What is Breast Abscess and is it Serious?

Yes and no.

Yes, it is an infection which should be treated promptly.

No, it is usually not life threatening and no, it’s usually not a sign of breast cancer.

First off, what is a breast abscess?

An abscess is a walled-off collection of pus. Pus is a thick fluid made up of dead white blood cells (your body soldiers used to fight infection), dead/living microorganisms (like bacteria), and tissue debris. Hence, a breast abscess is an abscess that is occurring in the breast.

Why does it occur?

Most breast abscesses occur in women who are breastfeeding (called lactational abscess) as a result of mastitis and/or blocked ducts. Some are found in women/men who are not breastfeeding (called non-lactational abscess). These are usually due to skin infection which progressed to an abscess, commonly found in people with low immunity (such as diabetics) and smokers. Rarely, breast cancer can present like an abscess or breast infection. This is called inflammatory breast cancer.

What is diagnosis like?

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.

How can it be treated?

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.

Thankfully, there is a new technique which we employ to reduce the need for formal surgical drainage. This is a hybrid procedure with the aid of a vacuum assisted biopsy probe to drain out the pus. This allows the drainage of the pus via a small incision and reduces the healing time. Furthermore, a small incision also means a smaller scar and better cosmetic outcome.

For more information on breast abscess, click here.

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