A 35-year-old woman presents with a painful, erythematous, swollen breast in the postpartum period. She has fever and tenderness. Ultrasound shows no abscess collection. What is the most appropriate initial management?

• A Incision and drainage
• B Empirical antibiotics (dicloxacillin or cephalexin) and continued breastfeeding ✓
• C Core needle biopsy to rule out inflammatory carcinoma
• D Simple mastectomy

Explanation

Lactational mastitis presents with painful, erythematous, swollen breast in postpartum women. Initial management is empirical antibiotics covering Staphylococcus aureus (dicloxacillin or first-generation cephalosporin) along with continued breastfeeding or milk expression. Incision and drainage is only indicated if an abscess forms. Biopsy is only considered if symptoms do not resolve with antibiotics.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.