Sandbox: Breast Abscess

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Synonyms and keywords: Mammary abscess

Classification

Breast Abscess may be classified according to site and clinical presentation into subtypes.

• Site: subcutaneous, subareolar, interlobular, central and retromammary.
• Clinical presentation: Lactational and Non-Lactational.

Pathophysiology

Following untreated Mastitis, Breast abscess could occur. Breast Abscess is mostly caused by staph aureus bacterial infection to an injured breast skin. The bacteria secrets killing substances that necrotize the tissue. The tissue secrets immune cells that help in killing the bacteria. However, these cells cause damage to the tissue forming abscess as well. As the breast abscess is the complicated form of mastitis, the pathophysiology is mostly like the mastitis pathophysiology.

Pathogenesis

Breast abscess pathogenesis depends on the lactation condition of the woman.

• Lactational:
  • Injured breast skin allows the entrance of the bacteria to the mammillary ducts. This bacteria can be from the infant or the mother herself. Overproduction of the breast milk with no flow to the infant forms a good field for the bacteria to cause infection.
  • Breast Duct Ectasia: Metaplastic change of the duct cells can cause duct ectasia. This change causes widening of the ducts lining which leads to thickening of the ducts and obstruction. The ducts become filled with fluid which leads to nipple discharge and infection by the entrance of the bacteria and can form pus and abscess as a final result.

• Non-Lactional:

Non lactational breast abscess is less