A Randomized Controlled Trial of Needle Aspiration under Ultrasonographic guidance versus Incision and Drainage of Breast Abscess

Abstract

Introduction: Breast abscess is a common cause of morbidity in women. Patients commonly present with a painful swelling of the breast and fever. Lactational breast abscess occurring during breast feeding is the result of Staphylococcus infection. Non-lactational breast abscesses are entirely different from those occurring during nursing. They occur in the peri-areolar tissues, frequently recur, and infecting organisms are a mixture of Bacteroides, Anaerobic streptococci, and Enterococci. Methods: This was a hospital based prospective randomized controlled trial. 60 patients were included in the study. 30 of them were randomized in the needle aspiration group and other 30 were treated by incision and drainage. The patients were followed up on days 3,7,14,21 post intervention and thereafter for three months on a monthly basis. Results: Our study showed mean age in incision and drainage group was 26 years, and in needle aspiration group, it was 29 years. The difference in age group between the 2 groups was not statistically significant. Requirement of analgesic was high in incision & drainage group as compare to needle aspiration group. Comparison of presence of fever between two groups was statistically significant with a p-value of 0.048. At the end of follow up patient satisfaction rate was high in needle aspiration as compare to incision & drainage. Conclusion: In conclusion it can be said that whenever and wherever the facility of ultrasound is available, serial percutaneous needle aspiration may be tried as a first line of therapy up to a maximum of three attempts, in patients whose abscess diameter <5cm and in those where the abscess diameter is >5cm, incision and drainage maybe used as first line therapy.