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Subareolar Abscess

Last updated Dec. 30, 2018

Approved by: Krish Tangella MD, MBA, FCAP


Microscopic pathology image showing subareolar abscess of the breast. Diagnostic anucleated squames associated with numerous neutrophils, keratinous debris, cholesterol crystals, parakeratosis and strips of squamous epithelium can be seen.

What are the other Names for this Condition? (Also known as/Symptoms)

  • Areolar Gland Abscess
  • Subareolar Breast Abscess
  • Zuska's Disease (Non-Puerperal case)

What is Subareolar Abscess? (Definition/Background Information)

  • The areolar gland is part of a breast and is located under the nipple and areola (the pigmented area surrounding the nipple). A breast is composed of several glands and ducts
  • When a duct near the areolar gland gets blocked, it can result in infection of the gland, which might result in abscess formation
  • Subareolar Abscess is a relatively rare condition that is predominantly seen in young and middle-aged women, who are not suckling (breastfeeding). Some major risk factors that contribute to Subareolar Abscess include smoking, diabetes, and cosmetic nipple piercing
  • The primary cause of Subareolar Abscess is the blockage of a breast duct located in the nipple area and subsequent infection of the areolar gland. It has been reported that a vast majority of women with this condition are smokers, and therefore, it is generally believed that smoking can be a causative factor
  • The condition may be recognized by signs and symptoms that include swollen breast, formation and drainage of pus, fever, and general malaise. Recurrence of the abscess is a potential complication of Subareolar Abscess
  • A healthcare provider might diagnose the condition through a breast exam. When warranted, culture of drainage fluid may be required to aid in the diagnosis of Subareolar Abscess
  • The treatment options for Subareolar Abscess include administration of oral antibiotics (when necessary), draining the abscess by making a surgical incision, or surgical removal of the affected gland (if there is repeat infection and abscess formation)
  • Being alert about breast health helps a woman identify changes early on and seek medical advice or treatment accordingly. This is considered the best method of preventing Subareolar Breast Abscess
  • When diagnosed and treated suitably, the prognosis of Subareolar Abscess is reported to be good

Who gets Subareolar Abscess? (Age and Sex Distribution)

  • Subareolar Abscess is a relatively rare condition, predominantly seen in young to middle-aged women, who are not nursing a baby
  • In extremely rare cases, men may also get Subareolar Abscess
  • No geographical, ethnic or racial preference is reported. There is no specific data available indicating that the condition is more prevalent among a particular race or ethnic group

What are the Risk Factors for Subareolar Abscess? (Predisposing Factors)

The risk factors for the development of Subareolar Abscess include:

  • Smoking: It has been observed that a majority of individuals with Subareolar Abscess are smokers
  • Poorly-controlled (longstanding) diabetes
  • Nipple piercing as a cosmetic procedure

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your health care provider.

What are the Causes of Subareolar Abscess? (Etiology)

The principal cause for the development of Subareolar Abscess is the obstruction of the ducts or glands located within the breast, leading to an infection and abscess formation in the subareolar gland.

  • It has been noted that a majority of individuals with Subareolar Abscess are smokers
  • Hence, it is believed that the toxin from smoking, leads to significant changes to the hormonal levels, causing changes to the structure of the breast tissue
  • Research is ongoing to prove or disprove this hypothesis concerning smoking of tobacco

What are the Signs and Symptoms of Subareolar Abscess?

The signs and symptoms of Subareolar Abscess may include:

  • Swelling in the areolar area
  • Lump in the breast in the areolar region
  • Breast tenderness
  • Pus formation in the lump, drainage of pus
  • Fever
  • General feeling of being unwell

How is Subareolar Abscess Diagnosed?

In order to diagnose Subareolar Abscess, the following tests and exams may be conducted:

  • A healthcare provider might conduct a breast exam to palpate the lump and look for swelling or drainage
  • The healthcare provider may evaluate the personal medical history of the individual, as well as their family history
  • Additionally, ultrasound imaging of the breasts may be required to arrive at an accurate diagnosis of the condition
  • If infection is suspected, a culture of the drainage from the abscess may be requested to characterize the infection

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Subareolar Abscess?

The following complications of Subareolar Abscess may be noted:

  • Recurrence of the abscess
  • Anxiety and irritation; emotional stress

How is Subareolar Abscess Treated?

The treatment options for Subareolar Abscess may include:

  • Oral antibiotics for combating the infection (if any)
  • Surgical incision to drain the abscess, if required
  • Surgical excision of the affected gland, if there is recurring abscess

How can Subareolar Abscess be Prevented?

The recommended methods of preventing Subareolar Abscess include:

  • Regular self-examination of the breast to detect changes in the breast
  • In case of a noticeable swelling in the breast, seeking immediate medical attention
  • Taking steps to ensure that diabetes is kept under control
  • Avoidance of smoking

Individuals who notice significant changes to their breast are advised to contact their healthcare providers. It is also important for these individuals to regularly do breast self-examination, as it can help detect any early abnormalities.

What is the Prognosis of Subareolar Abscess? (Outcomes/Resolutions)

  • The prognosis for Subareolar Abscess is reported to be good, if the condition is diagnosed and treated promptly
  • Draining the abscess is known to improve the condition and the prognosis; nevertheless, it can recur in some women

Additional and Relevant Useful Information for Subareolar Abscess:

It should be informed that if individuals (women) experience any pain or feel an abnormality within the areolar region, they should immediately seek medical advice.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: April 30, 2016
Last updated: Dec. 30, 2018