Breast Conditions
Breast disease presents in a variety of forms as lumps, breast pain, nipple discharge, breast ulcers, or eczema.
BREAST ABSCESS
This condition is common during lactation, especially the second week of puerperium, and during pregnancy. It rarely occurs at other times.
Clinical Features
There is severe breast pain and fever and there may be an area of induration. Aspirate with a big bore needle to confirm presence of pus.
Management
The following needs to be emphasized for breast abscess.
Do not delay inclusion and dependent drainage. If no pus, biopsy.
Do not wait for fluctuation or abscess to point.
Do not stop breastfeeding(unless the nipple is cracked or discharging, and in this case continue to express milk for the baby).
Give antibiotics early. Most infections are due to Staphylococcus aureus and flucloxacillin 500mg 8 hourly for 1 week is appropriate.
BREAST LUMPS
Breast lumps can be the result of a wide number of conditions, including the following:
- Cystic lesions that may be due to breast abscess, fibrocystic disease,cystosarcoma phylloides(serocystic disease), galactocele, and hydatid cysts.
- Solid lesions that may be due to developing breast abscess, antibioma, fibroadenoma, giant fibroadenoma, intraductal papilloma, tuberculosis lymphoma, neurofibroma, or carcinoma of breast.
Investigations
- Haemoglobin, white blood count, packed cell volume
- Triple assessment(history and physical examination, FNA, mammography)
- Abdominal ultrasound.
Management
Identify primary pathology and treat.