is a subareolar breast abscess?
One type of breast infection that can
occur in nonlactating women is a subareolar breast abscess. Subareolar breast abscesses are
infected lumps that occur just under the areola,
the colored skin around the nipple. An abscess
is a swollen area in the body that is filled with pus. Pus is liquid filled with dead
white blood cells.
The swelling and pus are due to a local
infection. A local infection is where bacteria invade your body at a certain
point and remain there. The bacteria do not spread to other parts of your body
in a local infection.
In the past, these infections were called
“lactiferous fistulas” or “Zuska’s disease,” after the doctor who first wrote
Symptoms of subareolar breast abscess
When a subareolar breast abscess first
develops, you may notice some pain in the area. There will likely be a lump
under the skin and some swelling of nearby skin. Pus may drain out of the lump
if you push on it or if it is cut open.
If left untreated, the infection can start
to form a fistula. A
fistula is an abnormal hole from the duct out to the skin. If the infection is
severe enough, nipple inversion
can occur. This is when the nipple is drawn into the breast tissue rather than
pointing out. You may also have a fever and a general feeling of ill health.
of subareolar breast abscess
A subareolar breast abscess is caused by a
blocked duct or gland inside the breast. This blockage can lead to an infection
under the skin. Subareolar breast abscesses usually occur in younger or
middle-aged women who aren’t currently breast-feeding.
Some risk factors for subareolar breast
abscesses in nonlactating women include:
Comparing subareolar breast abscess to
Abscesses in the breast often occur in
lactating women who are breast-feeding. Mastitis is an infection in lactating
women that causes swelling and redness in the breast area, among other
symptoms. Mastitis can occur when a milk duct becomes plugged. If left
untreated, mastitis can lead to abscesses in the breast.
Subareolar abscesses involve the nipple
tissue or areolar glands. They usually occur in young or middle-aged women.
Diagnosing subareolar breast abscess
Your doctor will perform a breast exam to
assess the lump.
Any pus may be collected and sent to a lab
to determine what type of infection you have. Your doctor may need to know
exactly what kind of bacteria are causing your infection since some bacteria
are resistant to certain medications. This will allow your doctor to provide
the best form of treatment for you. Blood tests may also be ordered to look for
infection and to check your immune health.
An ultrasound of your breast may also be
done to determine what structures under the skin are being affected and how
deep your abscess goes beneath your areola. Occasionally, an MRI scan may be
done as well, especially for a severe or a recurrent infection.
Treatment for subareolar breast abscess
The first stage of treatment is taking
antibiotics. Depending on the size of the abscess and your level of discomfort,
your doctor may also want to open up the abscess and drain the pus. This would
mean the abscess would be cut open in the doctor’s office. Most likely, some
local anesthetic will be used to numb the area.
If the infection doesn’t go away with a
course or two of antibiotics, or if the infection comes back repeatedly after
initially clearing up, you may need surgery. During surgery, the chronic
abscess and any affected glands will be removed. If nipple inversion has
occurred, the nipple can be reconstructed during surgery.
Surgery may be done in your doctor’s
office, in a surgical outpatient center, or in a hospital, depending on the
size and severity of the abscess.
Complications of subareolar breast abscess
Abscesses and infections can recur even
after you’ve been treated with antibiotics. Surgery may be required to remove
the affected glands in order to prevent recurrence.
Nipple inversion can occur. Your nipple
and areola can also be deformed or pushed off center by the abscess, causing
cosmetic damage, even if the infection is successfully treated with
antibiotics. There are surgical solutions to these complications.
In most cases, nipple problems or
abscesses don’t indicate breast cancer. However, any infection in a woman who
isn’t breast-feeding has the potential to be a rare form of breast cancer. According
to the American Cancer Society, inflammatory breast cancer can sometimes be
confused with an infection. Contact your doctor if you think you may have a
subareolar breast abscess.
outlook for subareolar breast abscess
Most breast abscesses are cured with
antibiotic treatment or by having the abscess drained. However, sometimes recurring
or severe infections require surgery. Most of the time, surgery is successful
in preventing the abscess and infection from returning.
Tips for home care
Since a subareolar breast abscess is an
infection, you will require antibiotics to reduce bacteria’s presence. However,
there are some at-home treatments you can use that can reduce pain and
discomfort while you are healing your subareolar breast abscess:
- Apply a
cloth-covered ice pack to your affected breast between 10 and 15 minutes at a
time, several times a day. This can reduce inflammation and swelling in the breast.
- Apply washed,
clean cabbage leaves on the breasts. After cleaning the leaves, place in the
refrigerator until they’re cooled. Remove the cabbage leaves’ base and place
the leaf over your affected breast. While this is traditionally used to relieve
mastitis, the cool nature of the cabbage leaf can be soothing.
- Wash your skin
and the nipple with a gentle antibacterial soap. Allow the area to air-dry
before putting on a bra or shirt.
- Wear a soft breast pad in your bra to help drain pus and
reduce any friction that could cause increased discomfort. Breast pads are
available in the nursing aisle. They usually have a soft side and an opposite
adhesive side to secure to your bra.
- Take an over-the-counter pain reliever, such as ibuprofen or
acetaminophen, to reduce pain and discomfort in your breast.
- Refrain from squeezing, pushing, popping, or otherwise
disturbing the abscess, as this can worsen symptoms.
Always contact your doctor if you have
signs of a worsening infection, such as high fever, spreading redness, fatigue,
or malaise, much like you would feel if you had the flu.
Tips for preventing subareolar
Practicing good hygiene, keeping the
nipple and areola very clean if you have a piercing, and not smoking can help
prevent subareolar breast abscesses. However, because doctors don’t know
specifically what causes them, there are not currently other means for