Mastitis and Breast Abscess
Mastitis is breast inflammation on a spectrum from lactational inflammation to bacterial infection; a breast abscess is a drainable collection that needs urgent ultrasound assessment and drainage, while persistent or non-lactational inflammation needs a clear malignancy safety-net.
Definition
Mastitis is inflammation of breast tissue, commonly during lactation and sometimes infective. A breast abscess is a localised collection of pus within the breast that usually requires imaging and drainage. Non-lactational mastitis includes periductal disease and other inflammatory or infectious causes.
First principles
Mastitis is not synonymous with bacterial infection
Lactational mastitis commonly begins with inflammation and oedema around milk ducts. Pain, swelling and impaired drainage can reinforce one another, but a red, painful breast does not by itself prove bacterial infection. Continue responsive breastfeeding when possible, avoid attempts to over-empty the breast, and use gentle supportive measures while monitoring the clinical course.
This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.

