Comparison of Aspiration Versus Incision and Drainage in the Treatment of Breast Abscess, in terms of Recurrence: An Analytical Cross-Sectional Study

Authors

  • Maha Tariq Department of General Surgery, Combined Military Hospital, Karachi, Pakistan.
  • Naveed Ahmed Department of General Surgery, Combined Military Hospital, Karachi, Pakistan.
  • Iftikhar Ahmed Department of General Surgery, Combined Military Hospital, Karachi, Pakistan.
  • Zainab Qutbuddin Department of General Surgery,Burhani Hospital, Karachi, Pakistan.
  • Rafia Wakil Department of General Surgery,Burhani Hospital, Karachi, Pakistan.
  • Sidra Batool Department of General Surgery, Jinnah Post Graduate Medical Center, Karachi, Pakistan.

Keywords:

Breast Abscess, Incision and Drainage, Needle Aspiration, Recurrence

Abstract

Objective: To assess and compare the treatment outcomes of breast abscess using two different methods aspiration versus incision and drainage.
Methods: This analytical cross-sectional study was conducted at Combined Military Hospital, Karachi, Pakistan, from October 2023 to March 2024. Females age`d 18 to 50 years with ultrasound-diagnosed acute breast abscesses up to 5 cm, presenting with signs and symptoms such as breast pain, localized swelling, erythema, tenderness, and fever, were included. Patients were randomly assigned to receive needle aspiration or incision and drainage. Outcomes were assessed based on recurrence and scarring. Recurrence was defined as the reappearance of similar signs and symptoms after complete resolution. Patients were monitored for one-month post-treatment.
Results: Of total 124 patients, the mean age was 38.10 ±5.21 years. The mean duration of procedure was 26.33 ±10.58 minutes. A significantly longer mean duration of the procedure was observed in the aspiration group as compared to the incision and drainage group i.e., 36.61 ± 2.82 minutes vs. 16.04 ± 1.67 minutes (p-value <0.001). A significant association found between the two groups in terms of parity (p-value <0.001) and site of abscess (p-value 0.001). Treatment outcome showed higher rate of recurrence and scarring in the aspiration group compared to the incision and drainage group i.e., 8 (66.7%) vs. 4 (33.3%) and 5 (100.0%) vs. 0 (0.0%). However, a significant association of scar (p-value 0.022) was observed between groups.
Conclusion: Incision and drainage proved more effective than aspiration for treating breast abscesses, with lower rates of recurrence and scarring.

Downloads

Download data is not yet available.

References

Boakes E, Woods A, Johnson N, Kadoglou N. Breast Infection: A review of diagnosis and management practices. Eur J Breast Health 2018; 14:136-43.doi:10.5152/ejbh.2018.3871

Sharma K, Costas A, Shulman LN, Mera JG. A systematic review of barriers to breast cancer care in developing countries resulting in delayed patient presentation. J Oncol 2012; 2012:121873. doi:10.1155/2012/121873.

Pileri P, Sartani A, Mazzocco MI, Giani S, Rimoldi S, Pietropaolo G, et al. Management of breast abscess during breastfeeding. Int J Environ Res Public Health 2022; 19: 5762. doi:10.3390/ijerph19095762

Amin A, Rang Ali AI, Hashmi JS, Khattak IA, Kamran H. Effectiveness of aspiration under ultrasound guidance in breast abscess in terms of early resumption of breast feeding: a randomized controlled trial. Pak J Med Health Sci 2022; 16:887-9. doi:10.53350/pjmhs22168887

Saeed S, Naumani AR, Kazmi A, Khalid R, Ali M, Naqi SA, et al. Comparison between needle aspiration versus incision and drainage in management of breast abscess. Pak J Surg 2006; 37:56-8.

Colin C, Delov AG, Peyron-Faure N, Rabilloud M, Charlot M. Breast abscesses in lactating women: evidences for ultrasound-guided percutaneous drainage to avoid surgery. Emerg Radiol 2019; 26:507-14. doi:10.1007/s10140-019-01694-z

Fathy E, Nashed GA, Awadallah EG, Shokralla SY, Abd Elmonim AM. Comparative study between surgical drainage of acute lactational breast abscess and ultrasound-guided needle aspiration and/or drainage. Egypt J Surg 2022; 41:97-104. doi:10.4103/ejs.ejs_281_21

Afzal S, Bashir A, Shahzad H, Masroor I, Sattar AK. Ultrasound-guided percutaneous aspiration for the treatment of breast abscess at a tertiary care center in the developing world. Cureus 2022; 14:e30865. doi:10.7759/cureus.30865

David M, Handa P, Castaldi M. Predictors of outcomes in managing breast abscesses—A large retrospective single‐center analysis. Breast J 2018; 24:755-63. doi:10.1111/tbj.13053

Ahmad S, Amin S, Alam M, Tahir R, Noreen S, Khan AG, et al. Frequency of breast abscess among lactating women presenting to ambulatory care of tertiary care hospital. Pak J Med Health Sci 2023; 17:152-4. doi:10.53350/pjmhs2023173152

Omranipour R, Vasigh M. Mastitis, Breast Abscess, G Mastitis. Adv Exp Med Biol 2020; 1252:53-61. doi:10.1007/978-3-030-41596-9_7

Zhou F, Li Z, Liu L, Wang F, Yu L, Xiang Y, et al. The effect-iveness of needle aspiration versus traditional incision and drainage in the treatment of breast abscess: A meta-analysis. Ann Med 2023; 55:2224045. doi:10.1080/07853890.2023.2224045.

Irusen H, Rohwer AC, Steyn DW, Young T. Treatment for breast abscesses in breast feeding women. Cochrane Database Syst Rev 2015; Cd010490. doi:10.1002/14651858.CD010490.pub2

Karvande R, Ahire M, Bhole M, Rathod C. Comparison between aspiration and incision and drainage of breast abscess. Int Surg J 2016; 3:1773-80. doi:10.18203/2349-2902.isj20163144

Chandika AB, Gakwaya AM, Kiguli-Malwadde E, Chalya PL. Ultrasound guided needle aspiration versus surgical drainage in the management of breast abscesses: A Ugandan experience. BMC Res Notes 2012; 5:12. doi:10.1186/1756-0500-5-12

Naeem M, Rahimnajjad MK, Rahimnajjad NA, Ahmed QJ, Fazel PA, Owais M. Comparison of incision and drainage against needle aspiration for the treatment of breast abscess. Am Surg 2012; 78:1224-27.

Qureshi UA, Arshad S, Tayyab MA, Khawar GR, Alvi AR. Efficacy of single time ultrasound guided needle aspiration in treating breast abscess. Pak J Med Health Sci 2022; 16:674-6. doi:10.53350/pjmhs22164674

Shah SI, Rasheed S, Rehman WU, Shaikh K, Hamid F, Azam Z. Comparison of outcome between percutaneous aspiration, incision and drainage in case of lactational and non-lactational breastabscess. Pak J Med Health Sci 2022; 16:876-7. doi:10.53350/pjmhs20221611876

Li Y, Ma XJ. Risk factors for failure of ultrasound-guided fine-needle aspiration therapy for lactational breast abscess. Breastfeed Med 2021; 16:894-8. doi:10.1089/bfm.2021.0060.

Menegas S, Moayedi S, Torres M. Abscess management: An evidence-based review for emergency medicine clinicians. J Emerg Med 2021; 60: 310-20. doi:10.1016/j.jemermed.2020.10.043

Trop I, Dugas A, David J, El Khoury M, Boileau JF, Larouche N, et al. Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics 2011; 31:1683-99. doi:10.1148/rg.316115521

Downloads

Published

2024-12-16

How to Cite

Tariq, M., Ahmed, N., Ahmed, I., Qutbuddin, Z., Wakil, R., & Batool, S. (2024). Comparison of Aspiration Versus Incision and Drainage in the Treatment of Breast Abscess, in terms of Recurrence: An Analytical Cross-Sectional Study. Journal of the Dow University of Health Sciences (JDUHS), 18(3), 150–156. Retrieved from https://mail.jduhs.com/index.php/jduhs/article/view/2326

Issue

Section

Original Articles