Mammary abscess

A localized area of pus accumulation within the layers of breast tissue is called a breast abscess.

This disease is not very common. It is usually secondary and appears as a result of other inflammatory processes in the gland, for example, mastitis. However, despite the low incidence rate, any woman who cares about her own health needs to know about this disease.

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Causes breast abscess

An abscess of the mammary gland usually begins after a microbial infection penetrates through the nipple. Most often, this can be observed with cracks in the nipple and areola in the first period after the onset of lactation. Sometimes the onset of the disease is caused by the nipple's inability to cope with constant irritation, or by milk stagnation in the breast (when the baby does not suck it out enough, or the mother, for some reason, does not want or cannot breastfeed). If there are cracks and irritations in the nipples, then the infection can simply be brought in by not following hygiene rules - with dirty hands.

Other possible causes of breast abscess include:

• obstruction of the milk ducts can provoke the appearance of cysts and the addition of infection, in this case, an abscess;
• Mastitis and other inflammatory diseases of the breast can lead to the spread of infection into the subcutaneous tissue of the gland.

The causative agent of the disease is most often staphylococci and streptococci, or a combination of staphylococcal infection with gram-negative bacteria - Proteus or E. coli.

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Symptoms breast abscess

Symptoms of a mammary gland abscess most often begin with a rise in temperature, a feverish state. The affected gland becomes extremely painful, so much so that it becomes impossible to use it for feeding. The lobes of the gland closest to the source of infection become denser and larger.

Little by little, the inflammatory process spreads to other areas of the breast. The skin above them turns red and swells until a visible abscess forms.

The disease can occur in several pathological forms:

• superficial form of abscess (subareolar), when the process forms in the areola area in the subcutaneous tissue;
• intramammary form of abscess, when the disease occurs against the background of stagnant mastitis. With this pathology, isolated areas of necrosis can form, and in severe cases, the abscess breaks through and the purulent contents flow out;
• retromammary form of abscess, when the abscess forms on the back of the gland. In such a situation, pus can also come out, breaking through the tissue between the organ and the external chest fascia.

Almost all stages of the inflammatory process occur against the background of high temperature: the fever may decrease somewhat after the abscess breaks through.

Diagnostics breast abscess

Diagnosis of a breast abscess is usually not a problem. The characteristic symptoms of the disease usually allow for a correct diagnosis and the correct treatment. Only in some cases, with long-term, chronic abscesses, can a differential diagnosis of an abscess be made from a malignant or benign tumor.

Most often, the diagnosis is established on the basis of characteristic symptoms, laboratory and instrumental examinations, and diagnostic manipulations (abscess biopsy).

A blood test usually indicates the presence of a persistent inflammatory process: an increase in the level of leukocytes, an accelerated ESR.

Urinalysis may reveal proteinuria and leukocyturia.

Bacteriological culture of nipple discharge can reveal pathogenic microflora.

When palpating the affected gland, a rounded convex formation is detected, fluctuating due to the liquid contents of the abscess. The affected gland is enlarged in volume, tense and sharply painful.

Ultrasound of the mammary gland allows detecting a hypoechoic focus of rounded configuration against the background of the edematous gland. Thanks to ultrasound, it is possible to accurately determine the location and size of the abscess, as well as perform a control puncture of the abscess and take the contents to determine the pathogen.

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Treatment breast abscess

Treatment of acute mammary gland abscess is urgent and surgical. Timely and immediate opening of the abscess, its cleaning and installation of drainage guarantee the preservation of full functionality of the organ in the future.

In addition, treatment is prescribed for the pathology that caused the abscess (mastitis, cysts, cracks, etc.), and measures are taken to prevent the recurrence of the abscess. Antibiotic therapy is administered (cephalosporins are prescribed - cefazolin, cephalexin; fluoroquinolones - ofloxacin, moxifloxacin; aminoglycosides - kanamycin, tobramycin, amikacin, isepamycin), intravenous administration of detoxifying solutions, and immunostimulant therapy. To eliminate pain, analgesics are prescribed (over-the-counter: paracetamol, analgin).

If a breast abscess has formed during breastfeeding, then breastfeeding from the affected breast is stopped throughout the entire course of treatment and recovery.

After the acute process has been eliminated, physiotherapy and therapeutic massage are prescribed.

Prevention

In order to prevent breast abscess, you should carefully follow the rules of personal hygiene:

• wash your hands under running warm water using soap immediately before each feeding or pumping procedure;
• Every day, wash the glands with warm water and detergent (avoiding the nipple area) and change your bra to a clean one;
• Every day, for a short period of time, you should leave your breasts uncovered;
• if cracks appear, you can use sea buckthorn or peach oil, vitamin A solution, Bepanten or Purelan ointments;
• when using breast pads, it is necessary to change them on time;
• the baby must be fed until he releases the breast himself, or carefully taken away from the breast, helping with the little finger, opening his mouth and releasing the breast;
• do not allow milk to stagnate, express milk regularly;
• avoid hypothermia and chest injury;
• Treat mastitis and other inflammatory processes in the gland in a timely manner, strengthen the immune system, and eat right.

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Forecast

Timely visit to a doctor and treatment of the disease guarantees a favorable prognosis for life and preservation of the functionality of the gland. Limitation of working capacity is observed only during the period of illness.

Incorrect and late treatment carries the risk of forced removal of the affected organ, since in advanced cases cicatricial changes in the gland, purulent tissue melting and the formation of fistulas with purulent and milky discharge may be observed.

To prevent complications and start treatment in time, you should consult a doctor if you feel pain in the gland, notice redness, compaction, if your temperature rises, if symptoms of intoxication appear: headache, muscle pain, nausea and vomiting.

A breast abscess is not so scary if measures to eliminate it are taken in time.

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