TREATMENT PLAN, PROGNOSIS & KEY INFORMATION
TREATMENT PLAN
Conservative:
- Simple analgesia
- Warm compress
- Encourage breastfeeding if lactational
- Address risk factors: nipple damage, smoking and feeding attachment Antibiotics if infected:
- Lactational: Flucloxacillin (first line)
- Alternative: Trimethoprim or Erythromycin if penicillin allergic
- Consider switching to Co-amoxiclav if not improving
- Non-lactational: Co-amoxiclav
- Review within 48 hours
- Consider Breast milk MC&S if not responding to initial treatment Prevention:
- Good nipple hygiene
- Well-fitted bras
- Avoid dummies
- Exclusive breastfeeding for 4-6 months
- Feed on demand
- Ensure good infant attachment
PROGNOSIS
- Can progress to breast abscess if untreated
- Good with appropriate treatment
KEY INFORMATION
- Breast abscess: localised collection o Location varies: Upper outer quadrant (lactational), Lower quadrant (nonlactational)
o Requires surgical referral for I&D if an abscess develops
EXTRAS
Other breast lumps differential:
- Fibroadenoma: common in the 16-24 age group
- Phyllodes tumours: typically, the 40-60 age group
- Galactoceles: milk cysts, associated with hyperprolactinaemia
- Breast cysts: >35 years, fluid-filled, mobile
- Fat necrosis: post-injury, common in large breasts
- Intraductal papilloma: wart-like with nipple discharge
- Ductal ectasia: post-menopausal, blocked duct.