Breast Abscess

Infection is generally caused by Staphylococcus aureus and is common in lactating women during nursing

Infection in nonlactating women is rare

However, subareolar abscesses may develop in nonlactating young or middle-aged women

In the nonlactating breast, consider inflammatory carcinoma

Redness, tenderness, and induration in the breast

In lactating women, diagnosis is generally clinical

In nonlactating women, incision and biopsy of indurated breast tissue are indicated to rule out malignancy

Differential diagnosis

• Breast cancer, especially inflammatory or Paget disease of the breast

• Local irritation or trauma

• Fat necrosis

• Fibroadenoma

Needle or catheter drainage is often adequate, but surgical incision and drainage may be necessary

An abscess tends to recur after aspiration unless area is explored during a quiescent interval with excision of the involved lactiferous duct or ducts at base of nipple

For abscess or cellulitis in nonlactating breast that does not promptly resolve with antibiotics, incision and biopsy of indurated tissue with small piece of erythematous skin are indicated

This biopsy is generally required to rule out malignancy (inflammatory breast cancer)