Prognosis
When treated promptly and appropriately, most breast infections, including abscess, will resolve without serious complications. Resolution of mastitis after 2-3 days of appropriate antibiotic therapy is expected among most patients.
Lactational abscesses tend to be easier to treat than non-lactational abscesses because their aetiology and pathology is better understood. Non-lactational abscesses can be multifactorial and have a greater risk of becoming chronic.[27]
Breastfeeding
Most patients with breast infection can continue to breastfeed.
Trimethoprim/sulfamethoxazole should not be given if the mother is breastfeeding a jaundiced infant (because of the risk of kernicterus), a premature infant, or a baby aged less than 30 days.[40][49] It was previously thought that mothers prescribed doxycycline must not breast-feed and would need to pump milk to maintain supply during the antibiotic course. However short-term use of doxycycline may be considered acceptable during lactation in courses up to 21 days if no alternative is available.[50][51]
HIV-infected mothers
To completely prevent HIV transmission via human milk, the US American Academy of Pediatrics recommends that HIV-infected mothers do not breastfeed their infants.[58]
The World Health Organization advises HIV-infected women to stop feeding from the affected breast until it has recovered.[1]
In countries with high HIV prevalence, the World Health Organization recommends that women taking antiretroviral therapy continue to breastfeed for at least 12 months and up to 24 months.[59]
Recurrence
Mastitis may recur with delayed therapy, inappropriate therapy, uncorrected poor breastfeeding technique, nipple candidiasis, an underlying breast condition, and in Staphylococcus carriers. Recurrent mastitis or persistence of a mass after therapy may be due to a breast abscess or underlying breast lesion. Granulomatous mastitis has a high (up to 50%) recurrence rate.
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