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Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center
Author(s) -
Giess Catherine S.,
Golshan Mehra,
Flaherty Karen,
Birdwell Robyn L.
Publication year - 2014
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22191
Subject(s) - medicine , abscess , lumpectomy , fine needle aspiration , incision and drainage , fistula , retrospective cohort study , pregnancy , etiology , surgery , biopsy , demographics , fistulotomy , mastectomy , radiology , obstetrics , breast cancer , cancer , anal fistula , genetics , biology , demography , sociology
Purpose Our purpose was to review needle aspiration of breast abscesses and identify factors associated with treatment by aspiration alone versus aspiration with surgical incision and drainage (I/D). Methods This Institutional Review Board–approved, retrospective review of the breast ultrasound database from 2008 to 2010 identified 40 patients (41 abscesses) who underwent aspiration, with or without I/D. Demographics, imaging, number of aspirations, and microbiology were reviewed. Results Twenty‐two abscesses underwent aspiration only, 16 > 3 cm, 6 ≤ 3 cm (mean 4.3 cm, range 0.9–10 cm). Known risk factors included lactational (11), 3 weeks post partum (1), pregnancy (1), recent biopsy/lumpectomy (5). Nineteen abscesses underwent aspiration and I/D, 15 > 3 cm, 4 ≤ 3 cm (mean 4.1 cm, range 2.2–7.5 cm). Known risk factors included lactational (4), recurrent subareolar abscess (4), diabetes (3), hydradenitis suppuritiva (1), nipple piercing (2), smoking (1), pregnancy (1), HIV (1), and lumpectomy (1). Identified reasons for I/D included lack of improvement/recurrence (12), fistula (3), and one electively after clinical improvement of a recurrent subareolar abscess. Conclusions Abscesses associated with pregnancy and lactation or breast biopsy are effectively managed with aspiration, even when large. Recurrence, chronicity, or fistula may require surgical intervention. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 42 :513–521, 2014