A breast abscess is a lump in the breast filled with pus. This condition, which is also called breast boils, is usually caused by an infection and is often experienced by nursing mothers. 

Breastfeeding mothers who experience breast abscesses need immediate treatment. However, don't worry; nursing mothers with breast abscesses can still breastfeed their children with uninfected breasts. 

Breast Abscess

Causes of Breast Abscess

Inflammation of the breast tissue (mastitis) that is not treated immediately or caused by a blockage in the breast gland is the main cause of pus gathering (abscess) in the breast. 

Breast infection itself can occur for several reasons, one of which is the entry of bacteria from the baby's mouth into the milk ducts through cracks in the nipples. Although it is more common in breastfeeding mothers, non-breastfeeding women and a small proportion of men can also develop breast abscesses. 

There are several factors that increase a person's risk of developing a breast abscess, including:

• Has piercings on the nipples
• Have diabetes
• Have a smoking habit
• Suffering from HIV/AIDS
• Had breast surgery in the last 2 months.
• Have had a breast infection.
• Elderly

Symptoms of Breast Abscess

A breast abscess is shaped like a lump under the skin that feels soft to the touch and can be moved. However, this lump cannot be felt if the abscess grows deeper in the breast. 

Other symptoms experienced by sufferers of breast abscesses can vary, depending on the severity. Some of the complaints that can arise are:

• Breast redness, swelling, and pain
• Lumps that don't go away after breastfeeding
• Pus discharge from the nipples
• Breast pain causes a mother to be unable to breastfeed her child.
• The breasts ache continuously, to the point of interfering with activities.
• Fever for more than 3 days that does not improve despite treatment

When to see a doctor

Breast abscesses form as a result of untreated mastitis. Therefore, nursing mothers need to be vigilant and see a doctor if they feel a lump in the breast or if the breast is red, painful, and swollen. 

Every woman is also encouraged to do breast self-examination (BSE). BSE is done every 7 days after menstruation. The goal is so that if there are abnormalities in the breast, they can be detected earlier. 

Women are also advised to undergo a clinical breast examination (SADANIS) by a doctor. SADANIS is recommended to be done every 1–3 years, starting at the age of 20. After the age of 40, SADANIS needs to be done regularly, at least once a year. 

BSE and SADANIS are performed as a form of anticipation and early examination of breast disease, especially if there is a family history of breast cancer. 

Diagnosis of breast abscess

The doctor will do a physical examination of the patient's breasts. Next, the doctor will ask the patient to undergo a breast ultrasound (ultrasound mammae). 

Ultrasound aims to examine the depth and location of infection in the breast and determine whether the lump is mastitis, a breast abscess, or a tumor. 

The doctor will also take a sample of breast milk or pus from the abscess by injection, which will be examined in the laboratory. From this examination, the doctor can find out the cause of the infection and determine the right type of treatment. 

Apart from ultrasound, scanning can also be done with mammography and breast biopsies. However, this procedure is only performed if the patient is not a breastfeeding mother. The test aims to ensure that the symptoms you are experiencing are not cancer symptoms. 

Treatment of Breast Abscess

To treat breast abscesses in nursing mothers, doctors will give antibiotics such as cephalexin. Please note that breastfeeding mothers can continue to breastfeed their children even though they are using the drug. 

Breast abscesses can also occur in women who are not breastfeeding. To fix this, the doctor can give clindamycin or amoxicillin antibiotics. 

Apart from treatment with antibiotics, there are other procedures that can be done to treat breast abscesses, namely:

• Remove pus with a syringe.
• Drain the pus out with the help of a catheter.
• Overcoming a breast abscess with a special action called vacuum assisted biopsy

Meanwhile, pain from a breast abscess can be treated by taking paracetamol and compressing the breast with a towel that has been soaked in warm water or ice water. 

During the healing period, patients who are breastfeeding need to continue expressing milk every 2 hours from the affected breast. This is done to prevent further infection. However, the child should not feed from the affected breast because of the risk of contracting an infection. 

Patients also need to get plenty of rest, eat nutritious food, drink enough water, and manage stress well. These things aim to speed up the healing of breast abscesses. 

Complications of breast abscess

There are several complications that can occur due to a breast abscess, namely:

• Recurrent breast infection
• The appearance of scars or scar tissue
• Shrinking breast size so it looks unbalanced
• Prolonged (chronic) breast abscess
• Spread of infection to other parts of the body
• The appearance of abnormal ducts in the breast
• Abnormalities of the lymph channels that cause swelling in the arm (lymphedema)

Breast abscess prevention

Mastitis is one of the causes of breast abscesses. Therefore, it is important to know how to prevent mastitis, especially in nursing mothers, including:

• Always wash your hands before breastfeeding to avoid the possibility of spreading bacteria.
• Ensure that the nipple and the brown part around it (areola) attach perfectly to the child's mouth when breastfeeding.
• Feeding with both breasts alternately and not in the same feeding position continuously
• Breastfeed regularly and avoid long breaks between feedings.
• Wear a bra that fits properly, and don't wear tight clothes.
• Do not use creams and ointments on the nipples.
• Not using nipple pads long term
• Drink lots of water to prevent dehydration.
• Perform BSE and SADANIS routinely to detect abnormalities in the breast earlier.

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