Comparison of Incision and Drainage with Needle Aspiration in the Treatment of Breast Abscess: Incision and Drainage with Needle Aspiration in the Treatment of Breast Abscess

Areej Mubashir; Ayesha Tahir; Sadeeq Ahmad; Shahzad Ahmed

doi:10.54393/pjhs.v7i8.3587

Authors

Areej Mubashir Department of General Surgery, Abbottabad International Medical Institute, Abbottabad, Pakistan
Ayesha Tahir Department of Surgery, District Headquarter Hospital, Haripur, Pakistan
Sadeeq Ahmad Department of General Surgery, Medical Teaching Institution, Mardan Medical Complex, Mardan, Pakistan
Shahzad Ahmed Department of General Surgery, Jinnah International Hospital, Abbottabad, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i8.3587

Keywords:

Breast Abscess, Incision and Drainage, Needle Aspiration, Lactational Mastitis, Ultrasound-Guided Aspiration

Abstract

Breast abscess is a common complication of mastitis in low- and middle-income countries and may impair cosmetic appearance and breastfeeding. Conventional incision and drainage (I/D) are effective but associated with scarring and delayed recovery. Ultrasound-guided needle aspiration is a minimally invasive alternative. Objective: To compare the efficacy of ultrasound-guided needle aspiration and I/D in the management of breast abscesses. Methods: This retrospective comparative study was conducted in the Department of Surgery, Hayatabad Medical Complex, Peshawar, from August to October 2025. A total of 110 female patients (18–60 years) with breast abscesses of ≥3 days duration was included using record-based sampling. Patients with BMI >29.9 kg/m², chronic diabetes, or recent breast intervention were excluded. Group A (n=55) underwent I/D, while Group B (n=55) received ultrasound-guided needle aspiration. All patients received antibiotics. The primary outcome was treatment success (complete resolution without recurrence). Data were analyzed using SPSS version 23.0, and a chi-square test was applied. A p-value <0.05 was considered significant. Results: Mean age was 29.17 ± 9.44 years in Group A and 30.11 ± 8.56 years in Group B. Overall, 63.6% were lactating women. Treatment success was achieved in 37/55 (67.3%) patients in Group A and 53/55 (96.4%) in Group B. The difference was statistically significant (p<0.01). Conclusions: Ultrasound-guided needle aspiration demonstrated significantly higher success rates than I/D and offers a less invasive approach with a better recovery profile. It should be considered the preferred first-line treatment in appropriately selected patients.

References

Egbe TO, Njamen TN, Essome H, Tendongfor N. The Estimated Incidence of Lactational Breast Abscess and Description of Its Management by Percutaneous Aspiration at the Douala General Hospital, Cameroon. International Breastfeeding Journal. 2020 Apr; 15(1): 26. doi: 10.1186/s13006-020-00271-2.

Srivastava V, Meena RK, Ansari MA, Kumar D, Kumar A. A Study of Anxiety and Depression in Benign Breast Disease. Journal of Mid-Life Health. 2020 Oct; 11(4): 200-9. doi: 10.4103/jmh.JMH_85_20.

Luo J, Long T, Cai Y, Teng Y, Fan Z, Liang Z et al. Abscess Drainage with or Without Antibiotics in Lactational Breast Abscess: Study Protocol for a Randomized Controlled Trial. Infection and Drug Resistance. 2020 Jan: 183-90. doi: 10.2147/IDR.S221037.

Lukassek J, Ignatov A, Faerber J, Costa SD, Eggemann H. Puerperal Mastitis in the Past Decade: Results of a Single Institution Analysis. Archives of Gynecology and Obstetrics. 2019 Dec; 300(6): 1637-44. doi: 10.1007/s00404-019-05333-3.

Yao YD, Dong BB, Wu W, Li Q, Chen Y, Chen BJ et al. Clinical Diagnostic Management and Bacteriological Etiology of Non-Puerperal Mastitis in the Population of Southern China. Journal of Bio-X Research. 2018 Jun; 1(01): 25-31. doi: 10.1097/JBR.0000000000000004.

Ullah K, Ahmad N, Jan Z, Shoaib A. Bacteriology and Antibiotic sensitivity of Breast Abscess. Journal of Saidu Medical College. 2019; 9(2).

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.

Hussain N, Khan I, Ahmed T, Parveen S, Malik M, Khan MI. Comparison of the Restoration of Breastfeeding 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.

Dayal P and Lal M. A Comparative Study of Outcomes in Management of Breast Abscess by Ultrasound Guided Needle Aspiration Against Incision and Drainage. International Journal of Medical and Biomedical Studies. 2019; 3(4). doi: 10.32553/ijmbs.v3i4.201.

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.

Mwenda AS and Wasike R. Breast Abscess Management and the Role of Post-Incisional Antibiotics. Annals of African Surgery. 2016; 13(2). doi: 10.4314/aas.v13i2.7.

Larson KE and Valente SA. Milk Fistula: Diagnosis, Prevention, and Treatment. The Breast Journal. 2016 Jan; 22(1): 111-2. doi: 10.1111/tbj.12528.

Kang YD and Kim YM. Comparison of Needle Aspiration and Vacuum-Assisted Biopsy in the Ultrasound-Guided Drainage of Lactational Breast Abscesses. Ultrasonography. 2016 Apr; 35(2): 148-52. doi: 10.14366/usg.15041.

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): e30865. doi: 10.7759/cureus.30865.

Ghunaim H. Percutaneous Ultrasound‐Guided Needle Aspiration for Management of Breast Abscesses–A Review. Journal of Medical Radiation Sciences. 2023 Sep; 70(3): 327-37. doi: 10.1002/jmrs.682.

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 1;20(3):194. doi: 10.4274/ejbh.galenos.2024.2024-3-2.

Ali MN, Hannan MA, Shahid SM, Kubba T, Roy D. Ultrasound Guided Needle Aspiration of Breast Abscess as an Alternative to Surgical Incision and Drainage. Journal of the Teachers Association. 2020 Jun; 33(1): 1-4. doi: 10.3329/taj.v33i1.49817.

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.

Fathy E, Nashed GA, Awadallah EG, Shokralla SY, Abd Elmonim AM. Comparative Study Between Surgical Drainage of Acute Lactational Breast Abscess and Ultrasound-Guided Needle Aspiration and/or Drainage. The Egyptian Journal of Surgery. 2 022 Oct; 41(1).

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.

Rigourd V, Benoit L, Paugam C, Driessen M, Charlier C, Bille E et al. Management of Lactating Breast Abscesses by Ultrasound-Guided Needle Aspiration and Continuation of Breastfeeding: A Pilot Study. Journal of Gynecology, Obstetrics, and Human Reproduction. 2022 Jan; 51(1): 102214. doi: 10.1016/j.jogoh.2021.102214.

Tran AT, Nguyen DM, Tran QH, Nguyen QH, Nguyen Thi TH, Tran Thi DQ et al. Assessment of the Effectiveness of Ultrasound-Guided Needle Aspiration of Lactating Breast Abscesses. International Journal of General Medicine. 2024 Dec: 553-7. doi: 10.2147/IJGM.S449432.