Breast abscess

Key points about breast abscess

  • A breast abscess is a painful, pus-filled lump that develops under the skin of your breast.
  • Breast abscess are is common in women who are breastfeeding, but can also occur in women who are not breastfeeding.
  • They are mostly caused by an infection, where bacteria gets into your breast through a sore or cracked nipple or a nipple piercing.
  • See your healthcare provider if your breast is red, swollen or sore. 
  • The main treatment for a breast abscess is to drain away the pus from the abscess. 
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Most abscesses are caused by a bacterial infection. They are often linked to mastitis, an inflammation of your breast tissue, particularly the milk ducts and glands if you are breastfeeding. 

Infections can occur when bacteria from the skin's surface or baby's mouth enter the milk ducts through a break or crack in the skin of the nipple, or through a milk duct opening. If the infection is not treated, an abscess can form. 

Women who are not breastfeeding can also develop a breast abscess if bacteria enters the breast through a sore or cracked nipple, or a nipple piercing.

Breast abscesses are hard, painful lumps in the breast that may also:

  • be red or swollen
  • feel hot
  • have pus or discharge from the nipple
  • be associated with a fever (high temperature), chills and a general feeling of unwellness.
Always visit your GP if you notice any changes to your breasts, such as a breast lump or discharge (leaking fluid) from your nipples. In some cases, such symptoms could be a sign of breast cancer.

See your doctor if your breast is red or swollen. If your doctor thinks you have a breast abscess, they may perform an aspiration of the lump to confirm that it is an abscess. This involves placing a needle in the swollen area, to check if the lump is filled with pus. Sometimes breastfeeding women develop cysts that are filled with milk-like fluid. This is not a breast abscess. 

Your doctor may also send you for an ultrasound scan of the breast to confirm whether or not the pain and swelling is caused by an abscess.

The main treatment for a breast abscess is to drain away the pus from the abscess. To do this, a local anaesthetic medicine is injected to numb the skin over your infected breast tissue, and using a needle and syringe, the pus is drained.

If the abscess is large, it needs a bigger cut to let the pus drain out. After the infected area has been drained, it may be left open and packed with sterile gauze or closed with a small tube left in so the pus can drain out. 

Your doctor may also prescribe a course of antibiotics, which you must take as directed. 

You can take paracetamol or ibuprofen to relieve pain and fever. These medicines are considered safe to be used by breastfeeding mothers. 

Breastfeeding can normally continue unless you are feeling very unwell, the abscess is very close to the nipple or you have had an incision to remove the abscess that makes feeding impossible.

If you are breastfeeding, it's important to keep emptying your breasts regularly by feeding your baby or expressing

Tips to help with breastfeeding with an abscess

  • Before breastfeeding, place a warm, wet face cloth over your breast for about 15 minutes. Try this at least 3 times a day.
  • As you feed, gently massage your whole breast from the outer edge towards the nipple to stimulate milk flow and help relieve blocked ducts.
  • Pump or hand express a small amount of breast milk before breastfeeding if your breasts are too full with milk or if it hurts too much to feed. This will make your breasts less full and may make it easier for your baby to feed.
  • Try feeding from the healthy breast. Then, after your milk is flowing, breastfeed from the affected breast until it feels soft.

The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers.

The following is from Auckland Regional HealthPathways changes in 2020, which include emphasising that antibiotics alone are not sufficient treatment for a breast abscess.

  • Request acute general surgery assessment(external link)(external link) for aspiration and drainage. There is no need to arrange an ultrasound prior to referral.
  • Advise the patient that the breast will still require milk drainage after aspiration or surgery. In many cases breastfeeding will continue after the surgical drainage while the mother is on further antibiotic treatment.
  • Follow up after surgery:
    • ensure symptom resolution
    • review breastfeeding or milk drainage
    • assess wound healing.

Read more: Mastitis and breast abscess(external link)(external link) Auckland Regional HealthPathways, NZ, 2020

Clinical resources

Mastitis and sore nipples while breastfeeding(external link)(external link) BPAC, NZ, 2008
Mastitis and breast abscess(external link)(external link) Ministry of Health, NZ, 2014
Prescribing in breastfeeding(external link)(external link) NZ Formulary
LactMed drugs and lactation database(external link)(external link) NCBI, US

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Alice Miller, FRNZCGP

Last reviewed:

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