Breast Abscess: Causes, Symptoms, Treatment, Recovery, and When to Seek Help

A breast abscess is a painful pocket of pus that forms inside the breast tissue, usually because of a bacterial infection. It most often develops as a complication of mastitis, especially during breastfeeding, but it can also occur in people who are not breastfeeding. A breast abscess usually needs medical treatment because antibiotics alone may not be enough once a collection of pus has formed. Drainage of the abscess is often required.

Breast Abscess: Key Facts in Summary

• A breast abscess is a painful pocket of pus inside the breast, usually caused by bacterial infection.


• It often develops after mastitis, especially during breastfeeding, but it can also occur in people who are not breastfeeding.


• Symptoms include a painful breast lump, redness, swelling, warmth, fever, chills, and sometimes pus discharge.


• Diagnosis is usually based on examination and ultrasound.


• Treatment commonly involves drainage by needle aspiration or incision and drainage, together with antibiotics when needed.


• Breastfeeding can often continue during treatment with medical guidance.


• Most people recover well, but recurrent breast abscesses need specialist review.

A breast abscess is a localized pocket of pus that forms within the breast due to an infection. It usually begins with inflammation of the breast tissue, known as mastitis, and can progress if the infection is not treated promptly. The result is a tender, firm lump that may feel warm to the touch. Image showing how breast abscess sample looks under a microscope. Image Credit: Netha Hussain - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=18575814

What Is a Breast Abscess?

A breast abscess is a localized collection of infected fluid or pus within the breast. It may feel like a painful lump and is often surrounded by red, swollen, warm, and tender skin. The area may be very sore to touch, and some people also develop fever, chills, tiredness, or a general feeling of being unwell.

Breast abscesses are most common in women who are breastfeeding, particularly when mastitis does not improve or is not treated early. However, breast abscesses can also occur in women who are not breastfeeding and, rarely, in men. Non-lactational breast abscesses often need careful evaluation, especially if they recur or occur around the nipple and areola.

Breast Abscess Causes and Risk Factors

The most common cause of a breast abscess during breastfeeding is mastitis that progresses to a pus-filled collection. Mastitis may develop when milk flow is reduced, the breast is not draining well, or bacteria enter through cracked or damaged nipples. Staphylococcus aureus is one of the common bacteria involved in breast infections.

Risk factors for lactational breast abscess include recent childbirth, breastfeeding difficulties, milk stasis, nipple cracks, previous mastitis, and delayed treatment of breast infection. First-time mothers may be more vulnerable because breastfeeding technique and milk drainage can take time to establish.

Non-lactational breast abscesses can occur when ducts under or near the areola become inflamed or infected. Smoking is an important risk factor for non-lactational and recurrent breast abscesses. Other possible risk factors include diabetes, previous breast surgery or injury, nipple piercing, and conditions that weaken the immune system.

Breast Abscess Symptoms

A breast abscess usually causes a painful, tender lump in the breast. The lump may feel firm, swollen, or fluctuant, meaning it may feel as though fluid is trapped inside. The skin over the abscess may be red, warm, shiny, or swollen.

Other symptoms may include fever, chills, body aches, tiredness, and feeling generally unwell. Some people may notice pus or fluid draining from the nipple or from the skin over the lump. Pain may be intense and may make breastfeeding, wearing a bra, or touching the breast difficult.

A breast abscess should be suspected when symptoms of mastitis do not improve with early treatment, when a painful lump becomes more defined, or when fever and breast tenderness continue despite supportive care.

Breast Abscess vs Mastitis

Mastitis and breast abscess are related, but they are not the same. Mastitis is inflammation of the breast that may or may not involve bacterial infection. It often causes breast pain, redness, swelling, warmth, and flu-like symptoms.

A breast abscess occurs when infection becomes localized and forms a pocket of pus. In simple terms, mastitis is usually a more diffuse inflammation or infection, while an abscess is a contained collection that often needs drainage.

This difference matters because mastitis may improve with milk drainage, pain relief, supportive care, and antibiotics when needed. A true abscess usually needs drainage in addition to antibiotics, because medicine may not fully penetrate a pus-filled pocket.

How a Breast Abscess Is Diagnosed

Diagnosis usually begins with a medical history and breast examination. A doctor will ask about breastfeeding, recent mastitis, fever, nipple cracks, previous abscesses, smoking, diabetes, breast surgery, and any nipple discharge.

Ultrasound is commonly used to confirm whether a painful lump is a fluid-filled abscess or another type of breast lump. Ultrasound can also guide needle aspiration, allowing the doctor to drain the abscess more accurately. In some cases, the drained fluid may be sent for culture testing to identify the bacteria and guide antibiotic choice, especially if the abscess is recurrent or not responding to treatment.

In non-lactating individuals, recurrent abscesses, unusual lumps, persistent skin changes, or symptoms that do not improve should be assessed carefully to exclude other breast conditions.

Breast Abscess Treatment and Management

Treatment usually includes drainage of the abscess and antibiotics when bacterial infection is suspected or confirmed. The exact treatment depends on the size of the abscess, symptoms, breastfeeding status, general health, and whether the abscess has occurred before.

Needle aspiration is often used as the first drainage method for suitable breast abscesses. This procedure involves inserting a needle into the abscess to remove pus. It is often guided by ultrasound. Some abscesses need to be aspirated more than once before they fully settle.

Incision and drainage may be needed if the abscess is large, has thick pus, has several pockets, does not improve after needle aspiration, or has already started to drain through the skin. This is a small surgical procedure that allows the pus to be released.

Antibiotics are used to treat the underlying infection. The choice of antibiotic depends on the likely bacteria, local resistance patterns, allergy history, whether the person is breastfeeding, and sometimes culture results.

Pain relief is also important. Warm or cool compresses may help some people feel more comfortable. Anti-inflammatory pain relievers may be useful when safe for the individual, but people with kidney disease, stomach ulcers, blood-thinning medication use, or other medical conditions should check with a doctor or pharmacist first.

Can You Breastfeed With a Breast Abscess?

In many cases, breastfeeding can continue during treatment, including from the affected breast, if it is comfortable and safe to do so. Continuing milk removal can help the breast drain and may support recovery. If the baby cannot feed from the affected breast because of pain, drainage site position, or medical advice, milk can usually be expressed instead.

Breastfeeding decisions should be guided by the treating clinician, especially if there is pus draining near the nipple, a drain in place, or antibiotics are being used. The goal is to treat the infection while protecting breastfeeding when possible.

Breast Abscess Recovery and Prognosis

Most people recover well after proper drainage and antibiotic treatment. Pain and fever often improve once the pus is drained, although complete healing may take longer. Some abscesses require more than one drainage procedure.

Recurrence can occur, especially in non-lactational abscesses, abscesses associated with smoking, incompletely drained abscesses, or ongoing duct inflammation. Recurrent breast abscesses should be reviewed by a breast specialist to check for underlying causes and to make sure no other breast condition is being missed.

When to Seek Medical Help

Medical advice is needed if there is a painful breast lump, breast redness, fever, chills, worsening mastitis symptoms, pus discharge, or symptoms that do not improve quickly. Urgent care is important if the person feels very unwell, has spreading redness, severe pain, high fever, or signs of sepsis. Any breast lump that persists after infection treatment should be reassessed.

This article is part of the 'Public Education Series' initiative by Exon Publications.

Disclaimer: This is for informational purposes only. For medical advice or diagnosis, consult a professional.

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