Ultrasound-Guided Percutaneous Aspiration for the Treatment of Breast Abscess at a Tertiary Care Center in the Developing World

Cureus. 2022 Oct 30;14(10):e30865. doi: 10.7759/cureus.30865. eCollection 2022 Oct.

Abstract

Purpose: Percutaneous ultrasound (US)-guided aspiration is the first line of management for breast abscess. Our study aimed to look at the success of US-guided percutaneous drainage in managing breast abscesses at a tertiary care center and additionally to look for any correlation between US features and failure rate. Methods: A retrospective review of the radiology database at a tertiary care hospital in Pakistan was done to identify 54 patients through non-probability convenience sampling who underwent a US-guided percutaneous aspiration with laboratory confirmation of abscess. A treatment course was observed for the development of complications or failure of treatment. A chi-square test was performed to correlate US features and patient characteristics with outcomes of treatment (p<0.05). Fisher's exact test was applied to evaluate the success of aspiration in small versus large abscesses, and in lactating versus non-lactating patients. Results: 75% of all women were successfully able to avoid surgery. Specifically, 80.6% of all lactating women and 66.7 % of non-lactating women with breast abscesses were successfully managed with US-guided percutaneous aspiration. Across a variety of parameters measured, including pathological and etiological factors, as well as features on imaging, no significant association was established between the variables and the failure of the intervention.

Conclusion: Low morbidity and high patient satisfaction rates make percutaneous aspiration preferable to surgical intervention as a first-line treatment of breast abscess. Early use of antibiotics is recommended as an adjunct to drainage.

Keywords: benign breast lesion; breast abscess; percutaneous aspiration; surgical debridement; ultrasound-guided fine-needle aspiration.