Breast abscess - should I go under the knife as surgeon has proposed?

[Dovemummy]

After 5 courses of antibiotics and general mismanagement of mastitis by my doctor surgery, I have now seen a consultant (general surgeon but specialising in breast and vascular) who has booked me in for excision of an abscess next wednesday. Diagnosis is of antibioma, and followed clinical exam, ultrasound and lab sample of pus (staph bacteria found). I am told my lump is too big and been there too long for needle aspiration or ?mammotene. I am terrified. Breastfeeding is finally going well after 2 months of agony and I no longer feel like I have been kicked in the chest or unwell. I am just stuck with a lump. As the crIsis is over and I have finally regained some quality of
life after a horrendous postnatal period the last thing I want to risk is an operation. I am determined to continue breastfeeding and my son is thriving now. The hospital won't allow children on wards because of swine flu and I've never been apart from my 4 month old.
Help! Does anyone have any experience of what to do in such a situation? Is there such a thing as a lactating breast specialist?

A really silly question - did you wear a bra post-op Cadmum KayM and dubaipieeye??

Not read all posts, just your initial one. I underwent surgery for an abscess 10 days ago, also due to mastitis. They tried aspirating several times, but it had a persistent viscose lump in the middle that couldn't be removed that way. The surgeon went in from underneath my breast, separating the breast tissue from my body wall and removed pus / debris then inserted a yeats drain - no requirement for packing and would still be able to b/f from that side if not for original position of abscess meaning DS couldn't latch on for some time. If you do need surgery could you ask for it to be done tihs way? minimises deformity and scarring. Sorry hasty post but DS needs me now!

HTH

nope, just a normal nursing bra x

If you have to stay in hospital for any length of time could you have a bed on a post natal ward? You would be able to have your baby with you then.

Thinking of you today and wondering if you are feeling more positive about your decision to go ahead with the op. Have you made enquiries about keeping baby with you?

I only ever wore a bravado nursing bra. (it was the only one comfy enough.). I only had regular aspirations though not the op, remember?

Postnatal ward not allowed because they don't want the risk of us bringing in infection. We have got an amenity bed and I'm in contact with PALS to try and get the cost of that back as the situation really is impossible. Met a really nice Infant Feeding Co-ordinator at the hospital today, who will provide support tomorrow. The hospital is apparently going for 'Baby Friendly Status' (UNICEF certificate). I think I'll have to write to the Chief Exec about that! Feeling more positive today and that I have done everything I possibly can to make this work. Encountered a fair bit of contradictory advice at the pre-op assessment today (along with the comment "of course you'll not be breastfeeding, then"!). Will let you know how I get on... :)

It sounds as though your pre- op appointment was interesting to say the least...

Who made the bold assumption that you will no longer be breastfeeding? I managed to feed ds2 until he was 29 months despite the early set backs with mastitis and the abscess.

I am pleased that you will have some support tomorrow. You sound more certain of your decision and it does seem like the best option.

I will be thinking of you. Best wishes for a speedy recovery and resumption of your normal life.

Optimistically or unrealistically checking to see if you posted after your op. I hope that things went well for you, dh and ds today.

Thinking of you.

Thanks Cadmum...where to start?? Well, 'day' surgery turned into a four-day hospital stay. Unfortunately, the tumour was much worse than the surgeon expected (he was surprised by it and said there was a real mess in my breast). As a result, they didn't manage to get all the infection out, so the wound was left open to drain and quickly became hideously infected (they tested for immune deficiency, blood poisoning etc but lab culture showed it was just staph bug waging war on my body), requiring IV antibiotics, morphine and cycline. I had a fever, looked and felt like death barely defrosted, and had a very sore breast. I am extremely glad I had the op when I did (although I wish I had been referred long before) as I lost some breast tissue. When the swelling goes down apparently I will be left with a cavity in my breast where they removed the dead tissue. Left much longer and I would have lost a lot more of my breast.
Happily, my little boy behaved like an angel throughout it all. My breast milk had no blood or pus in it and the consultant surgeon, anaesthetist and hospital pharmacist confirmed that any drugs would not affect him. He continued to feed from both(!) sides - it is only really sore on the bad breast when his over-enthusiastic little jaw tugs a little hard. It was extremely hard being separated from him at night but at least he slept through from 10pm til 5am for his daddy (who has had a crash course in househusbanding and mannying but has coped admirably).
So now the long road to recovery. The district nurse is coming each day for unknown weeks to drain (i.e. squeeze!), pack (stuff the wound) and dress it. This is the worst bit and is so painful I have blacked out. It is very frustrating that I can't really do anything (takeaways and greasy hair abound) and we have had to cancel our holiday in two weeks' time but I feel strangely lucky.

Dovemummy - you poor thing. I've been checking back and wondering how you got on but I never imagined that I would read this!

I am so sorry you have had this experience but I agree that you have been lucky as I suspect it could have been much worse very quickly. You were and continue to be very brave - I hope your recovery goes well. Plesae pop back here occasionally and let us know how you get on.

Thank you for the update. I was hoping that you had just lost the thread. What a terrifying experience. I am so glad that you opted to have the operation.

I am so impressed and pleased for you that you have managed to continue feeding fro bit sides. What an amazing mum you are.

Your dh sounds like he coped admirably.

You must be upset that it took so long to get to the point where you were referred...

I hope that the squeezing and packing doesn't have to continue for too long.

Thinking of you.

from both sides even...

Sorry. I am posting from a friend's iPhone.

Testing

Dear All

I would like to revive this post in the hope that I can understand this condition better. I am 35+2 days pregnant.
I am under the care of a Lead Consultant Breast Surgeon at Barts Breast Clinic. A brief history: referred to Barts Breast Clinic during the 1st Trimester with lumps in one breast which clinical exam and ultrasound confirmed was a florid glandular tissue which was typical of pregnancy. This then developed into Mastitis and then chronic abscess in the 3rd Trimester in both breast. Tried 3 doses of antibiotic which reduced the swelling the lump, pain and puss is still there (hence now in a state of Anti-bioma or nuisance as my Consultant calls it!)
I have had 3 ultrasounds and 2 needle aspiration on both breasts. I am waiting for results from lab which will confirm whether I have an acute chronic inflammation or TB. If I get negative result for TB, I still have to wait for further 6 weeks to get the all clear sign for TB. This means that I cannot breastfeed my baby after it?s born (due 21 May 2011). I am extremely disappointment by this. I am in so much pain that I can barely hug my 5 yr old dd. Today, I wasn?t able to hold my sisters newborn as my chest area hurt so much. This made very tearful as I wondered how much contact I can have with my newborn baby. I breastfed my first for 2 and half years and assumed that I would naturally do the same.
Look forward to any advice or suggestions from anyone who?s been there.

Dear Jeasmin,

You poor, poor thing, that sounds awful. I'm not familiar with the condition you had before mastitis. It is very fortunate that they were able to treat your antibioma non-invasively under local anaesthetic. I hope it isn't a daft question, but by TB do you mean tuberculosis? This is something else I don't know much about - is it a separate issue from the mastitis?

All I can say is that it is absolutely possible, and indeed can be beneficial (by bringing increased bloodflow to the area thereby promoting faster healing), to breastfeed after having surgery for an abscess or antibioma - provided you have supportive people around. I am now in my 13th week since surgery (under general anaesthetic as my condition was too chronic by the time I was referred to a specialist) which I underwent to cut out my nasty lump and have breastfed continually since despite post-op complications and other difficulties. In fact, breastfeeding has not been at all painful - and the risks of stopping breastfeeding have been significant. My husband passed me my ds when I couldn't move, or lift him and little one hasn't been put off in the slightest by the dressings. Unfortunately, my wound appeared to have healed 4 weeks ago and then the cavity burst open again and so I am back to daily cleaning, packing and dressing of the wound - but this is no longer painful. Recovery is a long, slow process and I don't know what would happen if I had another baby but presumably my breasts would cope as they are doing now.
There seems to be a lack of detailed information about breast abscesses and antibiomas and if I were you (and any other medical conditions aside), I would press your medical team for exactly why you shouldn't breastfeed following needle aspiration. I think lactation takes quite a while to stop after birth - perhaps worth checking out as you may be able to pick it up once your test results are back. Could you pump in the meantime?
If you need to undergo surgery under GA to remove any residual abscess, do ask if you have any questions and I'll do my best to help. This posting really helped me in my darkest days when I had practically nowhere to turn.

Thinking of you and wishing you well xx

Dovemummy - can I have a number to contact you? Or I can email you my phone number. I am due to have open breast biopsy and just wanted a chat.

Many thanks

Hello Lovewales, I'm really sorry to hear that you have to have a procedure on your breast. What is your diagnosis? Would you be up for discussing via posts here so that other women in future might be able to benefit? If you're feeling unwell I'd be happy to chat although probably can only lend an ear unless you have the same thing I had. Btw haven't posted for ages because I was unwell with the condition April to July this year. But happy to say I am now very much better :-)

I know this is already an old thread but i been crying my eyes out in pain and confused. I was just diagnosed with a breast abscess and have been put on antibiotics. Which is definitely not working i feel it getting bigger and painful. Its 2 am and i cant sleep. Im scared that its going to hurt to get any procedure done. I will find out tomorrow what is gong to be done. I been searching the web all week about this and so far nothing but negative feedback after the procedures. I finally came across this blog with alot of helpful and postive feedback. Thank you ladies for giving me hope that everything will be okay.

Hi lilycrowe09 I am going thru the same experience right now. Had baby end march, red hot swelling etc, put on antibiotics by my doctor, finally saw breast clinic and was diagnosed with breast abscess. Had needle aspiration several times and loads of antibiotics as it was an MRSA abscess (no idea how I got it except in maternity hospital...ladies, beware...). Done with the antibiotics about a month ago and in meantime I had a biopsy as the radiologist didn't know what she was looking at (in her own words) - thankfully came back negative so the breast surgeon was able to confirm it was an antibioma and not anything more sinister. So after being in and out of hospital for needle aspiration and breast consultant, I have been asked to come back in 3 months time for her review clinic. Which in a way is good news as if it was more serious I presume she wouldn't have said that. But could anyone perhaps let me know your experience of this - why 3 months later? Is she expecting the antibioma to break down over this time period? Is there a high chance it won't and I would need it to be surgically removed? Why isn't she seeing me even every month? Anyone with any info I would greatly appreciate it, especially if they had an antibioma that resolved itself over time. Hope you were ok in the end lilycrowe09.