Treatment of breast infection

#### Summary points A cohort study of American women reported that 10% of women who breast feed have mastitis,1 and a recent Cochrane review reported the incidence to be as high as 33%.2 Breast abscesses are seen less often, but when they do develop delays in referral to a specialist surgeon may occur. A recent survey in the United Kingdom found that many surgical units have no clear protocols for managing patients with breast infection who are referred to hospital.3 Some surgeons aspirate breast abscesses under local anaesthesia, whereas others use general anaesthesia. The management of breast infection has evolved over the past two decades, with advances in both diagnosis and treatment. A new concept is bedside ultrasound, and this plays an important part in current management. We review management of breast infection in the primary care setting and after hospital referral. The review is based on our current practice and the best quality evidence available. Few randomised controlled trials deal with this topic, and most breast specialists have adopted their own protocols for clinical management, loosely based on published algorithms, and largely …