Presentation
New onset of a solid, left retro areolar, breast mass (2-week duration) and pain.
Patient Data
Limited MLO views confirm a solid appearing left retro areolar mass. There is minimal posterior architectural distortion. There is regional skin/areolar/nipple thickening, especially when compared to the asymptomatic and normal right breast.
There is a circumscribed, left retro areolar, unilocular, hypoechoic collection. There is no internal vascularity. An echogenic vascular rim is present. Reactive, bilateral, benign, axillary lymph nodes are present. Breast ultrasound is otherwise normal.
Ultrasound confirms the left retro areolar, circumscribed, unilocular collection. There is an echogenic rim. The mass was tender to ultrasound palpation.
Ultrasound-guided aspirate revealed pus. Cytology confirmed a large inflammatory infiltrate and the absence of malignant cells.
Case Discussion
An unusual presentation of a male patient with a breast abscess. There is a short duration of symptoms that may possibly allude to benign pathology like a breast abscess, however, breast carcinoma must always be excluded based on imaging findings and ultrasound-guided core biopsy/aspirate in all instances. Unilateral gynecomastia may represent a differential diagnosis in this patient based on the mammogram. Ultrasound and guided aspirate confirm the clinical and radiological suspicion of a breast abscess. The patient was non-diabetic but confirmed recent treatment for inguinal abscesses, of uncertain significance. The breast abscess resolved completely post aspirate and antibiotic therapy on history. The patient refused a confirmatory repeat ultrasound due to the resolution of his symptoms.
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