BREAST INFECTION
- Breast abscess is a collection of pus in the breast which is a complication of mastitis. Once a pus collection develops in the breast, it often requires a drainage procedure and rarely improves with antibiotics alone
- It is important to differentiate mastitis from inflammatory breast cancer, as both can present with similar signs and symptoms. A breast specialist should be consulted as soon as possible to initiate investigation and appropriate treatment
- Mastitis is the inflammation of the breast tissue with or without bacterial infection. Symptoms include breast pain, swelling and redness, sometimes associated with fever and lethargy. It is common during breastfeeding. The bacteria from baby’s mouth infect breast tissue through cracked nipples. Incomplete emptying of the breasts during each feed or poor latch increases this risk. Mastitis may also occur in diabetics, smokers or those on steroids
In breast feeding women, breast feeds at regular intervals are advisable. After each feed, the breasts should be completely emptied with the help of a breast pump to avoid stagnation of milk. Cracked nipples should be avoided as the bacteria from the baby’s mouth can enter through them. Smoking and tobacco intake in any form should be avoided as they increase the risk of abscesses
Breast feeding can be continued during a breast infection as the bacteria causing these infections are usually already living in the baby’s mouth. Only those antibiotics which are safe during breast feeding should be prescribed
Once a pus collection develops in the breast, it often requires a drainage procedure and rarely improves with antibiotics alone. Pus can be drained in one of the following ways:
- Ultrasound guided Aspiration- Under ultrasound guidance, the pus is aspirated using a needle. The sample is then sent for culture and sensitivity to guide antibiotic treatment. Multiple aspirations may be required in few cases
- Surgical Incision and Drainage- This procedure is done in the operation theater under short general anesthesia. The surgical incision is usually placed in a way that allows the mother to continue breast feeding after surgery. Following abscess drainage, daily dressings are requires to allow complete wound healing
Pregnancy associated breast cancer is a special type of cancer that can occur during pregnancy and in the first two years following pregnancy. During this period, the symptoms and signs of breast cancer are often confused with expected changes associated with pregnancy, leading to a delay in diagnosis. A breast specialist should be consulted as soon as possible to initiate investigation and appropriate treatment
Abscesses are pockets of pus and during surgery these pockets are opened to remove pus and unhealthy tissue. If the wounds are immediately sutured, pus reaccumulates in the pocket and the stitches open up. Abscess wounds are hence left open, to allow healing from inside, healthy tissue grows from inside and fills up the pocket. Daily dressings are needed that may last days to weeks
Repeated breast abscesses can occur in smokers, diabetics and patients with a compromised immune system such as patients on steroids, immunosuppressive medications, HIV. Abscesses that occur in patients outside the setting of pregnancy or breast feeding or patients with recurrent abscess should be evaluated by a breast specialist
