Effectiveness of Ultrasound-Guided Needle Aspiration Versus Incision & Drainage in Breast Abscess Management: A Single-Centre Quasi-Experimental Study
DOI:
https://doi.org/10.47489/szmc.v40i1.852Keywords:
Breast disease, Abscess, Drainage, Fine needle aspiration, Ultrasonography, RecurrenceAbstract
Background: Breast abscess is a frequent complication of lactational mastitis particularly in low-resource settings where the priority is continuing effective breastfeeding, optimizing the management course, while maintaining satisfactory cosmetic outcomes.
Objective: To compare the effectiveness of ultrasound-guided needle aspiration (USG-NA) with incision and drainage (I&D) for breast abscess with respect to short-term recurrence and overall clinical outcomes.
Method: This single-centre quasi-experimental study was conducted at Ayub Teaching Hospital from August 2022 to June 2023. Ethical approval was obtained and all participants provided written informed consent. Sixty women aged 20–60 years with a first episode of breast abscess (>1 cm) were enrolled and allocated equally to ultrasound-guided needle aspiration (USG-NA; n=30) or conventional incision and drainage (I&D; n=30) in a 1:1 ratio based on clinical indication and patient consent. Empirical antibiotics were administered to both groups and modified based on culture results. The primary outcome measure was abscess recurrence at two weeks, confirmed either clinically or through ultrasonography. Secondary analyses stratified outcomes by age, residence, abscess size, and lactation status.
Results: The mean age was 25.45±3.83 years. Overall recurrence was 21.7% (13/60). Recurrence was observed in 3 (10.0%) after aspiration versus 10 (33.3%) after incision and drainage; (p = 0.028). Subgroup analysis showed significantly lower recurrence with aspiration among patients ?30 years (p=0.035), urban residents (p=0.021), and abscesses ?2 cm (p=0.009). No major procedure-related adverse events were reported. Breastfeeding continuation was maintained in most patients post procedure.
Conclusion: USG-NA reduced short-term recurrence versus I&D, particularly in younger patients, urban residents, and smaller abscesses. It is safe, minimally invasive, preserves tissue, and supports continued breastfeeding. Trials with longer follow-up are recommended.
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