Comparison of Pain, Cosmetic Outcomes and Early Restoration of Breast Feeding in Multiple Percutaneous Needle Aspiration Vs Incision and Drainage for Small Breast Abscess Management
Breast Feeding in Multiple Percutaneous Needle Aspiration Vs Incision and Drainage
DOI:
https://doi.org/10.54393/pjhs.v6i5.1725Keywords:
Breast Abscess, Percutaneous Needle Aspiration, Incision and Drainage, Pain ManagementAbstract
Breast abscesses disrupt postpartum women's well-being, hindering breastfeeding and affecting cosmetic outcomes. Traditional incision and drainage (ID) often causes significant discomfort and suboptimal aesthetics. Multiple percutaneous needle aspiration (MPNA) offers a minimally invasive alternative with potentially better outcomes. Objectives: To compare pain, cosmetic satisfaction, and breastfeeding restoration between MPNA and ID for breast abscess treatment. Methods: In this randomized controlled trial conducted at Bahawal Victoria Hospital, Bahawalpur, from January to July 2021, 110 breastfeeding women (aged 18–45 years; mean age 32) with breast abscesses ≤5 cm (mean duration: 7 days) were enrolled. Participants were randomized into two groups: MPNA (n=55) and ID (n=55). Outcomes, including pain (via a standardized scale), cosmetic satisfaction (patient surveys), and breastfeeding restoration, were assessed at baseline, one week, and one-month post-treatment. Results: The MPNA group reported lower mean pain scores (2.3 vs. 5.6 in the ID group). Cosmetic satisfaction was higher in the MPNA group, with 80% reporting "Highly Satisfactory" outcomes compared to 40% in the ID group. Additionally, 85% resumed breastfeeding within one-week post-treatment in the MPNA group, compared to 60% in the ID group. Conclusion: It was concluded that MPNA is a viable, less invasive alternative to ID for small breast abscesses in breastfeeding women, with significantly reduced pain, better cosmetic outcomes, and quicker breastfeeding restoration. MPNA should be considered a preferred first-line treatment in appropriate cases.
References
Koziol KJ, Smiley A, Latifi R, Castaldi MT. Predictive Risk Factors for Childbirth-Associated Breast Infections in the United States: A 10-Year Perspective. International Journal of Environmental Research and Public Health. 2023 Jul; 20(14): 6333. doi: 10.3390/ijerph20146333.
Lam E, Chan T, Wiseman SM. Breast Abscess: Evidence Based Management Recommendations. Expert Review of Anti-Infective Therapy. 2014 Jul; 12(7): 753-62. doi: 10.1586/14787210.2014.913982.
Kataria K, Srivastava A, Dhar A. Management of Lactational Mastitis and Breast Abscesses: Review of Current Knowledge and Practice. Indian Journal of Surgery. 2013 Dec; 75: 430-5. doi: 10.1007/s12262-012-0776-1.
Algammal AM, Hetta HF, Elkelish A, Alkhalifah DH, Hozzein WN, Batiha GE et al. Methicillin-Resistant Staphylococcus Aureus (MRSA): One Health Perspective Approach to the Bacterium Epidemiology, Virulence Factors, Antibiotic-Resistance, and Zoonotic Impact. Infection and Drug Resistance. 2020 Sep: 3255-65. doi: 10.2147/IDR.S272733.
Sullivan T and de Barra E. Diagnosis and Management of Cellulitis. Clinical Medicine. 2018 Apr; 18(2): 160-3. doi: 10.7861/clinmedicine.18-2-160.
Chen C, Luo LB, Gao D, Qu R, Guo YM, Huo JL et al. Surgical Drainage of Lactational Breast Abscess with Ultrasound‐Guided Encor Vacuum‐Assisted Breast Biopsy System. The Breast Journal. 2019 Sep; 25(5): 889-97. doi: 10.1111/tbj.13350.
Pal B, Shaikh O, Vijayakumar C, Prakash S, Balasubramanian G, Kumbhar U. A Randomized Controlled Trial Comparing Ultrasonography-Guided Needle Aspiration and Surgical Drainage for the Management of Breast Abscess. Cureus. 2023 Dec; 15(12). doi: 10.7759/cureus.50956.
Irusen H, Rohwer AC, Steyn DW, Young T. Treatments for Breast Abscesses in Breastfeeding Women. Cochrane Database of Systematic Reviews. 2015(8). doi: 10.1002/14651858.CD010490.pub2.
Totadri VM, Vetri R, Sainath S. A Comparative Study of Drainage of Breast Abscesses by Conventional Incision and Drainage vs Ultrasound-Guided Needle Aspiration/Re-Aspiration in A Tertiary Health Care Centre. European Journal of Breast Health. 2024 Jul; 20(3): 194. doi: 10.4274/ejbh.galenos.2024.2024-3-2.
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. BioMed Central Research Notes. 2012 Dec; 5: 1-7. doi: 10.1186/1756-0500-5-12.
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 Oct; 14(10). doi: 10.7759/cureus.30865.
Boakes E, Woods A, Johnson N, Kadoglou N. Breast Infection: A Review of Diagnosis and Management Practices. European Journal of Breast Health. 2018 Jul; 14(3): 136.
Singh SP, Kumar A, Chaudhary SK, Kumaran R. Comparison of Conventional Incision and Drainage Versus Ultrasound Guided Minimally Invasive Techniques in Management of the Breast Abscess: A Prospective Cohort Study. International Journal of Health Sciences. 2022; 6(S2): 4349-57. doi: 10.53730/ijhs.v6nS2.6001.
Hussain N, Khan I, Ahmed T, Parveen S, Malik M, Khan MI. Comparison of the Restoration of Breast Feeding After Percutaneous Aspiration Vs Incision and Drainage for Management of Breast Abscess. Journal of Liaquat University of Medical and Health Sciences. 2018; 17(01): 47-51. doi: 10.22442/jlumhs.181710548.
Karim SA, Sami FA, Shah AH, Hanif MU, Zai AR. Compare the Outcome of Percutaneous Aspiration with Incisional Drainage for Management of Breast Abscess. Pakistan Journal of the Medical Health Science. 2021; 15(8): 2157-9. doi: 10.53350/pjmhs211582157.
Manzoor A, Rashid I, Waqar SH, Shah SA. Comparison of Needle Aspiration and Incision and Drainage in the Management of Lactational Breast Abscess. Journal of The Society of Obstetricians and Gynaecologists of Pakistan. 2022 Mar; 12(1): 32-7.
Voruganti MR, Sistu MK, Gadipudi HC. A Comparative Study on Ultrasound Guided Percutaneous Aspiration Versus Incision and Drainage in the Management of Small Breast Abscesses. International Surgery Journal. 2022 Feb; 9(3): 620-6. doi: 10.18203/2349-2902.isj20220632.
Randhawa SR, Akram M, Akram H, Sajid M. Comparison of Needle Aspirations and Incision and Drainage of Breast Abscess. Journal of University Medical and Dental College. 2019 Jun; 10(2): 40-4.
Zhou F, Li Z, Liu L, Wang F, Yu L, Xiang Y et al. The Effectiveness of Needle Aspiration Versus Traditional Incision and Drainage in the Treatment of Breast Abscess: A Meta-Analysis. Annals of Medicine. 2023 Dec; 55(1): 2224045. doi: 10.1080/07853890.2023.2224045.
Bing F and Jie L. Ultrasound Guided Needle Aspiration and Cavity Washing Versus Incision and Drainage to Treat Breast Abscesses: A Meta-Analysis. International Journal of Clinical and Experimental Medicine. 2017 Jan; 10(6): 8656-65.
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