Abscess

If mastitis is not treated properly a collection of pus builds up in the breast tissue forming an abscess.

This is the most common cause for a poor response to antibiotics as the medication cannot penetrate into the walled off cavity.

Ultrasound is the best way to make the diagnosis.

The pus needs to be removed in one of 2 ways.

1.Aspiration of the pus with a needle and syringe.

This procedure can be  done immediately in the consulting room using local anaesthetic to numb the skin and ultrasound to guide the needle.  

You may need to return four or five times over the next few days for repeat aspiration as more pus can rdevelop, and you will stay on antibiotics.

This is a good way to treat the problem as it can be done without delay and it avoids the need for surgery and a general anaesthetic.

We have a 90% success rate in treating breast abscess in this way and only a small number of difficult cases need to go to theatre for surgical incision and drainage

View case example

2.Incision and drainage of an abscess in theatre

This is necessary if the pus is very thick so that it cannot be drained with a needle or if the woman is very uncomfortable and unable to tolerate needle aspiration.

You will require a light general anaesthetic.

Once asleep a cut is made in the skin over the abscess and the pus is washed out.

The cut has to be left open so that the wound can be cleaned and dressed daily to allow the tissue to heal from the inside. We can usually arrange for the district nurses to visit you at home for the dressings. It takes about two to three weeks for the wound to heal.