Management of Breast Abscess in Lactating Women

Diagnosis and Assessment

Ultrasound confirmation of a cystic lesion with thickened content is consistent with a breast abscess in a lactating woman 1

The National Comprehensive Cancer Network recommends repeated aspiration for intact-skin, deep, <5cm breast abscesses in lactating women already on appropriate antibiotic therapy, with a success rate of 80-90% 1, 2
Repeated aspiration is preferred over incision and drainage (I&D) due to its less invasive nature, ability to be performed as an outpatient procedure, and better cosmetic outcome with no scarring 2
Aspiration is also preferred over continuing antibiotics alone, as antibiotics alone are insufficient for established abscesses that require drainage 2
Excisional biopsy is not recommended for a clearly diagnosed abscess, as it is unnecessarily invasive 1, 3

The American Cancer Society suggests that breastfeeding from the affected breast can resume once pain improves, and follow-up ultrasound can confirm resolution after treatment 1