Ultrasound-guided percutaneous drainage as an alternative to surgery in treating breast abscesses

Abstract

Objectives: The aim of this study was to assess whether ultrasound-guided (US-guided) percutaneous drainage of breast abscesses could be used as an alternative to surgery.

Methods: We performed a retrospective study. Twenty patients were included in the study who were diagnosed as having a non-specific breast abscess. Eleven patients underwent surgery whereas nine patients were treated with US-guided drainage. Ultrasonographic findings, results of treatment and follow-up were evaluated between the two groups.

Results: In the US-guided drainage group, 5 patients were treated with needle aspiration and 4 were treated with catheter drainage. All cases within the needle aspiration group totally recovered. However, one case within the catheter drainage group failed. The total success rate of US-guided drainage was 88.8%. The median follow-up period was 21.0 days in the US-guided drainage group and 45.0 days in the surgical drainage group. There were no statistically significant differences in terms of recovery (p = 0.450) and follow-up periods (p = 0.112) between the surgical drainage and US-guided drainage groups.

Conclusions: US-guided percutaneous drainage may be preferred as a first method of choice in treatment of a breast abscess. The most appropriate approach to breast abscess treatment will be possible with a multidisciplinary approach of surgery and radiology.

Keywords

• Breast abscess,percutaneous drainage,US-guided drainage

References

1. [1] 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.
2. [2] Ozseker B, Ozcan UA, Rasa K, Cizmeli OM. Treatment of breast abscesses with ultrasound-guided aspiration and irrigation in the emergency setting. Emerg Radiol 2008;15:105-8.
3. [3] Karstrup S, Nolsoe C, Brabrand K, Nielsen KR. Ultrasonically guided percutaneous drainage of breast abscesses. Acta Radiol 1990;31:157-9.
4. [4] 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.
5. [5] Hook GW, Ikeda DM. Treatment of breast abscesses with US-guided percutaneous needle drainage without indwelling catheter placement. Radiology 1999; 213:579-82.
6. [6] Christensen AF, Al-Suliman N, Nielsen KR, Vejborg I, Severinsen N, Christensen H, et al. Ultrasound-guided drainage of breast abscesses: results in 151 patients. Br J Radiol 2005;78:186-8.
7. [7] Imperiale A, Zandrino F, Calabrese M, Parodi G, Massa T. Abscesses of the breast: US-guided serial percutaneous aspiration and local antibiotic therapy after unsuccessful systemic antibiotic therapy. Acta Radiol 2001;42:161-5.
8. [8] Ulitzsch D, Nyman MK, Carlson RA. Breast abscess in lactating women: US-guided treatment. Radiology 2004;232:904-9.

9. [9] Bushra S, Azhar AS, Khush MS, Roshan AS. Needle aspiration in treatment of breast abscess. RMJ 2014;39:58-60.
10. [10] Schwarz RJ, Shrestha R. Needle aspiration of breast abscesses. Am J Surg 2001;182:117-9.
11. [11] Tan SM, Low SC. Non-operative treatment of breast abscesses. Aust N Z J Surg 1998;68:423-4.
12. [12] Elagili F, Abdullah N, Fong L, Pei T. Aspiration of breast abscess under ultrasound guidance: outcome obtained and factors affecting success. Asian J Surg 2007;30:40-4.
13. [13] Berna-Serna JD, Madrigal M, Berna-Serna JD. Percutaneous management of breast abscesses: an experience of 39 cases. Ultrasound Med Biol 2004;30:1-6.
14. [14] Munakomi S, Adhikary S. Clinical profile and methodology in the management of inflammatory benign breast lesions. Cureus 2014;6:e214.
15. [15] Ranjeesh V, Kotha S. A prospective comparative study of needle aspiration vs incision and drainage of lactational breast abscess. IJCMR 2018;5:E13-7.