What is a Mastotomy? Understanding the Surgical Drainage of a Breast Abscess

September 30, 2025 •

4 min read

While commonly confused with mastectomy, a mastotomy is a distinctly different surgical procedure, used specifically for draining a deep breast abscess. This medical intervention is often necessary when an infection in the breast tissue does not respond to antibiotic therapy alone or is too large to resolve on its own, providing significant relief from pain and inflammation.

Quick Summary

A mastotomy is a surgical procedure performed to drain a deep breast abscess. This intervention involves making an incision to release infected fluid, clean the cavity, and promote healing, and is distinct from a mastectomy, which is the removal of breast tissue.

Key Points

Specific Procedure: A mastotomy is a surgical procedure to incise and drain a deep breast abscess, not to remove breast tissue.
Purpose: The primary goal is to clear a serious breast infection that hasn't responded to antibiotics, alleviating pain, swelling, and redness.
Distinction from Mastectomy: Mastotomy is a breast-conserving procedure, whereas a mastectomy is the partial or total removal of breast tissue, typically for cancer.
Procedure Details: It involves a small incision, drainage of the infected fluid, and often the placement of a temporary drain to prevent fluid re-accumulation.
Recovery: Recovery is typically quicker than a mastectomy, with most patients returning home the same day and managing pain with medication.
Diagnosis: A breast abscess is typically diagnosed through a physical exam, ultrasound, and sometimes needle aspiration for fluid analysis.

What Exactly is a Mastotomy?

Unlike a mastectomy, which involves the partial or total removal of breast tissue, a mastotomy is a targeted surgical procedure designed for the incision and drainage of a breast abscess. A breast abscess is a localized collection of pus and infected material within the breast tissue, often a complication of mastitis (an inflammation of the breast tissue). While many breast infections can be treated with antibiotics, larger or deeper abscesses may require a mastotomy to effectively clear the infection and prevent further complications. This procedure is typically performed under local or general anesthesia and is a critical intervention for relieving pain, swelling, and redness associated with the abscess.

Diagnosing a Breast Abscess

Before a mastotomy is performed, a breast abscess must first be accurately diagnosed. This typically involves several steps to confirm the presence of the infection and determine its location and size.

Diagnostic steps often include:

Clinical Examination: A doctor will physically examine the breast for signs of inflammation, including redness, swelling, and warmth, and will check for a tender, palpable lump.
Imaging: An ultrasound is a standard tool used to visualize the abscess. It can confirm the presence of fluid and distinguish it from a solid mass, which might require a biopsy.
Needle Aspiration: In some cases, a doctor may use a needle to aspirate fluid from the lump. This serves two purposes: confirming the presence of pus and collecting a sample for a culture to identify the specific bacteria causing the infection.

The Mastotomy Procedure

The procedure for a mastotomy is designed to be straightforward and effective, focusing on thorough drainage of the infected area.

Preparation: The patient is given either a local anesthetic to numb the breast area or general anesthesia to be completely asleep. The surgical site is cleaned with an antiseptic solution.
Incision: A small incision is made in the skin directly over the abscess. The size and location of the incision are carefully chosen to minimize scarring and optimize drainage.
Exploration and Drainage: The surgeon uses surgical tools to open the abscess cavity and drain the pus and infected fluid. The cavity may be irrigated with a saline solution to ensure it is thoroughly cleaned.
Drain Placement: A drainage tube may be inserted into the cavity to allow any remaining fluid to escape during the initial stages of recovery. This helps prevent fluid from re-accumulating, which is known as a seroma.
Closure: The incision is either left open to continue draining or partially closed with stitches, depending on the specific situation. A sterile dressing is applied to the site.

Mastotomy vs. Mastectomy

The fundamental difference between these two procedures is their purpose. Mastectomy is a breast removal surgery, while mastotomy is a breast-conserving drainage procedure.


Feature	Mastotomy	Mastectomy
Purpose	To incise and drain a breast abscess to treat an infection.	To remove part or all of the breast tissue, typically to treat or prevent breast cancer.
Invasiveness	Minimally invasive; involves a small incision to drain pus.	Major surgery, involving the removal of significant breast tissue and sometimes lymph nodes.
Recovery	Generally quicker, often completed within a few weeks.	Longer recovery time, potentially 4 to 6 weeks or more, especially with reconstruction.
Breast Tissue	Preserves breast tissue, leaving most of the breast intact.	Involves the removal of breast tissue, resulting in significant changes to breast size and shape.
Common Use	Treating infected breast abscesses.	Treating breast cancer or as a prophylactic measure for high-risk individuals.

Recovery and Potential Risks

Recovery after a mastotomy is generally swift, although the experience can vary depending on the abscess's size and location. Most patients can expect to go home the same day and can manage discomfort with over-the-counter pain medication. If a drain is in place, it will need to be cared for and emptied as instructed, typically for one to two weeks, or until drainage subsides. Full recovery, with the wound healed, can take several weeks.

Potential risks associated with a mastotomy include:

Infection: Although the procedure aims to treat an infection, there is a small risk of secondary infection.
Bleeding or Hematoma: Any surgery carries a risk of bleeding and the formation of a collection of blood (hematoma).
Seroma: Fluid accumulation can occur, although drain placement helps minimize this.
Scarring: Scarring is inevitable but is usually minimal.
Recurrence: In some instances, a chronic or complex abscess may recur and require further treatment.

Conclusion

A mastotomy is a focused and effective surgical solution for treating a breast abscess. It is a breast-conserving procedure that is crucial for clearing serious breast infections that do not respond to antibiotics. While the name may be similar to the more extensive mastectomy, understanding the distinction is key. For any individual facing a potential mastotomy, a thorough discussion with a healthcare provider is essential to clarify the procedure, recovery expectations, and treatment plan, ensuring the best possible outcome for their specific health needs. For further reading, additional resources on breast health and treatments are available through institutions like the National Institutes of Health.

Frequently Asked Questions

A mastotomy is a surgical procedure to drain a breast abscess, preserving the breast tissue. A mastectomy is a more extensive surgery to remove part or all of the breast, most often for breast cancer treatment or prevention.

During a mastotomy, a surgeon makes a small incision over the abscess, drains the pus and infected fluid, and cleans the cavity. A temporary drain may be placed to remove excess fluid during the recovery period.

A breast abscess is typically diagnosed using a physical examination, an ultrasound to confirm the presence of fluid, and sometimes a needle aspiration to collect a sample of the infected fluid.

Recovery from a mastotomy is generally quick, with most patients returning home the same day. Normal activities can often be resumed within a few weeks, depending on the size and location of the abscess.

For smaller abscesses, needle aspiration under ultrasound guidance can be used to drain the fluid. Antibiotics are also a primary treatment for breast infections, and a mastotomy is typically reserved for larger or unresponsive abscesses.

Potential risks of a mastotomy include infection, bleeding, seroma (fluid buildup), scarring, and the possibility of the abscess recurring, particularly in chronic or complex cases.

Pain after a mastotomy is typically well-managed with over-the-counter pain relievers. A doctor may also prescribe stronger medication if necessary, though many patients report that the drain is often more uncomfortable than the incision itself.