American Medical Association Family Medical Guide - American Medical Association [574]
Treatment
If you have a breast abscess, your doctor will prescribe antibiotics to fight the infection. He or she may recommend periodically applying a warm, moist washcloth to the inflamed area. You may be asked to stop breastfeeding from that breast until the infection clears up; to maintain your milk production and to prevent your breast from becoming engorged, use a breast pump to express the milk from the infected breast during this time.
Occasionally, antibiotics do not clear up the infection, and the abscess needs to be drained. To drain the abscess, a doctor makes a small incision at the edge of the areola to allow the pus to seep out.
Galactorrhea
The breasts normally produce milk after childbirth and, sometimes, for a few weeks before childbirth. Milk production that occurs at any other time in a woman, or at any time in a man, is called galactorrhea. Galactorrhea is uncommon in women and rare in men. In galactorrhea, milk is usually produced by both breasts and is whitish or gray-green. Although galactorrhea can occur for no apparent reason, excessive production of the hormone prolactin is a possible cause. Prolactin is made by the pituitary gland in the brain to stimulate milk production for breastfeeding.
Galactorrhea also can result from a disorder of the pituitary gland such as a tumor (prolactinoma; see page 885). Some medications—especially those that have an effect on the brain, such as drugs used to treat mental disorders—can cause galactorrhea. Galactorrhea also can be triggered by excessive nipple stimulation (such as during sexual foreplay) or friction (such as from not wearing a bra during jogging). In women, galactorrhea is often associated with an absence of periods (see page 846). If you notice any fluid leaking from your nipples, see your doctor.
Diagnosis
If your doctor suspects that the galactorrhea is caused by a pituitary tumor or another underlying hormonal disorder, he or she probably will order a blood test to measure the level of prolactin and may recommend diagnostic tests such as a CT scan (see page 112) or MRI (see page 113) of the brain.
Treatment
If the diagnostic tests do not find a problem, you probably will not need any treatment. For galactorrhea that results from taking a medication, discontinuing the drug will clear it up. If the condition is caused by a disorder of the pituitary gland, the doctor may prescribe hormone therapy or the drug bromocriptine to block milk production. In rare cases, surgery is necessary to remove a pituitary tumor.
Lumps in the Breast
Women who do regular breast self-examinations (see page 137) may occasionally find an area that feels different from the rest of the breast. These areas are referred to as breast lumps. Breast lumps often do not cause any discomfort, but they can sometimes be tender or painful.
Although breast lumps are usually not a cause for concern, always see your doctor if you notice any changes (including seemingly minor ones) in your breasts. Lumps can have a number of causes. They can be cysts (noncancerous fluid-filled sacs), or they can result from thickening of the milk-producing glandular tissue inside the breasts (called fibrocystic changes). They can also result from infections or from noncancerous growths such as fibroadenomas. All of these kinds of lumps are harmless, but, because lumps can also be cancerous, it’s essential to have them checked by a doctor. You might want to watch the lump through one menstrual cycle before seeing a doctor because benign lumps sometimes disappear after a menstrual cycle.
Benign Lumps and Cysts
Most lumps that develop in the breasts are harmless, noncancerous growths. Some women have naturally lumpy breasts that tend to develop numerous cysts or fibrous growths. Fibroadenomas are solid lumps that can range from the size of a pea to the size of a lemon.
Breast cysts
Cysts are fluid-filled sacs that can develop in the breasts. They are harmless, noncancerous growths that sometimes go away on their own. Some women have several cysts in their breasts, which is