Breast abscess is a pathological condition in which an encapsulated purulent cavity is formed in the thickness of the soft tissues of this organ. In the vast majority of cases, this disease has a secondary nature of occurrence. This suggests that it is preceded by any other pathology or injury from the mammary gland.
An important point is that although a breast abscess is most often formed in females, it can also occur in men. Approximately two percent of all cases occur in those women who practice breastfeeding. In some cases, such a disease can develop in children aged from one to one and a half months. The danger of this pathological process lies in the fact that in the absence of the necessary medical care, it can lead to phlegmon of the mammary gland and sepsis. In addition, with a long course of this disease, the risk of malignant degeneration of epithelial cells increases.
The main reason that causes the development of a breast abscess is the bacterial flora. In this case, most often staphylococci and streptococci act as pathogens, but other microorganisms can also play a role.
As we have already said, most often this pathology develops as a secondary disorder. Among women, it is most often preceded by mastitis. Inflammation in the mammary gland in about ten percent of cases ends with the formation of a purulent cavity. Cysts and other benign growths can also contribute to the onset of this disease. This is due to the fact that the neoplasm has a compressive effect on the milk ducts and leads to their blockage. The consequence of blockage of the milk ducts is the addition of a secondary bacterial flora.
Among men, trauma is the leading cause of abscess formation. With a strong contusion of the mammary gland, as a rule, a hemorrhage site is formed, which, without the necessary treatment, can suppurate and encapsulate. Both women and men can face this problem as a result of various hormonal disorders. In addition, the existing purulent foci in the body often play a role, from which the bacterial flora enters the mammary gland with blood flow. Another important point is the mandatory decrease in the level of immune protection.
Breast abscess is divided into several varieties: subcutaneous, subareolar, intramammary and retromammary. The subcutaneous variety implies the formation of a purulent cavity immediately under the skin. The subareolar variety is diagnosed if the pathological focus has formed in the region of the nipple and areola. With an intramammary variety, the cavity is localized in the thickness of the mammary gland. The retromammary variety is the most unfavorable, since with it there is a high risk of breakthrough of pus into the chest. It is characterized by the formation of purulent changes in the area that is located between the pectoral muscle and retromammary fatty tissue.
Symptoms of a breast abscess
As a rule, such a disease is accompanied by an acute onset. A sick person complains of a sudden increase in body temperature to febrile values. In the event that the cause of the development of an abscess lies in the trauma, then the symptoms appear approximately four or five days after it was received.
Without fail, there is an extremely pronounced pain localized in the mammary gland. Most often, it has a pulsating character and becomes more intense with any active movements. In the event that a palpation examination of the mammary gland is carried out, it is possible to accurately establish the epicenter of the pain syndrome. The presence of symptoms such as significant swelling of the mammary gland and local reddening of the skin in the projection of the purulent focus is noted. Often, purulent masses are released from the nipple, in which an admixture of blood may be present.
Together with an increase in body temperature, other symptoms also increase, indicating a general intoxication of the body. These include significant weakness and decreased performance, headache, and nausea with vomiting. As a rule, the lymph nodes located in the armpit on the affected side increase in size and become painful. It is worth noting that if the purulent cavity lies deep in the tissues of the mammary gland, external signs of the inflammatory process in this organ may be completely absent. With a superficial location of the focus, it can often be felt during palpation.
Diagnosis and treatment of the disease
To diagnose this disease, it is imperative to examine and palpate the mammary gland, as well as to collect an anamnesis from the patient. Additional research methods include a complete blood count, in which there will be signs of an inflammatory process, and bacteriological examination of the secret released from the nipple. Of the instrumental methods, ultrasound diagnostics, mammography or computed tomography are used.
The main treatment for an abscess is surgical intervention as soon as possible. It implies the opening of a purulent cavity with its subsequent drainage. With a single focus, having a small size, a puncture can be performed with aspiration of pus and washing the cavity with an antibacterial solution. In addition, the patient is prescribed antibacterial drugs, depending on the sensitivity of the isolated flora, and non-steroidal anti-inflammatory drugs.
Prevention of breast abscess
Prevention methods include compliance with all the rules for breastfeeding, avoiding traumatic effects on the mammary gland, as well as monitoring the state of hormone levels in the body.
Clinical surgery. national guides. / Ed. V.S. Savelyeva, A.I. Kiriyenko — 2013
Surgical diseases. Textbook in 2 volumes / Merzlikin N.V., Alperovich B.I., Tskhai V.F. — 2012