Mastitis in lactating women can be complicated by what, which would require incision and drainage?

• A. Fibroadenoma
• B. Breast cellulitis
• C. Necrotizing fasciitis
• D. Breast abscess requiring incision and drainage

Answer: (D)

A breast abscess is the complication that would require incision and drainage. When mastitis progresses and pus collects in the breast tissue, a localized abscess can form, presenting as a tender, sometimes fluctuant lump, often with fever or systemic symptoms. If this occurs, antibiotics alone are usually not enough; draining the pus is necessary to resolve the infection and relieve pressure. Ultrasound is typically used to confirm a fluid collection and guide drainage, which may be done surgically or with image-guided techniques. After drainage, antibiotics are continued as needed, and breastfeeding can often continue with proper technique to keep milk flowing.

Fibroadenoma is a benign solid lump, not a complication of mastitis. Cellulitis refers to the spreading skin and tissue inflammation from infection but does not imply pus collection requiring drainage. Necrotizing fasciitis is a rare, rapidly progressing infection requiring urgent surgical debridement, not a routine incision and drainage for an abscess.