Breast abscess

A breast abscess is a painful, pus-filled lump that develops under the skin of the breast. It is common in women who are breastfeeding, but can also occur in women who are not breastfeeding. See your doctor if your breast is red and sore. If you have mastitis, antibiotics may be prescribed to treat the infection.

What causes breast abscess?

undefinedMost abscesses are caused by a bacterial infection. They are often linked to mastitis – an inflammation of the breast tissue, particularly the milk ducts and glands in a breastfeeding woman. 

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.

Signs and symptoms of breast abscess

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

  • be red and 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.

How are breast abscesses diagnosed?

See your doctor if your breast is red and swollen. If your doctor thinks you have a breast abscess, they may perform 'an aspiration' of the lump to confirm that the lump 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.

How are breast abscesses treated?

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

If the abscess is large, it will require 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. Do not stop taking them just because you feel better. You need to take the full course of antibiotics. 

You can take paracetamol to relieve the pain and fever. Paracetamol is considered safe to be used by breastfeeding mothers. 

Breastfeeding with a breast abscess

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

If you are breastfeeding, it is important to empty your breasts regularly. However, your doctor may advise you to discard the milk from the affected breast until the abscess heals. 

Tips to help with breastfeeding with an abscess

  • Before breastfeeding, place a warm, wet face cloth over the 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.

Learn more

Mastitis and breast abscesses Ministry of Health, NZ

Credits: Editorial team. Last reviewed: 04 Mar 2016