A breastfeeding woman presents with a discrete tender lump in the breast, which may be tense or fluctuant. This pattern — distinct from mastitis alone — represents a localised abscess collection in the breast tissue, potentially arising as a complication of bacterial mastitis that progressed rapidly or was not managed promptly. This pathway applies where the patient has no allergy to penicillin.
Where specialist breast clinic access or ultrasound guidance is available, aspiration of the abscess collection combined with antibiotic cover is the safe first-line approach, with antibiotic selection guided by microbiological culture and sensitivity of the aspirated fluid. Management also includes supportive measures targeting breast drainage and pain relief.
A breast abscess, a localised collection in the breast tissue that results in a painful breast lump, is potentially secondary to bacterial mastitis that is rapidly progressive or is not managed expeditiously.
Breast abscess is characterised by symptoms similar to mastitis, with the additional sign of a discrete tender lump, which may be tense or fluctuant.
Aspiration with antibiotic cover is a safe first line approach where specialist breast clinics or ultrasound guidance are available.
For abscess – guided by microbiological culture and sensitivity.
Women with mastitis should be reviewed within 24–48 hours to ensure that the inflammation is settling.
View source ↗