Incision drainage or ultrasound guided needle aspiration for the management of breast abscess - a prospective observational study.

Breast abscess is an acute inflammatory condition of the breast. Once an abscess is established, management involves incision and drainage. Where an abscess has formed, aspiration of the pus, preferably under ultrasound guidance, has now supplanted open surgery as the first line of treatment.1Aims and objectives: To study ultrasound guided percutaneous needle aspiration v/s incision drainage in breast abscess in terms of: Operative time, Post-operative pain, Hospital stay , Healing time and Cosmetic outcome. Material and methods: Patients with clinical features suggestive of breast abscess were divided in two groups. The patients in Group A underwent needle aspiration using 18 gauge needle attached with 10cc syringe. Patients in Group B underwent Incision and drainage. Patients in both the groups were put on broad spectrum antibiotics till reports of culture and sensitivity were collected. All patients were followed up regularly. Patient satisfaction with treatment was also recorded. Results: The mean age of patients in our study was 27.90 years. The mean age in incision and drainage group was 27.35yrs with a std. deviation of 7.788 and in needle aspiration group, it was 28.15yrs with standard deviation of 8.437.Group A patients (USG guided needle aspiration) procedure was completed in a mean operative time of 12.5 while group B patients (incision and drainage) were done in a mean operative time of 28.0. Mean pain score in I & D group was 3.95 and Needle aspiration group was 1.35. Patients who underwent needle aspiration were not admitted. However those who underwent incision drainage had to be kept for a duration ranging from 12-24hours. Most of the patients from I&D had a mean healing time of 2.7 weeks and std. deviation of 0.979 while as the patients from usg guided aspiration group had mean healing time of 2.45 weeks and std. deviation of 0.826. Conclusion: USG guided aspiration is simple, painless, day care procedure and effective alternative treatment to incision and drainage in properly selected patient.