Abstract

Breast emergencies cover a range of acute breast conditions, and if unrecognized and untreated, can progress to sepsis, loss of tissue, and delayed diagnosis of malignancy and implant complications. This narrative review aims to provide a summary of current evidence on the pathological spectrum, diagnostic approach and treatment modalities for breast emergencies. A literature search was designed and carried out in PubMed/ MEDLINE, Google Scholar, and Scopus to find peer-reviewed articles published from 2018 to 2026.
Breast emergencies can be classified as infectious, inflammatory, vascular, traumatic and hemorrhagic, and malignant or malignancy-simulating types. Acute mastitis is now known to be a continuum from narrowing of the duct to milk stasis, bacterial mastitis, phlegmon, to abscess. Breast abscess is defined by liquefactive necrosis and encapsulated pus, while the necrotizing infection is a rare but potentially fatal process that can develop rapidly with soft tissue and fascial necrosis. Vascular and hemorrhagic emergencies like Mondor’s disease, pseudoaneurysm, hematoma and fat necrosis may mimic malignancy. Recurrent abscess and inflammatory breast cancer are significant diagnostic challenges.
The current diagnostic paradigm is based on a triage system focused on the urgency of presentation, with ultrasound as the first imaging modality in most acute cases. Management trends include ultrasound-guided drainage, culture-directed antibiotic therapy and early biopsy of non-resolving or atypical inflammation. Pathology-based and triage-based approaches may be helpful in improving early diagnosis and timely emergency management.

Key words: Breast emergencies, breast abscess, acute mastitis, inflammatory breast cancer, ultrasound.