What is surgery – Breast Abscess Symptoms

What is surgery – Breast Abscess Symptoms 

DEFINITION 
Infection in the breast tissue with pus accumulation. Puerperal (lactational) and non-puerperal are the two basic types. 

AETIOLOGY 
Lactational: Milk stasis caused by infection, usually caused by Staphylococcus aureus or coagulase-negative staphylococci. S. aureus and anaerobes, most commonly enterococci or Bacteroides spp., are non-puerperal (TB and actinomycosis are rare causes). Smoking, mammary duct ectasia/periductal mastitis, and inflammatory breast cancer associated with it should all be ruled out. Infections after breast surgery, diabetes, and steroid medication are also linked to this condition. 

EPIDEMIOLOGY 
Lactational breast abscesses are prevalent and usually appear shortly after starting to breastfeed and shortly after weaning, when inadequate emptying of the breast causes stasis and engorgement. Non-lactational abscesses are more common in smokers and individuals between the ages of 30 and 60. 

HISTORY 
The patient is experiencing discomfort and has developed a severe swelling in a breast location. She may complain of being unwell and having a temperature. Systemic upset is frequently less apparent in women with a non-puerperal abscess who have a history of previous infections.

EXAMINATION
Local: Swollen, warm, and tenderness are present in the breast area. The skin above it may be irritated, and a nipple examination may reveal cracks or fissures. There may be scars or tissue deformation from prior occurrences in non-puerperal patients, as well as symptoms of duct ectasia, such as nipple retraction. Pyrexia and tachycardia are systemic symptoms. 

INVESTIGATIONS
Imaging: Microscopy, culture, and sensitivity of pus samples using ultrasound and aspiration. 

MANAGEMENT 
Medical: Antibiotics (flucloxacillin in lactational abscesses, plus metronidazole in non-puerperal abscesses) may be used in the early cellulitic phase. Breast drainage should be done on a regular basis to avoid milk stasis. Surgical: Lactational: Daily needle aspiration with antibiotic cover seemed to be effective. 

Larger abscesses (>5 cm) require a formal incision and drainage. The incision should allow for complete drainage and is cosmetically pleasing; the loculi are investigated and broken down. The wound can be softly packed and left open, with daily packing, or it can be closed completely. Breastfeeding should be continued from the non-affected breast, with the afflicted breast emptied manually or with a breast pump. Advice on how to keep your nipples from cracking. Non-puerperal: Open drainage or drainage through a minor incision should be avoided. Once the infection has subsided, the affected duct system should be excised for definitive treatment. 

COMPLICATIONS
Slow wound healing, breastfeeding difficulties, poor cosmetic outcome, and mammary fistula formation; overlaying skin necrosis is rare. 

PROGNOSIS
A breast abscess will eventually develop and discharge onto the skin surface if left untreated. Non-puerperal abscesses are more likely to reoccur than puerperal abscesses.