Breast abscess with intrathoracic communication

We present a rare case of a breast abscess communicating with the thoracic cavity. This was discovered intra-operatively during incision and drainage of the abscess by the general surgery on-call team because of raised inflammatory markers and pyrexia. A chest x-ray was obtained intra-operatively and chest drain inserted, before transfer to cardiothoracics. The patient was subsequently discharged with no further interventions but failed to attend breast care services for follow up. This case highlights the importance of referring all breast abscesses to acute secondary care for assessment and immediate intervention if required. Onward referral to breast outpatient clinic is only appropriate in patients who are clinically well. It also raises the question of whether further imaging should be undertaken in high-risk patients before surgical intervention of acute breast abscesses. While breast abscesses are typically managed successfully in outpatient settings, rare complications, such as intra-thoracic extension into the intrapleural space, can occur. Irrespective of the underlying aetiology, this case report highlights the importance of considering rare complications in the management of breast abscesses, particularly in patients with a history of systemic upset and atypical symptoms. Prompt diagnosis, interdisciplinary collaboration, and timely surgical intervention are crucial in achieving successful outcomes in such challenging scenarios. Further studies and reports on similar cases will contribute to a better understanding of this rare complication and aid in optimising treatment strategies.