Breast Abscess in Mastitis Not Settling After Aspiration
This protocol addresses mastitis complicated by a breast abscess — a localised collection presenting as a discrete, tender lump — in cases where the initial aspiration-based approach has not achieved the expected resolution.
Clinical Scenario
A breast abscess is a localised collection in the breast tissue that produces a painful breast lump, potentially arising as a complication of bacterial mastitis that is rapidly progressive or not managed expeditiously. It is characterised by a discrete, tender lump in the breast, which may be tense or fluctuant.
When the Previous Treatment Has Not Worked
The recommended first-line approach — aspiration of the abscess collection with antibiotic cover, guided by microbiological culture and sensitivity where specialist breast clinics or ultrasound guidance are available — has not achieved the expected goal: inflammation of the breast settling within 24–48 hours. This protocol is the defined next step when that threshold has not been met.
Next Step
References
- 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.
- Incision and drainage if not settling or aspiration is unavailable.