Comparative study between surgical drainage of acute lactational breast abscess and ultrasound-guided needle aspiration and/or drainage

Fathy, Ehab; Nashed, George A.; Awadallah, Essam G.; Shokralla, Sally Y.; Abd Elmonim, Ahmed M.

doi:10.4103/ejs.ejs_281_21

Comparative study between surgical drainage of acute lactational breast abscess and ultrasound-guided needle aspiration and/or drainage

Authors

Abstract

Background
Management of breast abscess involves incision and drainage; however, this is associated with need for general anesthesia, prolonged healing time, regular dressing, difficulty in breastfeeding, and possible unsatisfactory cosmetic outcomes. Ultrasound-guided aspiration has been used successfully and is associated with less recurrence, excellent cosmetic results, and less costs.
Patients and methods
This study was conducted in the Department of General Surgery in Kasr Al-Ainy Hospital from August 2019 to March 2020. Patients admitted to the hospital with acute lactational breast abscess and met the inclusion criteria were the candidates of this study. A total of 48 female patients with acute lactational breast abscess between 18 and 50 years of age were included. The patients were randomized into group A (ultrasound-guided needle aspiration) and group B (incision and surgical drainage). The patients were followed up for 1 month after complete resolution.
Results
The mean age of patients in group A was 29.79 years and in group B was 29.04 years, the mean intervention time was 18.05 min in group A and 12.92 min in group B, and the healing time was less in group A (mean=11.6) than group B (mean=22.21). The pain was less in group A than group B in the second and third day postoperatively. All the patients were satisfied with the cosmetic results in group A, whereas in group B, only 54% of the patients were satisfied with the cosmetic outcome. Recurrence was found in two (11.8%) patients in group A, with a success rate of 70%, whereas in group B, the success rate was 100%, with no recurrence.
Conclusion
Ultrasound-guided needle aspiration could be an effective alternative to incision and surgical drainage in selected cases with acceptable success rate, less healing time, less postintervention pain, better cosmetic outcome, and without the need for general anesthesia.

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