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A breast abscess is an encapsulated accumulation of pus within the breast tissue that most commonly results from puerperal mastitis. Nonpuerperal abscesses are uncommon and may be caused by trauma. Breast abscesses typically manifest as a tender, erythematous breast mass with or without systemic signs of infection, such as fever. The diagnosis is primarily clinical, but imaging and aspiration are often required for confirmation and to guide management. Treatment involves drainage, antibiotics, and analgesia.
- Commonly a complication of mastitis, especially puerperal mastitis 
- Nonpuerperal abscesses (uncommon) may be caused by trauma and are associated with obesity, cigarette smoking, and immunosuppression. 
- Polymicrobial infections with aerobic and anaerobic bacteria are common; see “ ” for details.
Breast ultrasound 
- Indications: initial imaging modality for suspected breast abscess 
- Findings 
- Nonpuerperal abscesses (after the acute phase) 
- Prolonged symptoms in a lactating woman
- Findings: asymmetrical mass or architectural distortion with skin thickening
Abscess drainage 
- Percutaneous drainage; : first-line for abscesses with intact overlying skin 
- ; : Consider for multiloculated or large abscesses, necrosis of overlying skin, or failure of percutaenous drainage. 
Antibiotic treatment 
- See “.”
- Tailor therapy based on cultures.