<A mother complains of 3 lumps in one breast, one is on top of breast, one is
at bottom of breast, and one is right under the nipple. This started at 3 wks
pp, and was mostly resolved, but returned now 6 wks pp.>

Laurie, yes these could be abscesses. I've said before that it usually takes
2-3 weeks after the initial mastitis for an abscess to form. And it is easy for
the doctor to order a diagnostic ultrasound to give you the answer one way or
the other.

<In hindsight, I'm thinking maybe the "cold" she had on 4/1 was really a
breast infection, (obvious portal of entry from the badly cracked nipple
earlier) and the painless lump shortly after was the abcess starting?
Should we have seen this coming?  She cultured out penicillin-resistant
staph, so the infection would have been resistant to the amoxicillin,
right? >

Becky, yes I would think this severe abscess had been forming for several
weeks. And the antibiotic for mastitis should always be one that treats
penicillin-resistant staph, ie dicloxacillin or cephalexin, not amoxycillin.
Also, a pre-op ultrasound would have told the surgeon what to expect.

Lisa Amir
GP / IBCLC in Melbourne, Australia, who wishes that we knew as much about human
mastitis as the vets know about bovine mastitis.