poor diet, as well as delayed treatment of acute mastitis. 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. […] Acute mastitis and breast abscess during lactation are regarded as the leading causes of unintentional weaning, preventing mothers from implementing exclusive nursing. Acute mastitis during lactation is a form of breast cellulitis affecting the interlobular connective tissue. The WHO defines the disease as a state of breast inflammation, which may or may not be accompanied by infection, which may lead to breast abscess and septic fever, and may directly lead to the cessation of breastfeeding. The disease can elicit breast pain locally and is frequently accompanied by fast developing systemic symptoms, such as fever, muscular pain, chills and fatigue. In severe cases, the breast may be permanently scarred, and its occurrence rate ranges from 3% to 33%, with 4% to 11% developing breast abscesses.

• #1 Bacteriological profile of breast abscess and its antimicrobial susceptibility at tertiary care hospital – IJMMTD

  https://www.ijmmtd.org/html-article/23496

  The AMR Surveillance Network (ICMR) annual report of 2022 showed proportion of MRSA was 44.5% in the year 2022, which was slightly higher than the rate reported in 2021 (42.6%). […] Although the study identified several types of microorganisms, S. aureus (83.5%) was the most common isolate. […] The MRSA rate of present study (41%) was similar to studies like Jena P et al. (49%), Pileri P et al (44.8%) and Li D et al. (42%). […] It is very crucial to give proper antimicrobial treatment in initial phase of mastitis as it can prevent progression to abscess formation. […] For our institute recommended drugs for an initial empirical therapy are amoxycillin-clavulanic acid, erythromycin and clindamycin. […] Adherence to good infection control practices in maternity wards can help in decreasing chances of acquiring infection during hospital stay.

• #1 The estimated incidence of lactational breast abscess and description of its management by percutaneous aspiration at the Douala General Hospital, Cameroon | International Breastfeeding Journal | Full Text

  https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-020-00271-2

  The traditional treatment modality for lactation breast abscesses has been I D in most settings in both high-income and low-income countries. […] However, in recent times there is worldwide evidence that aspiration of lactational breast abscesses with or without ultrasound guidance has resulted in good outcomes in terms of an early resumption of breastfeeding. […] The resolution time of lactational breast abscesses in this study ranged from 6 to 10 days. […] In the present study, married women with lactational breast abscess continued breastfeeding for longer periods than single mothers. […] This is the first study in Cameroon, a low-income country that describes the management of lactational breast abscesses by percutaneous aspiration. […] Further research is needed to understand the role of local infiltration of antibiotics into the abscess cavity.

• #1 Health and Economic Burden of Post-Partum Staphylococcus aureus Breast Abscess | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0073155

  Fifty-four cases of culture-confirmed post-partum S. aureus breast abscess were identified. […] The mean attributable cost of post-partum S. aureus breast abscess ranged from $2,340-$4,012, depending on the methods and data sources used. […] Post-partum S. aureus breast abscess is associated with worse health and economic outcomes for women and their infants, including high rates of breastfeeding cessation. […] The overall rate of readmission among patients in the full cohort who returned to our center (N=32,188) was 3.2%, and in cases (N=54), 50% (p<0.0001). [...] The attributable medical cost of post-partum S. aureus breast abscess was high, and in the same range as other post-partum infections, including surgical site infection after Cesarean delivery ($3761, 95% CI, $3309-$4275) and post-partum endometritis ($4216, 95% CI, $3710-$4792). [...] Post-partum S. aureus breast abscess frequently led to breastfeeding cessation and was associated with additional poor patient outcomes, high health services utilization, and significant attributable medical costs; the economic burden was similar for MRSA and MSSA infections.

• #1 Abscess Drainage with or Without Antibiotics in Lactational Breast Abs | IDR

  https://www.dovepress.com/abscess-drainage-with-or-without-antibiotics-in-lactational-breast-abs-peer-reviewed-fulltext-article-IDR

  The current study is to investigate a debatable question: whether antibiotics are necessary for the treatment of lactational breast abscess? […] It would decrease the administration of antibiotics if single drainage is not inferior to drainage plus antibiotics. […] The findings of this randomized clinical trial will provide us evidence on the role of antibiotics for the management of lactational breast abscess. […] For many infectious diseases, like pneumonia, osteomyelitis, and endocarditis, shorter course or a shift from intravenous therapy to oral administration have proven to be as effective as standard courses of antibiotics. […] For mastitis or lactational breast abscess, however, proper studies that rule out the suitability and optimization of antibiotics are not available. […] To date, no randomized clinical trial with sufficient power has ever assessed the efficacy of drainage without postoperative antibiotics in lactational breast abscess. […] If non-antibiotic therapy is not inferior to the standard treatment, the length of hospital stay will be shortened, accompanying with lower hospital cost. […] For long-term interest, the optimization strategy for antibiotics retards the urgency of worldwide bacteriological drug resistance.

• #2 [Breast abscess: epidemiological, diagnostic and therapeutic features in patients hospitalized in the Main Hospital in Dakar] – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33062118/

  Breast abscesses are neoformed collections of purulent matter occupying the mammary gland and the periglandular tissue. The purpose of our study was to describe the epidemiological, diagnostic and therapeutic features of breast abscesses in patients hospitalized in the Division of General Surgery at the main hospital in Dakar. We conducted a retrospective, descriptive study involving all patients treated for breast abscess over a 4-year period. The main risk factor was mastitis during lactation (27%). Staphylococcus aureus was the most commonly isolated germ (79.5%). The average length of stay in hospital was 7 days and operative morbidity was 31.7%. Mortality was zero. Prevention of abscesses during lactation is based on improving breastfeeding practices and on early antibiotic treatment in patients with mastitis.

• #2 Pulsenotes | Lactational mastitis notes

  https://app.pulsenotes.com/surgery/breast-surgery/notes/lactational-mastitis

  Lactational mastitis affects around 10-33% of lactating women. […] It is approximated that anywhere from 0.1% to 3% of lactating women will suffer with a breast abscess. This is increased in those with lactational mastitis to around 3% to 11%.

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

  https://radiopaedia.org/articles/breast-abscess?embed_domain=staging.radpair.comfavicon.ico&lang=us

  Breast abscesses are thought to develop in 5-11% of lactating women with infectious mastitis. […] In this context they are also referred to as lactational abscesses. […] Note, that a neonatal breast abscess is a different entity occurring on a background of neonatal mastitis.

• #2

  https://journals.lww.com/jmso/fulltext/2012/26030/management_of_breast_abscess_by_repeated.11.aspx

  The study group comprises of 50 patients with breast abscess who attended the Outpatient Department (OPD) of surgery, Regional Institute of Medical Sciences (RIMS), Imphal during the period of May 2005 to April 2007. Of these, 31 patients (62%) were lactating and 19 patients (38%) were non-lactating. The diagnosis of the abscess was made when there was redness, warmth, tenderness, and swelling in the breast. […] The mean age of our patients was 32 years (range: 19-80 years) which is consistent with the finding of Elagili et al. and Ulitzsch et al. with the mean age of 31.93 years and 32 years in lactational and non-lactational cases. S.aureus was the most common pathogen isolated in this study in 32 (64%) cases which is comparable with findings by Elagili et al., Ulitzsch et al. and Dixon et al. Of the 50 patients aspirated in our study, 39 (78%) resolved well without recurrence, 8 (16%) cases failed to repeated aspiration and underwent incision and drainage and 3 (6%) cases had recurrent abscess occurring 1 month after the last aspiration. The success rate by needle aspiration without resorting to surgical drainage was 84%.

• #2 Breast Abscesses and Masses: Background, Pathophysiology, Epidemiology

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

  Breast infections occur in as many as 10%-33% of lactating women. […] Lactational mastitis is seen in approximately 2%-3% of lactating women, and breast abscess may develop in 5%-11% of women with mastitis. […] Approximately 2.1%-3.6% of women die of breast cancer. […] Abscess formation complicates postpartum mastitis in fewer than 10% of cases. […] Development of mastitis has been correlated with an increased risk of developing breast cancer. […] African-American women have been variably reported to have an increased incidence of developing a primary breast abscess. […] Recurrent or chronic infections, pain, and scarring are causes of morbidity. […] The recurrence rate of breast abscess is high (39%-50%) when treated with standard incision and drainage, and studies have shown even higher recurrence rates in women undergoing fine-needle aspiration. […] Nonpuerperal abscesses recur more frequently, especially when associated with non-staphylococcal species (50% recurrence rate).

• #2 Breast abscess epidemiology and demographics – wikidoc

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

  Most recent articles […] The incidence of breast abscess is 3,000-11,000 per 100,000 of patients with mastitis. […] The incidence of breast abscess is only 100-3,000 per 100,000 of the puerperal patients. […] Patients of all age groups may develop breast abscess. […] Breast abscess is more common observed in the infants and the young more than the elder. […] It is common in neonates with mastitis as approximately 50 percent of the neonatal patients with mastitis can develop breast abscess. […] Breast abscess occurs commonly in women. It is very rare in men. […] Breast abscess is more prevalent in the african american race.

• #2 Primary breast abscess – UpToDate

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

  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. Risk factors for a staphylococcal abscess in lactating parents in one study identified problems with breastfeeding (odds ratio 5.0) and being a lactating parent employed outside their home (odds ratio 2.74) as risk factors. […] In a retrospective study of 68 patients all with breast abscess, smoking was a significant risk factor for the development of an abscess (odds ratio 8.0, 95% CI 3.4-19.4). Of the 68 cases, over half (54 percent) needed multiple surgical treatments and 22 of these were heavy smokers. Five patients developed fistulas and all were heavy smokers. In another retrospective study of 89 patients with any type of breast abscess, 39 patients (43 percent) were heavy smokers. The majority of patients who developed recurrent abscesses were smokers (77 percent). Smoking was the only factor significantly associated with abscess recurrence.

• #2 Primary breast abscess – UpToDate

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

  In a retrospective study of 68 patients all with breast abscess, smoking was a significant risk factor for the development of an abscess (odds ratio 8.0, 95% CI 3.4-19.4). Of the 68 cases, over half (54 percent) needed multiple surgical treatments and 22 of these were heavy smokers. Five patients developed fistulas and all were heavy smokers. In another retrospective study of 89 patients with any type of breast abscess, 39 patients (43 percent) were heavy smokers. The majority of patients who developed recurrent abscesses were smokers (77 percent). Smoking was the only factor significantly associated with abscess recurrence.

• #2 Bacteriological profile of breast abscess and its antimicrobial susceptibility at tertiary care hospital – IJMMTD

  https://www.ijmmtd.org/html-article/23496

  A breast abscess often arises as a complication of bacterial mastitis, particularly when treatment is either insufficient or delayed. […] The present study was conducted to address microbiological profile of breast abscess and elucidates antimicrobial susceptibility of isolates. […] This retrospective study was conducted at tertiary care hospital, Jamnagar from July 2023 to June 2024. […] The maximum occurrence (71% cases) of breast abscess was seen in lactating women. […] The primary organism responsible for breast abscesses is often Staphylococcus aureus, with many isolated strains showing resistance to penicillin. […] In recent years, methicillin-resistant Staphylococcus aureus (MRSA) detection rates in breast milk and pus from lactating patients have been increasing gradually.

• #2 Staphylococcus aureus in breast abscess-major culprit besides others – Indian Journal of Medical Sciences

  https://ijmsweb.com/staphylococcus-aureus-in-breast-abscess-major-culprit-besides-others/

  Different types of microorganisms have been reported in pus cultures from breast abscesses. S. aureus is the predominant pathogen in breast abscesses, accounting for 32-100% cases. […] In our study, the proportion of MSSA: MRSA was 51% and 49% which indicates that methicillin resistance is widespread in the community. […] The Indian Network for Surveillance of Antimicrobial Resistance group found 40% of MRSA rates in skin and soft tissue infection in 2009. […] Infection control practices in nursery and maternity wards may help prevent breast abscess formation.

• #2

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

  Breast abscess develops as a complication of lactational mastitis. Recently, there is an increase in the incidence of non-lactational breast abscess. […] A total of 124 patients were included in the study, with 97 women were categorized into lactational breast abscess, and 27 women were classified as a non-lactational 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.

• #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

  A severe complication of acute mastitis during breastfeeding is breast abscess. The disease is associated with patient fatigue, pressure, blockage of the mammary duct, inadequate feeding times, oral abnormalities of infants (such as cleft lip or palate), local milk stasis, malnutrition of mothers, use of a manual breast suction device, community-acquired infection, breast injury and poor diet, as well as delayed treatment of acute mastitis. 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. […] Acute mastitis and breast abscess during lactation are regarded as the leading causes of unintentional weaning, preventing mothers from implementing exclusive nursing. Acute mastitis during lactation is a form of breast cellulitis affecting the interlobular connective tissue. The WHO defines the disease as a state of breast inflammation, which may or may not be accompanied by infection, which may lead to breast abscess and septic fever, and may directly lead to the cessation of breastfeeding. The disease can elicit breast pain locally and is frequently accompanied by fast developing systemic symptoms, such as fever, muscular pain, chills and fatigue. In severe cases, the breast may be permanently scarred, and its occurrence rate ranges from 3% to 33%, with 4% to 11% developing breast abscesses.

• #2 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

  „Breast abscess is a rare, but potentially serious, complication of mastitis.” […] „Ultrasound detection and ultrasound-guided treatment is now standard protocol at Danderyds Hospital, Ulitzsch wrote in an e-mail to AuntMinnie.com.” […] „The number of treated abscesses increased (in 2002), mainly due to an increased number of deliveries.” […] „Ulitzsch said future research would focus on the cost effectiveness of ultrasound-guided procedures for abscesses versus surgery.”

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

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

  Breast abscesses usually occur in women of childbearing age. About 10% to 30% of all breast abscesses occur after pregnancy, when nursing mothers breastfeed newborns. […] Up to 40% to 50% of breast abscesses can come back.

• #2 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. […] Breast abscesses, both lactational and non-lactational, are a very common clinical entity identified in daily practice. […] It has emerged that minimally invasive methods provide better results and are a more acceptable method of management. […] USG-guided needle aspiration under antibiotic coverage has become the latest management protocol in many institutions due to its ease and outcome. […] A meta-analysis of existing data and further randomized clinical studies are necessary to evaluate the benefit of USG guidance during needle aspiration in different categories of patients with breast abscesses in relation to puerperium and lactation.

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

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

  The only effective long-term treatment for these women is removal of all the affected ducts by total duct excision. […] Patients most likely to have recurrent breast abscesses include smokers as well as older patients. […] 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.

• #2 Abscess Drainage with or Without Antibiotics in Lactational Breast Abs | IDR

  https://www.dovepress.com/abscess-drainage-with-or-without-antibiotics-in-lactational-breast-abs-peer-reviewed-fulltext-article-IDR

  The current study is to investigate a debatable question: whether antibiotics are necessary for the treatment of lactational breast abscess? […] It would decrease the administration of antibiotics if single drainage is not inferior to drainage plus antibiotics. […] The findings of this randomized clinical trial will provide us evidence on the role of antibiotics for the management of lactational breast abscess. […] For many infectious diseases, like pneumonia, osteomyelitis, and endocarditis, shorter course or a shift from intravenous therapy to oral administration have proven to be as effective as standard courses of antibiotics. […] For mastitis or lactational breast abscess, however, proper studies that rule out the suitability and optimization of antibiotics are not available. […] To date, no randomized clinical trial with sufficient power has ever assessed the efficacy of drainage without postoperative antibiotics in lactational breast abscess. […] If non-antibiotic therapy is not inferior to the standard treatment, the length of hospital stay will be shortened, accompanying with lower hospital cost. […] For long-term interest, the optimization strategy for antibiotics retards the urgency of worldwide bacteriological drug resistance.

• #3 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

  Mastitis or inflammation of the breast is a common condition in people who are breastfeeding or lactating. The incidence has been reported as between 3% – 20% in the first 6 months after birth. Most cases occur in the first six weeks but can occur at any time during lactation or pregnancy. […] 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.

• #3 Breast abscess epidemiology and demographics – wikidoc

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

  Most recent articles […] The incidence of breast abscess is 3,000-11,000 per 100,000 of patients with mastitis. […] The incidence of breast abscess is only 100-3,000 per 100,000 of the puerperal patients. […] Patients of all age groups may develop breast abscess. […] Breast abscess is more common observed in the infants and the young more than the elder. […] It is common in neonates with mastitis as approximately 50 percent of the neonatal patients with mastitis can develop breast abscess. […] Breast abscess occurs commonly in women. It is very rare in men. […] Breast abscess is more prevalent in the african american race.

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

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

  Breast infections (including infectious mastitis and breast abscess) more commonly affect women aged 15-45 years, especially those who are lactating. However, mastitis and breast abscess can occur at any age. […] 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 coexistent causes of infection to facilitate resolution and prevent recurrence. […] Risk factors include female sex, poor breast-feeding technique, lactation, milk stasis, nipple injury, previous mastitis, prolonged mastitis (breast abscess), women aged 30 years (breast abscess), prior breast abscess (breast abscess), and immunosuppression.

• #3 Bacteriological profile of breast abscess and its antimicrobial susceptibility at tertiary care hospital – IJMMTD

  https://www.ijmmtd.org/html-article/23496

  The AMR Surveillance Network (ICMR) annual report of 2022 showed proportion of MRSA was 44.5% in the year 2022, which was slightly higher than the rate reported in 2021 (42.6%). […] Although the study identified several types of microorganisms, S. aureus (83.5%) was the most common isolate. […] The MRSA rate of present study (41%) was similar to studies like Jena P et al. (49%), Pileri P et al (44.8%) and Li D et al. (42%). […] It is very crucial to give proper antimicrobial treatment in initial phase of mastitis as it can prevent progression to abscess formation. […] For our institute recommended drugs for an initial empirical therapy are amoxycillin-clavulanic acid, erythromycin and clindamycin. […] Adherence to good infection control practices in maternity wards can help in decreasing chances of acquiring infection during hospital stay.

• #3 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

  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. […] The present study also suggested that, when appropriate, multiple USG-guided aspirations can be considered before resorting to ID, in order to optimize outcomes.

• #3 55.03 Pediatric Breast Abscess: National Epidemiology and Management at Children’s Hospitals – Academic Surgical Congress Abstracts Archive

  https://www.asc-abstracts.org/abs2019/55-03-pediatric-breast-abscess-national-epidemiology-and-management-at-childrens-hospitals/

  Pediatric breast abscesses are rare. Data is lacking on their epidemiology and management. The purpose of our study was to evaluate the current national management of pediatric breast abscesses. A total of 3,381 patients were included. Only female patients were analyzed, and this included 2,796 patients (83%). Seventeen percent (481) occurred in patients less than a year old. ID rates varied from 16% to 28% by age group and 0 to 50% by hospital. Despite concerns for damage to a developing breast bud, rates of ID are high throughout the nation. Overall the management of pediatric breast abscesses is variable and needs standardization with long term follow up of the two most common methods of drainage. Further study is needed.

• #4 Subareolar breast abscess in male patients: a report of two patients with a literature review | Surgical Case Reports | Full Text

  https://surgicalcasereports.springeropen.com/articles/10.1186/s40792-017-0402-3

  Subareolar breast abscess (SBA) is a rare infectious disease of the breast in male patients. […] To our knowledge, only nine case reports of SBA in male patients have been published to date. […] Smoking, diabetes mellitus, obesity, nipple piercing, or nipple inversion has been suggested as a risk factor for SBA. […] The relationship between smoking and SBA seems particularly strong; Bundred et al. reported that breast abscesses containing anaerobic bacteria were significantly more likely to occur in current smokers than in non-smokers. […] Although SBA in male is very rare, it is important to consider it in the differential diagnosis of breast tumors in male patients. Importantly, cytological and pathological analyses are useful for preoperative diagnosis. And to prevent recurrence of the disease, complete resection of the effected duct along with the tumor was recommended essential as derived from previous reports.

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