Subareolar Breast abscess in Males:Brief Communication

Subareolar Breast abscess in Males:Brief Communication | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Subareolar Breast abscess in Males:Brief Communication Imtiaz Wani, Rauf Wani, Munir Wani This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5240543/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction Subareolar breast abscess is extremely rare in males .Only a few cases of male breast abscess are reported in the literature till date. The clinical presentation of male breast include pain, periareolar swelling, tenderness and rarely nipple discharge. Aim To study occurrence of subareolar abscess in males Patient and Methods A retrospective study of 11 patients from April 2014 –July 2024 is reported who presented with subareolar breast abscess. Four had uncomplicated abscess and one has underlying carcinoma breast. Incision drainage was done in 7 cases and one who has underlying carcinoma was managed by local toilet and antibiotics for abscess whereas rest two had needle aspiration for pus and one has conservative treatment by antibiotics. Conclusion Subareolar breast abscess is rare in males. Incision and drainage is treatment of choice in an uncomplicated cases. Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Introduction Breast abscess is extremely rare in males. [1 ]Subareolar breast abscess is commonly seen in females than males. Male subareolar abscess is a localized infection secondary to ductal ectasia, ductal obstruction, with inflammation. [ 2 ]The predisposing factors suggested in its etiology are iatrogenic, trauma, nipple piercing, smoking, diabetes mellitus and immunocompromised states.[3,4 ] Stasis of secretions within the duct ,its dilation followed by inflammatory reaction with added infection leading to abscess formation. Subareolar breast abscess is unilateral or bilateral presenting with swelling, pain, erythema or tenderness [ 5 , 6 ] Although subareolar abscess is rare in males, an associated risk factor should always be looked for. The causative organisms detected in male breast abscess are mainly staphylococcus. [ 7 ] The diagnosis of male breast abscess is clinical. The characteristic inflammatory cutaneous signs and symptoms clinch to the on spot diagnosis. Ultrasonography and fine needle aspiration cytology are useful adjuncts in making diagnosis.[ 8 ]The treatment of simple male breast abscess is incision and drainage. Aim The aim of study was to study clinical occurrence of male breast abscess in males Methods A 10 year retrospective study with prospectively collected data from April 2014 to July 2024 was conducted to study occurrence of male breast abscess. The medical record of all patients who presented All patients who had diagnosis of male breast abscess were evaluated retrospectively from IPD files and detailed clinical features ,examination, ultrasound ,FNAC and surgery findings were studied. Us culture were analyzed in this study. Being retrospective study, does not require ethical committee approval. Table 1 showing characteristics of breasr abscess male patients Age Duration of symtptoms Presentation Size Location of swelling Investigation Treatment Culuture 26 7 Idiopathic Painful swelling 2.7 x1.5 Right ,Outer quadrant Periareolar Ultrasound/fnac Incision Drainage 37 5 Idiopathic Painful swelling 2x1.9 cm Right ,Outer quadrant Periareolar area Ultrasound/fnac Incision Drainage 52 720 Underlying Ductal carcinoma Painful swelling 3x3 xcm Left,Inner, upper quadrant Periareolar area Ultrasound/fnac/CTScan Local toilet with Neoadjuvant chemotherapy 31 4 Idiopathic Painful swelling 2.1.8x1 cm Left outer upper quadrant Periareolar area Ultrasound/fnac Aspiration managed conservatively 21 M Underlying perareolar swelling Painful swelling 1.8x0.9 cm Left, SBA,outer quadrant with underlying gynecomastia Ultrasounf./FNAC Aspiration ,incision drainage and excision of involved duct 13 M Underlying periareolar swelling Painful swelling 1x0.4 cm Right, upper with underlying gynecomastia Ultrasound/FNAC Conservatively 31 M Idiopathic Painful swelling 1.8x1cm Right outer upper Periareolar Ultrasound Aspiration with Conservatively 66 M Idiopathic Painful swelling 3.7x1.8 cm Right upper periareolar area Ultrasound/FNAC Incision Drainage 22 M Idiopathic Painful swelling 1x1 cm Left outer periareolar area Ultrasound Incision Drainage 19 M Underlying Periareolar swelling Painful swelling 1’7x1.1 cm Right upper outer periareolar area Ultrasound Incision Drainage Results Total of 11 cases were diagnosed as a case of male breast abscess from April 2014 to July 2024. Left side involvement was seen in 4 patients whereas rest had on right side involvement [Figure 1 ,2, 3,4,5,6,7 &8 ] Age range was from 13–66 years. [Table 1 ]Amount of pus drained varied from 5 ml to 30 ml. Only one case had axillary lymphadenopathy. Smokers were 4 in this series. Only one case was a diabetic. Retraction of nipple was seen in one case only, having underlying cancer. Mammography and computed tomography Scan chest/abdomen was done in one case only, rest had ultrasound only .Fine needle aspiration was done in 8 cases which confirmed abscess only. In 7 cases there was growth of staphylococcus, one had mixed flora with E.coli prominent (Breast abscess with underlying cancer), two had no growth of any organism. Incision drainage was done in 7 cases .One had conservatively managed, two had aspiration simply and were prescribed Amoxyclavunate and one elderly had Linzeolid prescribed who was diabetic. Recurrence was seen in one case twice, with excision of involved duct one in final surgery. Discussion A myriad of benign conditions is reported to occur in the male breast .These encompass gynecomastia, intramammary lymph node, sebaceous cyst, diabetic mastitis, hematoma, fat necrosis, and subareolar abscess [ 9 ].The inflammatory lesion of male breast comprises of around 2% of cases [ 10 ].A subareolar breast abscess is an infected lesion that occurs in the subareolar area. In 1951, Zuska et al. [ 11 ] first reported occurrence of subareolar breast abscess, which is also known as Zuska’s disease. Male breast abscess is mostly located at the subareolar area, and the etiology is obscure. The normal male breast consists predominantly of fat, and contains few secretory ducts, scanty lobules which limits rapid spread and large abscess formation unlike in females. The suggested hypothesis for predisposition for the subareolar location of male breast abscess is that it arises from underlying fat or gynecomastia, usually prominent at the subareolar area. The nipple is considered to be the primary site of inoculation for causative organism.[ 12 ] Smoking, diabetes mellitus, obesity, HIV,nipple piercing, or nipple inversion has been suggested as a risk factor for subareolar breast abscess.[ 13 , 14 ] Rarely, Salmonella infection, pseudomonas, actinomycosis, mobiluncus curtisii, Finegoldia magna, Propionibacterium avidum ,tuberculosis, larvae of Musca domestica (common house fly) have been implicated in causation of mastitis in males.[ 16 , 17 , 18 , 19 , 20 ] Majority of cases are uncomplicated and this is in par with our study where most cases were uncomplicated The pathogenesis is believed to be either a component of squamous metaplasia of either normally occurring columnar epithelium of the secretory ducts. This ultimately progresses to abscess formation following rupture of the duct into the surrounding breast tissue. Sequence of gross changes observed was that there was initial localized cellulitis, followed by formation of localized collection usually in outer quadrant side with circumareolar spread from outer quadrant in periareolar area. Resolution occurs in circumferential mode in opposite direction with initial point resolving at the end. The clinical manifestations are painful swelling, redness, tenderness, nipple retraction, and nipple discharge. Fever is not much reported [ 5 ]. Most cases of subareolar breast abscess are unilateral, but rare cases can be bilateral also. [ 6 ]All cases in this study were unilateral. The history of nipple discharge may or may not be elicited. In this series; there was no discharge of nipple in any case. Rarely, breast abscess in a male may mimic breast cancer [ 21 ] On imaging male breast abscess has appearance mimicking of female breast abscess. This acute breast abscess is very difficult to be differentiated from malignancy due to pathological changes in abscess .The presence of skin and trabecular thickening in subareolar breast abscess distinguish this from gynecomastia [ 9 ]. Ultrasonography-guided core needle biopsy (CNB) may be performed, and reveal inflammatory cells. In one of case, there was underlying malignancy with secondary infection, mimicking breast abscess diagnosed by fine needle Aspiration cytology.. This is same as in our case where infected malignant lesion mimicking breast abscess. Ultrasonography findings in male breast abscess include subareolar hypoechoic lesions, distended thickened lymphatic vessels skin and trabecular thickening.[22,23 ] On Doppler ultrasound of male breast abscess, there is presence of irregular, heterogeneous mass having enhanced peripheral vascular flow with lack of vascularity in the fluid collection. Mammographic findings are variable in male breast abscess. On mammography, male breast abscess shows a subareolar ill-defined mass density with or without calcifications [ 24 ]. Skin thickening, a retroareolar mass, or sinus tract formation is characterized on mammography as a dense tracts connecting a breast density to the skin. In advanced cases, there may be fibrosis and architectural distortion of the breast tissue. Eccentric location to the nipple can be a differential diagnostic point for the male breast cancer without microcalcifications .Focal or diffuse asymmetry and even normal looking breast is sometimes visible on mammography. MRI has high accuracy in differentiating between patients with mastitis and those with inflammatory breast cancer.[ 25 ] Treatment for simple subareolar male breast abscess is incision and drainage. Repeated aspiration under cover of antibiotics with follow-up until complete resolution is treatment available, who refuse incision drainage [ 26 ]. Needle aspiration is employed in cases of small abscesses. Surgical excision of involved duct is done in case of recurrences after repeated aspiration.[ 27 ] Zuska et al. found several major microscopic findings, including acute and chronic inflammation of the lactiferous duct, dilatation of the duct, stasis, and desquamated keratinized epithelium in the duct lumen. Smear shows dense acute inflammatory exudate along with sheets of anucleated squamous in a background of dense acute inflammation. Very rarely, recurrent male breast has been reported in literature and deems removal of underlying focus.[ 28 ] Conclusion Male breast abscess is rare to occur. Most of cases are uncomplicated and usually occur in outer quadrant. Incision drainage is treatment of choice in uncomplicated cases. Declarations Disclosure Nothing to disclose Conflicts of Interest The author declare that he has no conflicts of interest. Authors’ Contributions Author has the idea of the research, editing, and approving the final manuscript. IW: wrote the main manuscript text, performed data collection, data analyses, and literature review, wrote the main manuscript text and edited the manuscript.RW and MW edited, revised and approved final manuscript. Data Availability Statement The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Ethical Approval Ethical approval was waived by the local Ethics Committee of Government Gousia Hospital, Srinagar, Kashmir in view of the retrospective nature of the study and all the procedures being performed were part of the routine care. Competing interests policy The authors did not receive support from any organization for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants, or other support was received. References Alqahtani SM. A subareolar breast abscess in a man: A case report and literature review. J Taibah Univ Med Sci. 2020;15(6):557–60. 10.1016/j.jtumed.2020.07.002 . PMID: 33318748; PMCID: PMC7715457. Alzayyat R, Bokhari D, Almuhanna A, Al-Maghrebi D. Male breast abscess: A rare entity. Radiol Case Rep. 2023;19(3):1122–7. 10.1016/j.radcr.2023.12.014 . PMID: 38259713; PMCID: PMC10801142. Kazama T, Tabei I, Sekine C, et al. Subareolar breast abscess in male patients: a report of two patients with a literature review. Surg Case Rep. 2017;3(1):128. Aiyappan SK, Ranga U, Veeraiyan S. Idiopathic subareolar breast abscess in a male patient. J Clin Diagn Res. 2015;9:TJ01. Toomey AE, Le JK. Breast Abscess. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK459122/ Sinha RK, Sinha MK, Gaurav K, Kumar A. Idiopathic bilateral male breast abscess. BMJ Case Rep. 2014;2014. pii: bcr2013202169. Jena P, Duggal S, Gur R, Kumar A, Bharara T, Dewan R. Staphylococcus aureus in breast abscess-major culprit besides others. Indian J Med Sci. 2019;71(1):40–4. Saboo A, Bennett I. Trends in non-lactation breast abscesses in a tertiary hospital setting. ANZ J Surg 2018 Jul-Aug;88(7–8):739–44. [PubMed]. Önder Ö, Azizova A, Durhan G, Elibol FD, Akpınar MG, Demirkazık F. Imaging findings and classification of the common and uncommon male breast diseases. Insights Imaging. 2020;11(1):27. 10.1186/s13244-019-0834-3 . PMID: 32072386; PMCID: PMC7028902. Mondal K, Mandal R. Cytological Evaluation of Pathological Male Breast Lesions. Eur J Breast Health. 2021;17(2):103–11. 10.4274/ejbh.galenos.2020.6154 . PMID: 33870108; PMCID: PMC8025724.*. Zuska JJ, Crile G, Jr, Ayres WW. Fistulas of lactiferous ducts. Am J Surg. 1951;81:312–7. Boakes E, Woods A, Johnson N, Kadoglou N. Breast Infection: A Review of Diagnosis and Management Practices. Eur J Breast Health. 2018;14(3):136–43. 10.5152/ejbh.2018.3871 . PMID: 30123878; PMCID: PMC6092150. Yoshino R, Yoshida N, Ito A, Ujiie N, Nakatsubo M, Kamikokura Y, Kitada M. Subareolar Breast Abscess in a Male: A Case Report. Cureus. 2023;15(7):e42623. 10.7759/cureus.42623 . PMID: 37641739; PMCID: PMC10460623. Brncic N, Gorup L, Strcic M, Abram M, Mustac E. Breast abscess in a man due to salmonella enterica serotype enteritidis. J Clin Microbiol. 2012;50:192–3. Bundred NJ, Dover MS, Coley S, et al. Breast abscesses and cigarette smoking. Br J Surg. 1992;79:58–9. Shuyi HOU, Liangtao LI, Juanjuan HUANG. One case report of male breast abscess caused by Finegoldia magna and Propionibacterium avidum. Chin J Infect Chemother. 2021;21(2):220–2. https://doi.org/10.16718/j.1009-7708.2021.02.021 . Ursavaş A, Ege E, Bilgen OF, Taşdelen I, Coskun F, Sönmez S, et al. Breast and osteoarticular tuberculosis in a male patient. Diagn Microbiol Infect Dis. 2007;58:477–9. Sunil Krishna M, Shenoy PA, Priyanka KS, Vishwanath S. Breast abscess in a male patient due to Finegoldia magna and Bifidobacterium scardovii: An unusual entity. Anaerobe. 2022;75:102536. https://doi.org/10.1016/j.anaerobe.2022.102536 . Article 102536. Kangas-Dick AW, Bornstein Y, Azar O, Rojas KE, Borgen PI. Larvae of Musca domestica (common house fly) found intraoperatively in a male breast abscess. SAGE Open Med Case Rep. 2020;8. 10.1177/2050313X20917841 . Veera Jayasree Latha Bommu, Utpat K, Travis Hendricks DO. Breaking the Mold. Mobiluncus in Male Breast Abscess– Unveiling an Unlikely; 2024. Gochhait D, Dehuri P. Umamahesweran Sandyya, Kamat Rohan. Breast Abscess Mimicking Breast Carcinoma in Male. Journal of Mid-life Health 9(1):p 39–40, Jan–Mar 2018. | 10.4103/jmh.JMH_78_17 Kishore M. Prajwala GuptaA rare presentation of Subareolar breast abscess in male Inte Yitta, Singer S, Toth CI, Mercado HB. CL. Image presentation. Sonographic appearances of benign and malignant male breast disease with mammographic and pathologic correlation. J Ultrasound Med 2010;29:931 – 47. rnational Journal of Current Research, 9, (01), 44827–44828. Draghi F, Tarantino CC, Madonia L, Ferrozzi G. Ultrasonography of the male breast. J Ultrasound. 2011;14(3):122–9. 10.1016/j.jus.2011.06.004 . Epub 2011 Jun 25. PMID: 23397020; PMCID: PMC3558246. Günhan-Bilgen I, Bozkaya H, Ustün E, Memiş A. Male breast disease: clinical, mammographic, and ultrasonographic features. Eur J Radiol. 2002;43(3):246–55. Renz DM, Baltzer PA, Bottcher J et al. Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis: a comparative study. Eur Radiol 2008; 18. Pesce CE, Yao K. Abscess/infections/periareolar mastitis. Ann Breast Surg. 2021;5:25. Singh G, Singh G, Singh LR, Singh R, Singh S, Sharma K, Lekhachandra. Management of breast abscess by repeated aspiration and antibiotics. Journal of Medical Society 26(3):p 189–191, Sep–Dec. 2012. | 10.4103/0972-4958.113249 Saber T, Abdel Backi S, Ismail M, El Asmar A, El Khoury M. Managementof Recurrent Idiopathic Male Breast Abscess by Nipple and AreolarExcision: 2 Cases Report. World J Surg Surg Res. 2019;2:1145. Additional Declarations No competing interests reported. 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[1 ]Subareolar breast abscess is commonly seen in females than males. Male subareolar abscess is a localized infection secondary to ductal ectasia, ductal obstruction, with inflammation. [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]The predisposing factors suggested in its etiology are iatrogenic, trauma, nipple piercing, smoking, diabetes mellitus and immunocompromised states.[3,4 ] Stasis of secretions within the duct ,its dilation followed by inflammatory reaction with added infection leading to abscess formation. Subareolar breast abscess is unilateral or bilateral presenting with swelling, pain, erythema or tenderness [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] Although subareolar abscess is rare in males, an associated risk factor should always be looked for. The causative organisms detected in male breast abscess are mainly staphylococcus. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] The diagnosis of male breast abscess is clinical. The characteristic inflammatory cutaneous signs and symptoms clinch to the on spot diagnosis. Ultrasonography and fine needle aspiration cytology are useful adjuncts in making diagnosis.[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]The treatment of simple male breast abscess is incision and drainage.\u003c/p\u003e \u003cp\u003eAim\u003c/p\u003e \u003cp\u003eThe aim of study was to study clinical occurrence of male breast abscess in males\u003c/p\u003e \u003cp\u003e\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eA 10 year retrospective study with prospectively collected data from April 2014 to July 2024 was conducted to study occurrence of male breast abscess. The medical record of all patients who presented All patients who had diagnosis of male breast abscess were evaluated retrospectively from IPD files and detailed clinical features ,examination, ultrasound ,FNAC and surgery findings were studied. Us culture were analyzed in this study. Being retrospective study, does not require ethical committee approval.\u003c/p\u003e\u003cp\u003e \u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eshowing characteristics of breasr abscess male patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDuration of symtptoms\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePresentation\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSize\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLocation of swelling\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eInvestigation\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eTreatment\u003c/p\u003e \u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eCuluture\u003c/p\u003e \u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIdiopathic\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePainful swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.7 x1.5\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRight ,Outer quadrant Periareolar\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUltrasound/fnac\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eIncision Drainage\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIdiopathic\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePainful swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2x1.9 cm\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRight ,Outer quadrant Periareolar area\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUltrasound/fnac\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eIncision Drainage\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e720\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnderlying Ductal carcinoma\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePainful swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3x3 xcm\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLeft,Inner, upper quadrant Periareolar area\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUltrasound/fnac/CTScan\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eLocal toilet with Neoadjuvant chemotherapy\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIdiopathic\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePainful swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.1.8x1 cm\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLeft outer upper quadrant Periareolar area\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUltrasound/fnac\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eAspiration managed conservatively\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnderlying perareolar swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePainful swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.8x0.9 cm\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLeft, SBA,outer quadrant with underlying gynecomastia\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUltrasounf./FNAC\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eAspiration ,incision drainage and excision of involved duct\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnderlying periareolar swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePainful swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1x0.4 cm\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRight, upper with underlying gynecomastia\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUltrasound/FNAC\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eConservatively\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIdiopathic\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePainful swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.8x1cm\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRight outer upper Periareolar\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUltrasound\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eAspiration with Conservatively\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIdiopathic\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePainful swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.7x1.8 cm\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRight upper periareolar area\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUltrasound/FNAC\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eIncision Drainage\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIdiopathic\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePainful swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1x1 cm\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLeft outer periareolar area\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUltrasound\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eIncision Drainage\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnderlying Periareolar swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePainful swelling\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1’7x1.1 cm\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRight upper outer periareolar area\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUltrasound\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eIncision Drainage\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eTotal of 11 cases were diagnosed as a case of male breast abscess from April 2014 to July 2024. Left side involvement was seen in 4 patients whereas rest had on right side involvement [Figure\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e,2, 3,4,5,6,7 \u0026amp;8 ] Age range was from 13\u0026ndash;66 years. [Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e]Amount of pus drained varied from 5 ml to 30 ml. Only one case had axillary lymphadenopathy. Smokers were 4 in this series. Only one case was a diabetic. Retraction of nipple was seen in one case only, having underlying cancer. Mammography and computed tomography Scan chest/abdomen was done in one case only, rest had ultrasound only .Fine needle aspiration was done in 8 cases which confirmed abscess only. In 7 cases there was growth of staphylococcus, one had mixed flora with E.coli prominent (Breast abscess with underlying cancer), two had no growth of any organism. Incision drainage was done in 7 cases .One had conservatively managed, two had aspiration simply and were prescribed Amoxyclavunate and one elderly had Linzeolid prescribed who was diabetic.\u003c/p\u003e \u003cp\u003eRecurrence was seen in one case twice, with excision of involved duct one in final surgery.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eA myriad of benign conditions is reported to occur in the male breast .These encompass gynecomastia, intramammary lymph node, sebaceous cyst, diabetic mastitis, hematoma, fat necrosis, and subareolar abscess [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].The inflammatory lesion of male breast comprises of around 2% of cases [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].A subareolar breast abscess is an infected lesion that occurs in the subareolar area. In 1951, Zuska et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] first reported occurrence of subareolar breast abscess, which is also known as Zuska\u0026rsquo;s disease. Male breast abscess is mostly located at the subareolar area, and the etiology is obscure. The normal male breast consists predominantly of fat, and contains few secretory ducts, scanty lobules which limits rapid spread and large abscess formation unlike in females. The suggested hypothesis for predisposition for the subareolar location of male breast abscess is that it arises from underlying fat or gynecomastia, usually prominent at the subareolar area. The nipple is considered to be the primary site of inoculation for causative organism.[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] Smoking, diabetes mellitus, obesity, HIV,nipple piercing, or nipple inversion has been suggested as a risk factor for subareolar breast abscess.[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] Rarely, Salmonella infection, pseudomonas, actinomycosis, mobiluncus curtisii, Finegoldia magna, Propionibacterium avidum ,tuberculosis, larvae of Musca domestica (common house fly) have been implicated in causation of mastitis in males.[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] Majority of cases are uncomplicated and this is in par with our study where most cases were uncomplicated\u003c/p\u003e \u003cp\u003eThe pathogenesis is believed to be either a component of squamous metaplasia of either normally occurring columnar epithelium of the secretory ducts. This ultimately progresses to abscess formation following rupture of the duct into the surrounding breast tissue.\u003c/p\u003e \u003cp\u003eSequence of gross changes observed was that there was initial localized cellulitis, followed by formation of localized collection usually in outer quadrant side with \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003ecircumareolar\u003c/span\u003e spread from outer quadrant in periareolar area. Resolution occurs in circumferential mode in opposite direction with initial point resolving at the end.\u003c/p\u003e \u003cp\u003eThe clinical manifestations are painful swelling, redness, tenderness, nipple retraction, and nipple discharge. Fever is not much reported [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Most cases of subareolar breast abscess are unilateral, but rare cases can be bilateral also. [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]All cases in this study were unilateral. The history of nipple discharge may or may not be elicited. In this series; there was no discharge of nipple in any case. Rarely, breast abscess in a male may mimic breast cancer [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eOn imaging male breast abscess has appearance mimicking of female breast abscess. This acute breast abscess is very difficult to be differentiated from malignancy due to pathological changes in abscess .The presence of skin and trabecular thickening in subareolar breast abscess distinguish this from gynecomastia [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Ultrasonography-guided core needle biopsy (CNB) may be performed, and reveal inflammatory cells. In one of case, there was underlying malignancy with secondary infection, mimicking breast abscess diagnosed by fine needle Aspiration cytology.. This is same as in our case where infected malignant lesion mimicking breast abscess. Ultrasonography findings in male breast abscess include subareolar hypoechoic lesions, distended thickened lymphatic vessels skin and trabecular thickening.[22,23 ] On Doppler ultrasound of male breast abscess, there is presence of irregular, heterogeneous mass having enhanced peripheral vascular flow with lack of vascularity in the fluid collection.\u003c/p\u003e \u003cp\u003eMammographic findings are variable in male breast abscess. On mammography, male breast abscess shows a subareolar ill-defined mass density with or without calcifications [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Skin thickening, a retroareolar mass, or sinus tract formation is characterized on mammography as a dense tracts connecting a breast density to the skin. In advanced cases, there may be fibrosis and architectural distortion of the breast tissue. Eccentric location to the nipple can be a differential diagnostic point for the male breast cancer without microcalcifications .Focal or diffuse asymmetry and even normal looking breast is sometimes visible on mammography. MRI has high accuracy in differentiating between patients with mastitis and those with inflammatory breast cancer.[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eTreatment for simple subareolar male breast abscess is incision and drainage. Repeated aspiration under cover of antibiotics with follow-up until complete resolution is treatment available, who refuse incision drainage [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Needle aspiration is employed in cases of small abscesses. Surgical excision of involved duct is done in case of recurrences after repeated aspiration.[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eZuska et al. found several major microscopic findings, including acute and chronic inflammation of the lactiferous duct, dilatation of the duct, stasis, and desquamated keratinized epithelium in the duct lumen. Smear shows dense acute inflammatory exudate along with sheets of anucleated squamous in a background of dense acute inflammation. Very rarely, recurrent male breast has been reported in literature and deems removal of underlying focus.[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eMale breast abscess is rare to occur. Most of cases are uncomplicated and usually occur in outer quadrant. Incision drainage is treatment of choice in uncomplicated cases.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eDisclosure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNothing to disclose\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author declare that he has no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthor has the idea of the research, editing, and approving the final manuscript.\u003c/p\u003e\n\u003cp\u003eIW: wrote the main manuscript text, performed data collection, data analyses, and literature review, wrote the main manuscript text and edited the manuscript.RW and MW edited, revised and approved final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was waived by the local Ethics Committee of Government Gousia Hospital, Srinagar, Kashmir in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests policy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors did not receive support from any organization for the submitted work.\u003c/p\u003e\n\u003cp\u003eNo funding was received to assist with the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003eNo funding was received for conducting this study.\u003c/p\u003e\n\u003cp\u003eNo funds, grants, or other support was received.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAlqahtani SM. 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Mobiluncus in Male Breast Abscess\u0026ndash; Unveiling an Unlikely; 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGochhait D, Dehuri P. Umamahesweran Sandyya, Kamat Rohan. Breast Abscess Mimicking Breast Carcinoma in Male. Journal of Mid-life Health 9(1):p 39\u0026ndash;40, Jan\u0026ndash;Mar 2018. | \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/jmh.JMH_78_17\u003c/span\u003e\u003cspan address=\"10.4103/jmh.JMH_78_17\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKishore M. Prajwala GuptaA rare presentation of Subareolar breast abscess in male Inte Yitta, Singer S, Toth CI, Mercado HB. CL. Image presentation. Sonographic appearances of benign and malignant male breast disease with mammographic and pathologic correlation. J Ultrasound Med 2010;29:931\u0026thinsp;\u0026ndash;\u0026thinsp;47. rnational Journal of Current Research, 9, (01), 44827\u0026ndash;44828.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDraghi F, Tarantino CC, Madonia L, Ferrozzi G. Ultrasonography of the male breast. J Ultrasound. 2011;14(3):122\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jus.2011.06.004\u003c/span\u003e\u003cspan address=\"10.1016/j.jus.2011.06.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2011 Jun 25. PMID: 23397020; PMCID: PMC3558246.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eG\u0026uuml;nhan-Bilgen I, Bozkaya H, Ust\u0026uuml;n E, Memiş A. Male breast disease: clinical, mammographic, and ultrasonographic features. Eur J Radiol. 2002;43(3):246\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRenz DM, Baltzer PA, Bottcher J et al. Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis: a comparative study. Eur Radiol 2008; 18.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePesce CE, Yao K. Abscess/infections/periareolar mastitis. Ann Breast Surg. 2021;5:25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSingh G, Singh G, Singh LR, Singh R, Singh S, Sharma K, Lekhachandra. Management of breast abscess by repeated aspiration and antibiotics. Journal of Medical Society 26(3):p 189\u0026ndash;191, Sep\u0026ndash;Dec. 2012. | \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/0972-4958.113249\u003c/span\u003e\u003cspan address=\"10.4103/0972-4958.113249\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaber T, Abdel Backi S, Ismail M, El Asmar A, El Khoury M. Managementof Recurrent Idiopathic Male Breast Abscess by Nipple and AreolarExcision: 2 Cases Report. World J Surg Surg Res. 2019;2:1145.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-5240543/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5240543/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSubareolar breast abscess is extremely rare in males .Only a few cases of male breast abscess are reported in the literature till date. The clinical presentation of male breast include pain, periareolar swelling, tenderness and rarely nipple discharge.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo study occurrence of subareolar abscess in males\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient and Methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA retrospective study\u003cu\u003e\u003cem\u003e \u003c/em\u003e\u003c/u\u003eof 11 patients from April 2014 –July 2024 is reported who presented with subareolar breast abscess. Four had uncomplicated abscess and one has underlying carcinoma breast. Incision drainage was done in 7 cases and one who has underlying carcinoma was managed by local toilet and antibiotics for abscess whereas rest two had needle aspiration for pus and one has conservative treatment by antibiotics.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSubareolar breast abscess is rare in males. Incision and drainage is treatment of choice in an uncomplicated cases.\u003c/p\u003e","manuscriptTitle":"Subareolar Breast abscess in Males:Brief Communication","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-26 14:04:07","doi":"10.21203/rs.3.rs-5240543/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"56504498-bef2-42d8-bdd2-20d07aab2bac","owner":[],"postedDate":"November 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-11-26T14:04:09+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-26 14:04:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5240543","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5240543","identity":"rs-5240543","version":["v1"]},"buildId":"CiT4i_kKBbxQbnFL0ufpk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}