Comparison between needle aspiration versus incision and drainage in management of breast abscess

Breast abscess is defined as an acute suppurative inflammatory lump which yields pus on incision/aspiration. The high incidence is reported during lactation and is caused due to nipple piercing by child during feeding and bacterial colonization due to improper nursing technique and incomplete emptying of breast. Non-lactational abscesses are entirely different from those occurring during breast feeding. They occur in peri areolar tissue, has high recurrence and infecting organisms are polymicrobes. The present study compares the outcome and effectiveness of traditional technique of incision and drainage against needle aspiration in treatment of breast abscess. Material and Methods: This is comparative study carried out in department of General Surgery Mayo Hospital, Lahore in East Surgical ward for a period of 1.5 years from 1st January 2017 to 30th June 2018 after taking approval from Institutional Ethics Committee. 50-female patients of age between 18-60 years and diagnosed breast abscess with abscess size of equal to or < 5 cm in diameter clinically or on ultrasonography were included in the study after taking written consent. Of these 25-patients had undergone percutaneous aspiration of the breast abscess (group-A) and 25 had undergone incision and drainage of the breast abscess (groupB). Follow up of both groups was done for 6-weeks. Results: A total of 50 breast abscess were treated by these methods. In group-A 20 patients were successfully treated with needle aspiration and antibiotics after culture and sensitivity. The mean time for healing in group-A is 11.3 days for 2 cm abscess and longest is 16.1 days in 5 cm abscess. Failure rate in aspiration group is 20%. This is an outpatient procedure with no scar and does not require general anesthesia. Patient satisfaction is more in aspiration group. Group-B patients underwent incision and drainage, but it was associated with bad scars while healing time was not so different from that in group-A. Conclusion: Breast abscess in patients with abscess size of less than or equal to 5 cm can be treated with needle aspiration successfully and with good cosmetic outcome. (author)