During nursing, an area of redness, tenderness, and induration may develop in the breast. The organism most commonly found in these abscesses is Staphylococcus aureus (see Puerperal Mastitis, Chapter 19).
Infection in the nonlactating breast is rare. A subareolar abscess may develop in young or middle-aged women who are not lactating. Often needle or catheter drainage is adequate to treat an abscess, but surgical incision and drainage may be necessary; these infections tend to recur after incision and drainage unless the area is explored during a quiescent interval, with excision of the involved lactiferous duct or ducts at the base of the nipple. In the nonlactating breast, inflammatory carcinoma must always be considered. Thus, incision and biopsy of any indurated tissue with a small piece of erythematous skin is indicated when suspected abscess or cellulitis in the nonlactating breast does not resolve promptly with antibiotics.
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et al. Factors associated with surgical treatment in postpartum women with mastitis or breast abscess: a retrospective cohort study. Breastfeed Med. 2022;17:233.