Pediatric Breast Abscess

  • Etiology: Inflammatory mass draining purulent material, most common organism is Staphylococcus aureus
  • Imaging US:
    — Hypoechoic collection which is often multiloculated
    — Echogenic vascular rim with no vascularity within collection
    — Posterior acoustic enhancement due to fluid content
  • DDX: Breast hematoma, galactocele, breast tumor
  • Complications:
  • Treatment: Treat carefully to avoid damaging developing breast bud, antibiotic treatment and ultrasound guided aspiration usually sufficient, surgery in rare cases
  • Clinical: Often associated with mastitis during breastfeeding

Radiology Cases of Breast Abscess

US of pediatric breast abscess
Transverse (above) and sagittal (below) color doppler US of the breast show a poorly defined retroareolar mass that has a hyperemic thick wall with a multiloculated hypoechoic center. The surrounding subcutaneous fat is hyperechoic.
US of breast abscess
Sagittal US of the upper outer quadrant of the left breast shows skin thickening at the top of the image. In the center of the image is a round hypoechoic mass-like area of disorganized breast tissue and edema with a small adjacent anechoic fluid collection superiorly.