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 nonlactational abscesses because their etiology and pathology is better understood. Nonlactational abscesses can be multifactorial and have a greater risk of becoming chronic.[27]
Breast-feeding
Most patients with breast infection can continue to breast-feed.
Trimethoprim/sulfamethoxazole should not be given if the mother is breast-feeding a jaundiced infant (because of the risk of kernicterus), a premature infant, or a baby aged less than 30 days.[40][50] 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.[51][52]
HIV-infected mothers
To completely prevent HIV transmission via human milk, the US American Academy of Pediatrics recommends that HIV-infected mothers do not breast-feed their infants.[59]
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 breast-feed for at least 12 months and up to 24 months.[60]
Recurrence
Mastitis may recur with delayed therapy, inappropriate therapy, uncorrected poor breast-feeding 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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