Breast Abscess

Overview

A breast abscess is a painful collection of pus that forms inside the breast. It usually happens when bacteria get into the breast and cause an infection. The body sends white blood cells to fight the infection, and these cells, along with dead tissue and germs, collect into a pocket of pus. A breast abscess feels like a hard, tender lump and can make the surrounding area red, swollen, and warm.

Breast abscesses are not very common, but they do happen. They occur most often in women who are breastfeeding, especially in the first few months after giving birth. Outside of breastfeeding, breast abscesses are much rarer but can still occur, particularly in people with certain risk factors.

A breast abscess can affect anyone, but it is most common in women who are breastfeeding. It can also affect women who are not breastfeeding, and rarely men. People with diabetes, a weakened immune system, or those who smoke may have a higher risk. It can happen at any age, though it is uncommon in young children.

Symptoms

Common symptoms

• A tender or painful lump in the breast
• Redness and warmth of the skin over the lump
• Swelling of the breast
• A feeling of general illness, such as tiredness or aches
• Fever or chills
• Thick, foul-smelling discharge from the nipple (less common)

Symptoms in children

• Breast abscess in children is rare, but if it happens, the affected area may be red, swollen, and painful
• The child may have a fever and be generally fussy or unwell
• There may be a small, hard lump under the skin near the nipple

Symptoms in older adults

• An older adult may have a tender breast lump with redness and heat, but symptoms might be less obvious
• They may feel generally weak, confused, or more tired than usual
• If diabetes or poor circulation is present, the infection may progress more quickly and feel more severe

Causes

Main causes

• A bacterial infection, most often Staphylococcus aureus, that enters the breast through a cracked or sore nipple
• Milk duct infection (mastitis) that is not fully treated, which can develop into an abscess
• An infection caused by a blocked or clogged milk duct, which creates a pocket where bacteria can grow
• Skin infections that spread into the breast tissue through small cuts or hair follicles
• A breast injury that leads to an infected haematoma (a collection of blood that becomes infected)

Risk factors

• Breastfeeding, particularly if your baby has thrush or you have cracked nipples
• Being a smoker, because smoking can damage breast tissue and make it harder to fight infection
• Having diabetes, especially if blood sugar levels are not well controlled
• Having a weakened immune system due to illness or medication
• Having a breast piercing, which can introduce bacteria
• Having had a breast abscess before, as it can come back

When to see a doctor

See a doctor urgently if:

• If you have a painful breast lump that is growing or becoming more tender
• If you have a breast infection (mastitis) that does not improve within 24 to 48 hours of self-care and any recommended medicines
• If you have a fever, chills, or feel unusually unwell with a breast lump

Book a routine appointment if:

• If you feel a new lump in your breast that is not getting better after a week
• If you notice redness or warmth in the same spot on your breast more than once
• If you have ongoing nipple discharge or skin changes on your breast

Diagnosis

A doctor will start by asking about your symptoms and doing a physical examination. They will feel the breast to check the size, tenderness, and location of the lump. Because a breast abscess can sometimes look or feel like a tumour, the doctor may need to do further tests to be sure.

Tests that may be done

• An ultrasound scan, which is the most common test to see if a breast lump is an abscess or a solid mass
• A blood test to check for signs of infection, such as a high white blood cell count
• A sample of the pus or fluid, if it is drained, can be sent to a lab to identify which bacteria are causing the infection
• A mammogram (breast X-ray) may be recommended in certain cases, especially for women over 35 or if there is any concern about breast cancer

What to expect at your appointment

Usually the doctor can make a diagnosis based on the physical exam and an ultrasound. If an abscess is found, the doctor will discuss treatment with you. This may include draining the pus, which is often done in the clinic, and prescribing antibiotics. The whole process is usually straightforward, and you will be given advice on how to take care of yourself while the infection clears.

Treatment

The main treatment for a breast abscess is to drain the pus and to clear the infection. This is usually done with a needle or a small cut in the skin, and antibiotics are given to fight the bacteria. Early treatment helps relieve pain quickly and prevents the infection from spreading. If you are breastfeeding, you will get advice on how to continue safely.

Self-care at home

• Apply a warm, clean compress to the affected breast several times a day to help with pain and encourage drainage, as advised by your doctor
• Take over-the-counter pain relievers that are suitable for you, after checking with your pharmacist or doctor
• If you are breastfeeding, keep the breast clean and dry between feeds, and talk to a lactation consultant about the best way to continue feeding or expressing
• Rest and drink plenty of fluids to help your body fight the infection
• Do not squeeze or try to pop the abscess yourself, as this can spread the infection

Medical treatments

Medical treatment for a breast abscess usually involves draining the pus and taking antibiotics. The abscess may be drained using a needle (aspiration), sometimes with ultrasound guidance, or by making a small cut to let the pus out. In some cases, a small drain may be left in place for a day or two to allow repeated drainage. Antibiotics are prescribed to treat the underlying infection, and it is important to take the full course exactly as your doctor advises. You may be given pain relief to manage discomfort. If you are breastfeeding, your doctor may advise you on safe antibiotics and how to manage feeding from that breast.

When is surgery considered?

Surgery is not usually the first option, but it may be needed if the abscess cannot be fully drained with a needle, if it keeps coming back, or if it is very large. A small operation cuts open the abscess to drain it completely, usually done under local or general anaesthetic.

Living with this condition

For a few days after treatment, you may need to take it easy and avoid strenuous activity that could cause pain. You may need to wear a supportive, comfortable bra. If you have a small drain in place, you will be shown how to care for it and when to come back to have it removed. Take all your antibiotics as prescribed, even if you start to feel better, to make sure the infection is fully gone.

Lifestyle tips

• Keep the area clean and dry to prevent further infection
• Avoid tight clothing or anything that presses on the tender area
• If you smoke, consider stopping, as smoking increases the risk of recurrence
• If you have diabetes, keep your blood sugar well managed to help healing

Diet and exercise

Eating a balanced diet and drinking plenty of fluids supports your immune system. Gentle exercise, like walking, is fine if it does not cause pain. Avoid heavy lifting or intense chest exercises until your healthcare provider says it is safe.

Mental health and emotional wellbeing

Having a breast lump or infection can be worrying and stressful. You might feel anxious about pain, breastfeeding, or the possibility of cancer. These feelings are normal. Give yourself time to recover, talk to your healthcare team about your concerns, and ask for extra support if you need it.

Prevention

You cannot always prevent a breast abscess, but you can lower the risk. If you are breastfeeding, try to avoid cracked nipples by making sure your baby latches on well. Treat any signs of mastitis (such as breast pain, redness, or a fever) early. Keep your nipples clean and dry, and do not ignore a tender area that is not improving. If you smoke, quitting can reduce your risk, and managing diabetes carefully helps too.

Complications

If left untreated

• The infection can spread deeper into the breast tissue, making the abscess bigger and harder to treat
• The infection can spread to the bloodstream, causing a serious condition called sepsis, which is life-threatening
• The abscess may rupture on its own, creating a draining sinus track that may be slow to heal
• There is a small risk of ongoing (chronic) infection or the abscess coming back after treatment

Long-term outlook

With prompt treatment, a breast abscess usually heals completely. The pain improves quickly after the pus is drained, and the infection clears with a course of antibiotics. Most people fully recover within a week or two. In rare cases, the abscess may come back, but your care team can help manage that. Even after an abscess, the long-term outlook for your breast health is very good.

Find support

International organisations

• World Health Organization (WHO) – Breastfeeding support resources ↗

Local organisations

• NHS – Breast conditions and breast lumps ↗ · United Kingdom

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