Swelling And Pus In The Breasts – Causes And Treatment Options For Breast Abscess

Swelling And Pus In The Breasts – Causes And Treatment Options For Breast Abscess

Anything like bulge, swelling on the body can instill fear in you. One of the common types of disorders that primarily occur in the women is the breast abscess. Often, a bacterial infection can result in accumulation of pus in an area below the skin. When a small portion or pocket of this pus forms in the breast, it is called as breast abscess.

Breast abscess can be a painful condition that requires urgent medical attention to avoid any complications.

Causes - How breast abscess forms?

If a bacterium invades the breast tissue, the immune system jumps into action and send white blood cells to fight against the infection. During this process, certain affected tissues are destroyed while leaving a pocket of fluid. This pocket gradually fills with pus and mix of white blood cells, dead tissues and bacteria. Slowly when the pocket fills up and swells, it turns into a painful lump known as abscess.

Breast abscesses or pus collection mostly affects women in the age group of 18-50, especially if they are breastfeeding.

Types of breast abscess

Breast abscess can be categorized into two types:

Lactational or puerperal abscess

Occurs in breastfeeding women and forms in the upper and outer areas of the breast. Breast abscess is usually a serious complication of mastitis, a condition in which the breast produces more milk than the baby consumes. In this case, it can be referred to as lactational abscess. This abscess occurs in the milk ducts carrying milk towards the nipple of the breastfeeding woman.

The extra milk produced is then backed up in the breast. And when this happens, the harmless bacteria in the milk duct starts to grow rapidly, generating response from the immune system. If mastitis is left untreated, the abscess or pus can accumulate in one or more milk ducts.

Non-lactational abscess

This kind of abscess is located just under areola (the coloured skin around the nipple) or the lower sections of the breast. In non-lactating women, bacteria can make its way through a sore or cracked nipple. Though, it can also occur in lactational abscess.

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Risk factors – Who get breast abscess?

Following factors can put you at the risk of developing breast abscess.

  • Breastfeeding baby for the first time
  • Woman whose pregnancy lasted 41 weeks or more
  • History of mastitis
  • Diabetes
  • Smoking
  • HIV infection or undergoing immunosuppressive therapy
  • Nipple piercing

Symptoms of breast abscess

  • When breast abscess develops, it can show following signs:
  • Feeling of painful tender lump in the breast that feels hot while the surrounding area of the skin might swell up.
  • Lump that has regular borders and is smooth or feels solid on touching
  • One might feel unwell or may have high temperature or fever
  • Inverted nipple

Can a woman continue breastfeeding with abscess?

This is an important question since the newborn is heavily dependent on mother’s milk. As per WHO and National Institute for Health and Care Excellence, you should continuing breastfeeding during the treatment of abscess as it is completely safe. And most of the time until the condition is diagnosed, the baby will have already exposed to the bacteria. Emptying the breast is very important in treating the condition.

However, some babies might refuse to feed from the affected breast. It is very important to keep the breast well drained and if it seems too painful to breastfeed directly, you can also try pumping using breast pump.

How breast abscess is diagnosed?

If you are experiencing symptoms, you should talk to a doctor immediately. And regardless if it’s a breast abscess or lump, it is important to seek medical advice right away to avoid complications and rule out serious conditions such as breast cancer.

  • At the first appointment, the doctor would be performing breast exam to analyze the lump.
  • He would likely to collect the pus for lab testing and to determine what type of infection you have. This would help him evaluate which strain of bacteria is causing infection since many of them are resistant to certain medications. This will also allow the doctor to formulate appropriate treatment for you.
  • You might also undergo blood testing to check for infection and immune health.
  • The doctor may also order ultrasound to determine the structures under the skin which are being affected. The ultrasound will also reveal how deep the abscess has gone and how many pockets of pus are there.
  • At times, MRI scan might also be done, especially in cases of severe or recurring infection.

Treatment of breast abscess

After diagnosing the abscess, the doctor might refer you to a breast surgeon for further course of action. Following treatments can be expected.

  1. Draining pus using needle syringe - The abscess will be drained to remove the fluid or pus from the breast. This will be done through needle and syringe. However, in case of large abscess, a small cut or incision would be made to drain the fluid and remove the pus. Ultrasound might be used to guide the medical instruments which are used to drain the pus.
  2. Anesthesia - Irrespective of the draining technique, you will first be given a local anesthetic to numb the skin around the affected area.
  3. Culture – After draining the pus, it will then be cultured to figure out the type of antibiotic that should be given.

Home treatments

  • While you undergo treatment, you can try some useful tips at home to reduce discomfort. These include:
  • Apply ice-pack on the affected area for 10-15 minutes several times a day. This can reduce swelling.
  • Use gentle antibacterial soap for washing the skin and the nipple.
  • Wear soft breast pad in the bra.
  • Avoid squeezing or pushing the abscess as this could worsen symptoms.

Breast abscess would not cause any harm to your child, but delayed treatment could result in complications such as scarring, nipple inversion and chronic pain. So it’s important to promptly act and talk to your doctor as soon as you discover any symptoms.