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Abscess
Lori Strachowski, MD; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Localized pus collection within breast tissue
              • Types

                • Puerperal, associated with lactation, usually near nipple
                • Nonpuerperal: Central or peripheral

              IMAGING

              • General Features

                • Imaging Recommendations

                  • Mammographic Findings

                    • Ultrasonographic Findings

                      • MR Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Boakes E et al: Breast infection: A review of diagnosis and management practices. Eur J Breast Health. 14(3):136-143, 2018
                                          2. David M et al: Predictors of outcomes in managing breast abscesses-A large retrospective single-center analysis. Breast J. ePub, 2018
                                          3. Patani N et al: Best-practice care pathway for improving management of mastitis and breast abscess. Br J Surg. ePub, 2018
                                          4. Barron AU et al: Do acute-care surgeons follow best practices for breast abscess management? A single-institution analysis of 325 consecutive cases. J Surg Res. 216:169-171, 2017
                                          5. Debord MP et al: [Lactational breast abscesses: Do we still need surgery?.] J Gynecol Obstet Biol Reprod (Paris). 45(3):307-14, 2016
                                          6. Irusen H et al: Treatments for breast abscesses in breastfeeding women. Cochrane Database Syst Rev. CD010490, 2015
                                          7. Giess CS et al: Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center. J Clin Ultrasound. 42(9):513-21, 2014
                                          8. Kasales CJ et al: Nonpuerperal mastitis and subareolar abscess of the breast. AJR Am J Roentgenol. 202(2):W133-9, 2014
                                          9. Lam E et al: Breast abscess: evidence based management recommendations. Expert Rev Anti Infect Ther. 12(7):753-62, 2014
                                          10. Lo G et al: Squamous metaplasia of lactiferous ducts (SMOLD). Clin Radiol. 67(11):e42-6, 2012
                                          11. Trop I et al: Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics. 31(6):1683-99, 2011
                                          12. Gollapalli V et al: Risk factors for development and recurrence of primary breast abscesses. J Am Coll Surg. 211(1):41-8, 2010
                                          13. Rizzo M et al: Management of breast abscesses in nonlactating women. Am Surg. 76(3):292-5, 2010
                                          14. Bharat A et al: Predictors of primary breast abscesses and recurrence. World J Surg. 33(12):2582-6, 2009
                                          15. Rizzo M et al: Breast abscesses in nonlactating women with diabetes: clinical features and outcome. Am J Med Sci. 338(2):123-6, 2009
                                          16. Elagili F et al: Aspiration of breast abscess under ultrasound guidance: outcome obtained and factors affecting success. Asian J Surg. 30(1):40-4, 2007
                                          17. Moazzez A et al: Breast abscess bacteriologic features in the era of community-acquired methicillin-resistant Staphylococcus aureus epidemics. Arch Surg. 142(9):881-4, 2007
                                          18. Bassett LW et al: Diagnosis of Diseases of the Breast. Philadelphia: Elsevier Saunders. 421-4, 2005
                                          19. Christensen AF et al: Ultrasound-guided drainage of breast abscesses: results in 151 patients. Br J Radiol. 78(927):186-8, 2005
                                          20. Eryilmaz R et al: Management of lactational breast abscesses. Breast. 14(5):375-9, 2005
                                          21. Varey AH et al: Treatment of loculated lactational breast abscess with a vacuum biopsy system. Br J Surg. 92(10):1225-6, 2005
                                          22. Versluijs-Ossewaarde FN et al: Subareolar breast abscesses: characteristics and results of surgical treatment. Breast J. 11(3):179-82, 2005
                                          23. Lannin DR: Twenty-two year experience with recurring subareolar abscess andlactiferous duct fistula treated by a single breast surgeon. Am J Surg. 188(4):407-10, 2004
                                          24. Ulitzsch D et al: Breast abscess in lactating women: US-guided treatment. Radiology. 232(3):904-9, 2004
                                          25. Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
                                          26. Leborgne F et al: Treatment of breast abscesses with sonographically guided aspiration, irrigation, and instillation of antibiotics. AJR Am J Roentgenol. 181(4):1089-91, 2003
                                          27. Imperiale A et al: Abscesses of the breast. US-guided serial percutaneous aspiration and local antibiotic therapy after unsuccessful systemic antibiotic therapy. Acta Radiol. 42(2):161-5, 2001
                                          28. Rosen PP: Rosen's Breast Pathology. Philadelphia: Lippincott Williams & Wilkins. 65-75, 2001
                                          29. Hook GW et al: Treatment of breast abscesses with US-guided percutaneous needle drainage without indwelling catheter placement. Radiology. 213(2):579-82, 1999
                                          30. Berna JD et al: Percutaneous catheter drainage of breast abscesses. Eur J Radiol. 21(3):217-9, 1996
                                          31. Crowe DJ et al: Breast infection. Mammographic and sonographic findings with clinical correlation. Invest Radiol. 30(10):582-7, 1995
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Definitions

                                                        • Localized pus collection within breast tissue
                                                      • Types

                                                        • Puerperal, associated with lactation, usually near nipple
                                                        • Nonpuerperal: Central or peripheral

                                                      IMAGING

                                                      • General Features

                                                        • Imaging Recommendations

                                                          • Mammographic Findings

                                                            • Ultrasonographic Findings

                                                              • MR Findings

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Boakes E et al: Breast infection: A review of diagnosis and management practices. Eur J Breast Health. 14(3):136-143, 2018
                                                                                  2. David M et al: Predictors of outcomes in managing breast abscesses-A large retrospective single-center analysis. Breast J. ePub, 2018
                                                                                  3. Patani N et al: Best-practice care pathway for improving management of mastitis and breast abscess. Br J Surg. ePub, 2018
                                                                                  4. Barron AU et al: Do acute-care surgeons follow best practices for breast abscess management? A single-institution analysis of 325 consecutive cases. J Surg Res. 216:169-171, 2017
                                                                                  5. Debord MP et al: [Lactational breast abscesses: Do we still need surgery?.] J Gynecol Obstet Biol Reprod (Paris). 45(3):307-14, 2016
                                                                                  6. Irusen H et al: Treatments for breast abscesses in breastfeeding women. Cochrane Database Syst Rev. CD010490, 2015
                                                                                  7. Giess CS et al: Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center. J Clin Ultrasound. 42(9):513-21, 2014
                                                                                  8. Kasales CJ et al: Nonpuerperal mastitis and subareolar abscess of the breast. AJR Am J Roentgenol. 202(2):W133-9, 2014
                                                                                  9. Lam E et al: Breast abscess: evidence based management recommendations. Expert Rev Anti Infect Ther. 12(7):753-62, 2014
                                                                                  10. Lo G et al: Squamous metaplasia of lactiferous ducts (SMOLD). Clin Radiol. 67(11):e42-6, 2012
                                                                                  11. Trop I et al: Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics. 31(6):1683-99, 2011
                                                                                  12. Gollapalli V et al: Risk factors for development and recurrence of primary breast abscesses. J Am Coll Surg. 211(1):41-8, 2010
                                                                                  13. Rizzo M et al: Management of breast abscesses in nonlactating women. Am Surg. 76(3):292-5, 2010
                                                                                  14. Bharat A et al: Predictors of primary breast abscesses and recurrence. World J Surg. 33(12):2582-6, 2009
                                                                                  15. Rizzo M et al: Breast abscesses in nonlactating women with diabetes: clinical features and outcome. Am J Med Sci. 338(2):123-6, 2009
                                                                                  16. Elagili F et al: Aspiration of breast abscess under ultrasound guidance: outcome obtained and factors affecting success. Asian J Surg. 30(1):40-4, 2007
                                                                                  17. Moazzez A et al: Breast abscess bacteriologic features in the era of community-acquired methicillin-resistant Staphylococcus aureus epidemics. Arch Surg. 142(9):881-4, 2007
                                                                                  18. Bassett LW et al: Diagnosis of Diseases of the Breast. Philadelphia: Elsevier Saunders. 421-4, 2005
                                                                                  19. Christensen AF et al: Ultrasound-guided drainage of breast abscesses: results in 151 patients. Br J Radiol. 78(927):186-8, 2005
                                                                                  20. Eryilmaz R et al: Management of lactational breast abscesses. Breast. 14(5):375-9, 2005
                                                                                  21. Varey AH et al: Treatment of loculated lactational breast abscess with a vacuum biopsy system. Br J Surg. 92(10):1225-6, 2005
                                                                                  22. Versluijs-Ossewaarde FN et al: Subareolar breast abscesses: characteristics and results of surgical treatment. Breast J. 11(3):179-82, 2005
                                                                                  23. Lannin DR: Twenty-two year experience with recurring subareolar abscess andlactiferous duct fistula treated by a single breast surgeon. Am J Surg. 188(4):407-10, 2004
                                                                                  24. Ulitzsch D et al: Breast abscess in lactating women: US-guided treatment. Radiology. 232(3):904-9, 2004
                                                                                  25. Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
                                                                                  26. Leborgne F et al: Treatment of breast abscesses with sonographically guided aspiration, irrigation, and instillation of antibiotics. AJR Am J Roentgenol. 181(4):1089-91, 2003
                                                                                  27. Imperiale A et al: Abscesses of the breast. US-guided serial percutaneous aspiration and local antibiotic therapy after unsuccessful systemic antibiotic therapy. Acta Radiol. 42(2):161-5, 2001
                                                                                  28. Rosen PP: Rosen's Breast Pathology. Philadelphia: Lippincott Williams & Wilkins. 65-75, 2001
                                                                                  29. Hook GW et al: Treatment of breast abscesses with US-guided percutaneous needle drainage without indwelling catheter placement. Radiology. 213(2):579-82, 1999
                                                                                  30. Berna JD et al: Percutaneous catheter drainage of breast abscesses. Eur J Radiol. 21(3):217-9, 1996
                                                                                  31. Crowe DJ et al: Breast infection. Mammographic and sonographic findings with clinical correlation. Invest Radiol. 30(10):582-7, 1995