Breast abscess
A breast abscess is a collection of pus that forms - usually just under the skin of the breast.
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Book an appointment onlineWhat is a breast abscess?
A painful pocket of pus can build up within breast tissue when a bacterial infection takes hold, forming what's known as a breast abscess. This most often follows from an earlier breast infection, mastitis, that hasn't cleared up in time.
What symptoms does a breast abscess cause?
A breast abscess usually shows up as a lump or area of swelling in the breast, alongside:
- pain, and skin that feels warm or looks red, though in people with darker skin tones this redness can be much harder to notice
- a tender, firm area of breast tissue
- a raised temperature
- an overall sense of feeling unwell
- occasionally, fluid leaking from the nipple.
What are the causes of a breast abscess and who is at risk?
Most breast abscesses follow on from a case of mastitis that hasn't settled quickly enough. Mastitis often starts when bacteria get into the breast tissue through a cracked or damaged nipple, or when a build-up of milk in the breast (common during breastfeeding) creates the conditions for infection to take hold.
Your chances of this go up if you:
- have had mastitis in the recent past, or an abscess before
- are breastfeeding, particularly with a cracked or sore nipple
- smoke, live with diabetes, or are above a healthy weight, all of which are linked to abscesses outside of breastfeeding
- have a nipple piercing.
Are there different types of breast abscess?
Breast abscesses are broadly grouped into two types. Lactational abscesses develop during breastfeeding and are the more common type, usually caused by bacteria such as Staphylococcus aureus entering through the nipple.
Non-lactational abscesses happen outside of breastfeeding, often involving a broader mix of bacteria, and tend to affect a slightly older age group. Because they're less common and less predictable, doctors are generally more cautious about ruling out other explanations, including underlying diabetes or, rarely, a cancer that's mimicking an abscess.
How is a breast abscess diagnosed?
A doctor will examine your breast and ask about your symptoms. If mastitis seems the most likely explanation, you may be started on antibiotics without further tests at this stage.
Where an abscess is suspected, you'll usually be referred to a breast clinic for scanning with ultrasound, which can confirm a pocket of pus and distinguish it from other causes of breast swelling. If there's any discharge, a sample may be sent for testing to help guide which antibiotics to use. Occasionally, a needle sample is taken to confirm the diagnosis before treatment begins.
How is a breast abscess treated?
The pus needs to be drained for the abscess to heal. Increasingly, this is done with a fine needle drawing the fluid out, often guided by ultrasound imaging, and may need repeating over a few visits if fluid builds up again.
Where the abscess is large, doesn't respond to needle drainage, or the overlying skin is at risk of breaking down, a small surgical cut may be made instead to let the pus drain more fully. Both approaches are usually done under local anaesthetic, so you shouldn't feel pain during the procedure, and most people are able to head home again on the same day.
You may also be given a course of antibiotics, either alongside drainage or beforehand while waiting for a hospital appointment. People with a large abscess or signs of a more widespread infection may need admission to hospital for closer monitoring and antibiotics given directly into a vein.
The abscess should heal fully within a few days to a few weeks.
When should I see a doctor?
See a GP urgently, or contact NHS 111, if your breast turns red, feels painful, or you notice a lump or swelling. If you're started on antibiotics for a suspected infection, go back to your GP if things haven't improved within 2 days.
Seek immediate medical help if you also develop a rapid heartbeat, shivering or chills, or start to feel seriously unwell, as these can be signs that the infection is spreading more widely.
FAQs
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Can I carry on breastfeeding if I have a breast abscess?
You may be advised to continue to feed from both breasts where you can, since this doesn't harm your baby and may help your breast heal, with expressing by hand or pump as an alternative if feeding is too painful.
Sometimes it may be recommended to avoid feeding from the affected breast until the infection has cleared, to reduce any risk of passing infection to your baby, so it's worth asking your doctor or midwife what they'd suggest for your situation.
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Does a breast abscess mean I have breast cancer?
Almost always, no, an abscess is an infection rather than cancer. Because the two can occasionally look similar, especially if you're not breastfeeding, over 50, or the lump doesn't resolve as expected, your doctor may arrange extra tests or a specialist referral to rule cancer out.
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Can men get a breast abscess?
Yes, although it's rare. The large majority of breast abscesses happen in women, but men can develop them too, usually linked to similar risk factors such as infection or skin damage around the nipple.
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What's the difference between mastitis and a breast abscess?
Mastitis is inflammation of the breast tissue, which may or may not involve infection, and often responds to antibiotics or better milk drainage alone. An abscess takes this further: a distinct, walled-off pocket of pus that generally needs draining rather than antibiotics alone.
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Why do breast abscesses happen in women who aren't breastfeeding?
Non-lactational abscesses are more often linked to smoking, diabetes, obesity, or damage to the nipple such as a piercing. They tend to have a higher chance of coming back than abscesses linked to breastfeeding and sometimes need more than one round of drainage.