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28.08.2009 Health & Fitness

Breast Abscess

28.08.2009 LISTEN
By Kofi Owusu Aduonum - Ghanaian Chronicle

The breast is in fact, a modified sweat gland and it has several functions. Breasts enhance a woman's beauty and outlook but primarily, they are for producing milk to feed babies. They are also called the mammary glands. A breast abscess is an infection of the breast tissue that causes lots of discomfort and unrest among women especially lactating mothers.

Breast abscess refers to collections of pus in the hollow spaces in the breast that forms as a result of a bacterial infection. This infection is most common among lactating or breast feeding mothers occurring normally within 6-8 weeks of breast feeding. Breast abscesses may also develop during weaning.

When a mother is breast feeding a baby, the nipples often crack or get bruised. This often occurs when the baby is not properly latched onto the breast. As a result, the baby's gums pinch the nipple or the nipple rub against the roof of the baby's mouth.

Once the nipples crack, bacteria such as Staphylococcus already living harmlessly on the skin enter the breast through the breakages in the skin. Once in the breast tissue, the bacteria multiply to cause the infection.

When the infection starts, the body's immune system responds by mobilising and sending lots of white blood cells to the breast to fight the infection. Thus, tissue in the breast is destroyed by the bacteria and white blood cell activities to produce pus. Pus, therefore is actually a collection of dead and dying bacteria, dead and dying white blood cells and debris of tissue.

Breast abscess starts with the sensation of pain at the sight of infection that begins to spread gradually. The affected area then becomes reddened and forms a firm swelling which is very painful. The pain becomes severe and throbs such that it becomes impossible to sleep without pain killers. The breast also becomes very hot compared with the rest of the body. In severe cases the whole body becomes hot as and the affected person becomes quite ill, loses appetite and vomits copiously.

Without help from the doctor or health worker, the pus can spread to involve the whole breast or spread to other parts of the body and cause a fatal infection of the whole body. It may also break open by itself and the pus flow out and heal by itself.

All forms of breast abscesses must be attended to by qualified health care givers. This is because what looks like a breast abscess may be cancer of the breast.

At the hospital, the doctor will take a history of how the symptoms developed and examine you to assess the extent of the infection and to make sure it is not cancer of the breast. It is not difficult for the trained health care giver to distinguish between these two diseases.

For a breast abscess that is developing, a good dose of appropriate antibiotics from the doctor and some pain killers causes the abscess to resolve without forming pus. With late cases in which a lot of pus has collected, the pus must be drained or removed. This is because pus has no blood vessels and so any antibiotics given orally or by injections cannot reach bacteria in pus.

To drain pus, the skin over the collection is cut and the pus collections washed out. Of course adequate medications are given at the site to numb the skin so the person feels little or no pain at all. With the pus drained the cavity is packed with gauze soaked with bacteria-killing solutions and dressed. Here as well adequate antibiotics and pain killers are given. Daily dressing is done until the wound heals. During the drainage, some of the pus is taken to the lab to find out which specific bacteria are involved and what drugs can best kill them. This test is called a culture and sensitivity test or a CS for short. Other laboratory tests are done as well.

Very rarely, non-lactating mothers present with a breast abscess. This is due to periductal mastitis i.e., inflammation of tissues surrounding the milk ducts. This condition, although rare, is seen in women over 30 years of age.

If you notice any swelling or pain in either of your breasts, contact your local healthcare practitioner immediately. It is best to start on antibiotics immediately and prevent an abscess from forming.

Secondly, it is important to continue breast-feeding as this allows the infected milk to flow out and is not harmful for the baby either. The bacteria in the infected milk are killed in the baby's stomach. If the pain is unbearable and feeding impossible, a breast pump may be used to empty infected milk. Also try placing a warm cloth over the breast and gently massaging it before breast-feeding as this soothes and eases the flow of milk.

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