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Chapters

0:00 Introduction
0:23 Causes of Breast Abscess
1:28 Symptoms of Breast Abscess
2:15 Diagnosis of Breast Abscess
2:54 Treatment of Breast Abscess


Mastitis is inflammation of the breast or udder, usually associated with breastfeeding.[1][5][6] Symptoms typically include local pain and redness.[1] There is often an associated fever and general soreness.[1] Onset is typically fairly rapid and usually occurs within the first few months of delivery.[1] Complications can include abscess formation.[2]

Risk factors include poor latch, cracked nipples, use of a breast pump, and weaning.[1] The bacteria most commonly involved are Staphylococcus and Streptococci.[1] Diagnosis is typically based on symptoms.[2] Ultrasound may be useful for detecting a potential abscess.[1]

Prevention is by proper breastfeeding techniques.[2] When infection is present, antibiotics such as cephalexin may be recommended.[2] Breastfeeding should typically be continued, as emptying the breast is important for healing.[2][1] Tentative evidence supports benefits from probiotics.[1] About 10% of breastfeeding women are affected.[2]
When it occurs in breastfeeding mothers, it is known as puerperal mastitis, lactation mastitis, or lactational mastitis. When it occurs in non breastfeeding women it is known as non-puerperal or nonlactational. Mastitis can, in rare cases, occur in men. Inflammatory breast cancer has symptoms very similar to mastitis and must be ruled out.

The symptoms are similar for puerperal and nonpuerperal mastitis but predisposing factors and treatment can be very different.
Pregnancy related
An ultrasound image of puerperal mastitis

Puerperal mastitis is the inflammation of the breast in connection with pregnancy, breastfeeding or weaning. Since one of the most prominent symptoms is tension and engorgement of the breast, it is thought to be caused by blocked milk ducts or milk excess. It is relatively common; estimates range depending on methodology between 5–33%. However, only about 0.4–0.5% of breastfeeding mothers develop an abscess.[7]

Some predisposing factors are known but their predictive value is minimal. It appears that proper breastfeeding technique, frequent breastfeeding and avoidance of stress are the most important factors that can be influenced.

Light cases of mastitis are often called breast engorgement; the distinction is overlapping and possibly arbitrary or subject to regional variations.
Non pregnancy related
Main article: Nonpuerperal mastitis

The term nonpuerperal mastitis describes inflammatory lesions of the breast occurring unrelated to pregnancy and breastfeeding. This article includes description of mastitis as well as various kinds of mammary abscesses. Skin related conditions like dermatitis and foliculitis are a separate entity.

Names for non-puerperal mastitis are not used very consistently and include mastitis, subareolar abscess, duct ectasia, periductal inflammation, Zuska's disease and others.

Periductal mastitis is a form of nonlactational mastitis, and is characterized by inflammation of the subareolar ducts. Although the cause of periductal mastitis is currently unknown, it is predicted that smoking may be related. This condition is mainly seen in young women but can also be seen in men.[8]
Signs and symptoms
Mastitis localized on the underside of the breast, with a large area of inflammation.

Lactation mastitis usually affects only one breast and the symptoms can develop quickly.[9] It develops into three stages, from the initial stage, the pus formation stage, to the restoration stage.[10] The signs and symptoms usually appear suddenly and they include:

Breast tenderness or warmth to the touch
General malaise or feeling ill
Swelling of the breast
Pain or a burning sensation continuously or while breast-feeding
Skin redness, often in a wedge-shaped pattern
Fever of 101 F (38.3 C) or greater[11]
The affected breast can then start to appear lumpy and red.

Some women may also experience flu-like symptoms such as:

Aches
Shivering and chills
Feeling anxious or stressed
Fatigue[12]