Question 239

Question:

A 24-year-old woman who breast-feeds her infant develops a warm, painful mass and erythema of the overlying skin in the upper outer quadrant of the right breast. The pain and redness resolve with antibiotic therapy. Several months later, the same area is firm and the overlying skin is dimpled. Which of the following is the most likely cause of these findings?

Correct Answer: A.  Breast abscess with scarring

A warm, painful, and erythematous breast mass (often accompanied by fluctuance), experienced by breast-feeding women, that resolves with antibiotics suggests an infectious cause. Although far less common than mastitis, a breast abscess is the only infectious etiology among the answer choices. Risk factors include primiparity, maternal age >30, and a pregnancy lasting longer than 41 weeks. Fibrosis (scarring) can replace the abscess in some women, leaving a firm mass and dimpled overlying skin months after the abscess has resolved.