Breast abscess

Definition of breast abscess

A breast abscess is usually the full picture of an inflammation, also known as mastitis / breast inflammation.It is initially an acute inflammation of the mammary gland. The causative agent of inflammation is most often Staphylococcus aureuswhich is initially transferred to the infant in the hospital from the nursing staff or from the mother. The transmission path back to the mother occurs during breastfeeding. After the pathogens have penetrated the chest, there is usually a reddish circumscribed area, mostly in the upper outer quadrant. The entire glandular body is rarely affected.

With inflammation of the mammary gland, the typical inflammation symptoms can be recognized, which consist of reddening, overheating, swelling and pain. Often they are Lymph nodes the armpit swollen and the Body temperature the patient is lying above 38 degrees Celsius. In the early stages, this inflammation is also known as phlegmon. There is an urgent need for action as there is a risk of encapsulation occurring, which is then referred to as a breast abscess.

More information on the subject Breast abscess see the main article abscess.

Symptoms of a breast abscess

Typical symptoms are:

  • Pain
  • Redness
  • overheat
  • Feeling of tension
  • Swelling of the lymph nodes

In many cases, a breast abscess arises from simple inflammatory processes in the area of ​​the mammary glands. For this reason, the symptoms of mastitis are similar (mastitis) and breast abscess very severe.

In most cases, the affected women notice a painful lump in the breast region very early on.

Redness in a breast abscess

Typical symptoms that occur in the presence of a breast abscess are redness that either occurs locally or even covers the entire breast surface.

However, in most cases this symptom appears as a coin to palm-sized skin abnormality.
This reddening is one of the first symptoms that indicate the presence of a breast abscess.

For this reason, if a noticeable lump and reddening are visible, a specialist in gynecology (gynecologist) can be visited.

Overheating from the breast abscess

In addition, a significant overheating can be felt in the area of ​​the affected breast.
Many women who suffer from breast abscesses even report some kind of heat that spreads over the abscess cavity. Since a breast abscess is the inflammation-related formation of a cavity filled with pus, the affected breast can significantly increase in size.

Please also read our article on this Swelling of the chest

Feeling of tension

Furthermore, a pronounced feeling of tension is one of the most common symptoms that are described in connection with a breast abscess.
Many of the affected patients also suffer from pain, sometimes severe.
The pain symptoms that occur in the course of a breast abscess can either be limited to the glandular tissue or even radiate into the armpit.

In many cases, the inflammatory processes within the chest region mean that the affected patient is no longer able to raise the arm adequately.

Even the attempt to raise the arm of the affected half of the body to a 90 degree position is described by the majority of women as extremely painful.

In addition, the fact that active warming aggravates the pain symptoms, whereas putting on a cooling pad is perceived as relief, is a typical symptom of a breast abscess.

Pronounced disease courses and / or very large breast abscesses are also associated with general symptoms.

Many of the affected patients have an increased body temperature (fever), Fatigue and malaise.

Lymph node swelling in a breast abscess

Furthermore, the lymph nodes in the chest and chest area can swell significantly. Especially the lymph nodes of the armpits (axillary lymph nodes) are often particularly sensitive to pressure in the presence of a breast abscess.

Other symptoms of a breast abscess

In addition to these general symptoms of a breast abscess, there are some warning signs that require immediate medical attention.

These particular symptoms include:

  • Deconsciousness or loss of consciousness
  • Breathlessness or rapid breathing
  • Sharp decrease in urine output
  • High fever

Pain in a chest abscess

As part of a breast abscess, various types of pain of various degrees can occur. The accumulation of pus and the swelling of the chest can cause mild to very severe tension pain.

In addition, certain messenger substances are released as part of the inflammatory process. These are used for communication between the cells. They can activate the pain receptors. Finally, the sensory perception of pain is reported to the brain. A breast abscess can sometimes lead to very severe pain.

In addition, arm movement can be restricted and painful due to the swelling of the chest. Often the lymph nodes in the armpit are also swollen. In many cases these are painful to the touch. Body aches and headaches can also occur. Depending on where the breast abscess developed, the pain can be extremely severe. Non-drug and limited drug measures are available to treat pain. Only a few painkillers are allowed during breastfeeding. Advice from the attending gynecologist is advisable.

Breast abscess without pain

In some cases, breast abscesses can be pain-free. However, those affected often report a feeling of tension or that it feels like something is wrong. This should definitely be investigated. A recurrence of the breast abscess is often painless. This means that if an apparently healed breast abscess forms again, it can show atypical symptoms. If the breast abscess is not externally noticeable and does not cause pain, it does not mean that it is absent. An ultrasound examination can provide information.

Even a painless, invisible abscess must be treated to avoid complications.

Treatment of the breast abscess

How do I treat a breast abscess?

In the initial stage, an inflammation or abscess should be cooled and immobilized. In breastfeeding mothers, breast milk should be pumped out and discarded in order to avoid obstructive milk. Furthermore, it must be assumed that the breast milk is colonized with germs in the event of an inflammation of the mammary gland and must no longer be fed to the child.

In the early stages, an inflammation or abscess is treated with antibiotics. At an advanced stage, in addition to expressing the milk, the production of breast milk is inhibited with medication. These are drugs such as Bromocriptine, lisuride or Gabergoline administered. In the late stages of an abscess, heat treatment with a red light consisting of short waves should accelerate the melting process. Smaller abscesses are punctured, larger ones are incised and rinsed.

Read more on this topic at: Treatment of an abscess

Homeopathy for a breast abscess

Some women benefit from homeopathic treatment in addition to medicinal and surgical measures. For example, Hepar sulfuris and Mercurius solubilis can have a supportive effect on medicinal and surgical interventions. The potentization in the treatment of a breast abscess is usually C 12. However, a different potentiation can also be useful on an individual basis. Arnica is often recommended if the breast abscess is the result of a breast infection. Complexing agents are also recommended by homeopaths. A commercial preparation is, for example, Naranotox plus®.

Antibiotics for breast abscesses

Because a breast abscess is a bacterial inflammation, antibiotics are often used in different ways. Depending on the severity, type, localization and individual conditions, antibiotic treatment is carried out orally in tablet form, as part of infusions, locally in the form of so-called pull ointments or with the help of antibiotic carriers that are introduced into the affected area during an operation.

You might also be interested in this topic: Betaisodona spray

Puncturing a breast abscess

At the Dotting of a breast abscess is a minimally invasive methodto remove the pus that has built up in the chest. This is the common method used when there is a breast abscess.

First of all, the puncture site is numbed locally before a thin, hollow needle is inserted into it. The puncture is performed under ultrasound guidance so that doctors can see exactly where the needle is going and when the pus has reached it. The pus is then drained to the outside via a cannula and, under certain circumstances, passed through beforehand Saline solution liquefied.

In some cases, the cannula is initially left in the chest and the exit point only with it Adhesive tape (Steristrips) held together, softly padded and connected. This allows pus, which may form again, to drain off even after the procedure. In addition, an antibiotic is usually required after the puncture, as the accumulation of pus was mostly caused by bacteria.

Surgery for a breast abscess

Breast abscesses don't necessarily have to be treated with surgery.

Especially in the case of small, uncomplicated abscesses, initially cooling compresses and / or quark compresses should be placed on the surface of the chest.
In many cases, these conservative treatment measures already lead to a significant reduction in the accumulation of pus.

The women concerned should also take care to relieve the affected breast and, for example, wear a tight bra.

In addition, surgery can often be bypassed by taking various drugs. Since a breast abscess is an accumulation of pus induced by inflammatory processes and bacterial colonization, anti-inflammatory medication and an antibiotic should usually be taken.

If these treatment methods are not successful within a very short time, an operation should be considered as soon as possible.

In addition, large breast abscesses and those breast abscesses that are in critical positions should always be treated with the help of an operation.
In most cases, breast abscess surgery can be performed under local anesthesia.

Anesthesia is only necessary in exceptional cases or at the request of the patient concerned.
In this context, however, it should always be weighed whether the benefits of general anesthesia outweigh the risks to the cardiovascular system.

During the operation on the breast abscess, the surface of the skin overlying the accumulation of pus is opened under sterile conditions.

Usually this is done through a small incision (Incision) with the scalpel.
The pus in the abscess cavity can then be drained and the wound rinsed.

In the case of a breast abscess caused by bacterial pathogens, it is particularly important to thoroughly clean the abscess cavity even after the pus has been removed.

The skin surface can then be left open or closed with a small suture.
In some cases, a drain must be placed in the cavity of the breast abscess.
In this way, a continuous outflow of the breast abscess content can be guaranteed.

After surgery for a breast abscess, healing should be observed for several weeks.

For this reason, it is important that the affected patient attends regular follow-up appointments even after successful breast abscess surgery.

In addition, even after the abscess cavity has been completely emptied, there is a possibility that a breast abscess may form again in the same place.

The abscess as a danger?

The breast abscess is usually the complication of an acute breast inflammation, which means that it is also associated with redness, overheating and pain. However, it also manifests itself as a delimited and palpable hardening or as a lump.
An intensified inflammatory reaction is shown, for example, by swelling of the axillary lymph nodes or the occurrence of fever. In general, prompt drug therapy and, if necessary, surgical opening and cleaning of the abscess is necessary.

If this is not done, there is a risk that the inflammation will spread and pathogens penetrate into the vascular system, causing a systemic inflammatory reaction (sepsis) or get into other organs and trigger further inflammatory changes there.
There is a risk of developing a life-threatening clinical picture.

diagnosis

The visual diagnosis gives a first indication of an inflammation. An ultrasound of the breast then shows the classic division of the abscess, which consists of a blurred edge, a hypoechoic mass and a hyperreflective content.

Duration of a breast abscess

Often times, a breast abscess is the result of a breast infection. If left untreated, it can become chronic. The result is often a breast abscess. A mature breast abscess does not usually go away on its own. It requires a treatment that consists of different components.

The time it takes to heal wounds after surgery varies widely. The earlier the treatment and the stronger the immune system, the faster the healing process will take place. The later the treatment and the weaker the immune system, the longer it will take to recover.

The duration can therefore be a few days to a few weeks. In some cases, the healing process can take months. If the breast abscess doesn't heal completely, it can keep coming back. Medical advice and treatment cannot be avoided. Even when the symptoms subside, regular checks and, if necessary, supportive measures are advisable.

Course of the disease without fever

Very rarely does abscesses form without developing a fever. Because abscesses are often caused by bacteria, in most cases there will be a general inflammatory response in the body, including a fever.

In rare cases, the typical symptoms of breast abscesses may not appear. Only red spots can appear on the chest without fever and possibly without pain. One speaks of one atypical course of the clinical picture. Nevertheless, the disease is the same and, as soon as it is recognized, it must be treated accordingly.

It is therefore very important to have breasts under observation while breastfeeding. The tiniest signs of inflammation should be reported to the doctor in order to rule out a breast inflammation, which could possibly develop into a breast abscess.

Healing a Breast Abscess

As a rule, a breast abscess has a very good prognosis.

In most cases, timely and adequately initiated treatment can achieve complete healing of the breast abscess. The affected patients must be aware, however, that it can take several weeks for the healing to be complete, even with medical therapy.

In addition, it takes some perseverance and discipline to promote the healing of the breast abscess. For the affected patients, it is important to pay particular attention to wound hygiene when caring for the breast abscess. The breast abscess should never be touched with your fingers, even when applying special ointments!

Ideally, protective gloves should always be worn when treating wounds during healing.
After the treatment, the hands must be washed and disinfected thoroughly. The time it takes for the breast abscess to heal completely can also be shortened by avoiding excessive tension on the wound surface.

After a breast abscess has been surgically opened and the abscess cavity has been emptied, a sample is usually sent to a special laboratory.
This sample can be examined for various germs in the pus. As soon as the causative bacterial pathogen is known, the targeted intake of an antibiotic can be ordered.
In this way, too, it is possible in most cases to shorten the time to complete healing.

In patients who suffer from general immune deficiency or diabetes mellitus, the healing of a breast abscess may be disturbed and consequently expensive treatment may be necessary.

Breast abscess in men

Breast abscesses can also occur in men. This is however significantly less often than with the woman. In most cases, it assumes that the nipple is inflamed (mastitis). In contrast to women, in whom it occurs mainly after childbirth, there are other causes for the development of a breast abscess in men. This includes, among other things, the pricking of a Nipple piercings. Through the puncture, bacteria can penetrate the breast tissue and lead to a purulent inflammation here. This can also occur due to other injuries in the chest area. In some cases, rubbing clothes while running can cause minor nipple injuries that allow bacteria to migrate.

Breast abscesses are mainly found in men who have breasts very similar to that of women (Gynecomastia). This happens because of being overweight or because of a liver or hormone disorder.

As with women, the therapy takes place through antibiotic therapy and possibly a puncture of the abscess to drain the pus.

Abscess during breastfeeding

If you have an abscess resulting from a breast infection (mastitis) can be used in the in most cases the child continued to breastfeed become. Therapy consists of a puncture of the abscess and possibly an additional antibiotic therapy. When choosing the antibiotic, care must be taken to ensure that it is harmless to the breast-fed child.

If the abscess has to be opened surgically, this should be done in one Initial stage done so that the restrictions on breastfeeding are as low as possible. After the operation, you do not necessarily have to wean. At first you can breastfeed unilaterally until the wound on the other side has healed sufficiently. Then you can begin breastfeeding on both sides of the breast again.

If major surgery is required because of the advanced size of the abscess or if there are complications during treatment, breastfeeding should be weaned to avoid unnecessary stress on the child. However, since this happens extremely rarely, breastfeeding can be continued in most cases.