Comparison between aspiration and incision and drainage of breast abscess

Abstract

Background: Breast abscess is defined as an acute inflammatory lump which yields pus on incision/aspiration. The frequency of occurrence is highly related to pregnancy and caused due to nipple piercing by a child during feeding and bacterial colonization due to improper nursing technique and incomplete emptying of the breast. Non-lactational breast abscesses are entirely different from those occurring during breast feeding. They occur in the peri-areolar tissues, frequently recur, and infecting organisms are mixture of anaerobes. The present study compares the outcome and effectiveness of traditional treatment incision and drainage against needle aspiration in the treatment of breast abscess. Methods: This is a comparative study carried out in department of general surgery in a tertiary health care center, LTMMH and GH, Mumbai for a period of 2 years (May 2012 - May 2014) after taking approval from institutional ethics committee. 60 female patients of age between 18-65 years and diagnosed breast abscess with abscess size of less than 10 cm in diameter on ultrasonography were included in the study after taking written consent form. Of these 30 had undergone aspiration of the breast abscess (group A) and 30 had undergone incision and drainage of the breast abscess (group B). Results: The mean age of the female patients in the study were 18-42 years. 90% of the cases were lactating. S. aureus was the common organism isolated in both lactating and non-lactating cases, encountered in 34 patients (57.7%). Out of that 20 were in the aspirated group (66.7%). 14 patients were in the incised group (46.7%). The mean healing time and cosmetic outcome was significantly (p = 0.001) very good in patients treated with needle aspiration compared to incision and drainage. There was no recurrence of breast abscess observed in needle aspiration group during the study. There was 3.3% recurrence rate observed in the incision and drainage group. Conclusions: Breast abscess in patients with diameter of less than 7 cm can be treated with needle aspiration successfully and with a good cosmetic outcome.