From the Guidelines
General surgeons do not typically perform breast abscess aspirations, as this procedure is often performed by interventional radiologists using image-guided percutaneous drainage or aspiration. This approach is preferred due to its minimally invasive nature, which reduces morbidity, length of hospital stay, and cost, as noted in a 2019 study published in the American Family Physician 1. The study highlights the benefits of percutaneous drainage, including its safety, tolerability, and effectiveness in treating abnormal fluid collections, including abscesses.
When it comes to breast abscesses, patients with larger abscesses (typically greater than 3 cm) are often considered candidates for drain placement, whereas those with smaller abscesses may be treated with aspiration or antibiotic therapy alone 1. The use of image guidance, such as ultrasound, can facilitate the aspiration or drainage procedure, allowing for precise targeting of the abscess cavity.
In terms of management, patients with breast abscesses may be prescribed antibiotics, such as dicloxacillin or clindamycin, to treat the underlying infection. However, the primary treatment approach is often focused on drainage or aspiration of the abscess, rather than solely relying on antibiotic therapy. The most effective and recommended approach for breast abscess aspiration is image-guided percutaneous drainage, which can be performed by interventional radiologists, as supported by the 2019 study 1.
From the Research
Breast Abscess Aspirations
- General surgeons may not typically perform breast abscess aspirations, as the provided studies suggest that these procedures can be effectively performed by other medical professionals, such as obstetricians and gynecologists 2, or using minimally invasive methods like ultrasound-guided aspiration 3, 4, 5.
- The treatment of breast abscesses using needle aspiration, with or without ultrasound guidance, has been shown to be a viable alternative to surgical incision and drainage 3, 4, 5, 6.
- Studies have demonstrated that needle aspiration can be an effective treatment for breast abscesses, with success rates ranging from 82% to 96% 4, 5.
- The use of local instillation of antibiotics, as described in one study, may also be beneficial in the treatment of breast abscesses 5.
- Minimally invasive methods, such as sonographically guided percutaneous aspiration, have been shown to have advantages over surgical incision, including no requirement for general anesthesia, superior cosmetic results, and shorter hospitalization times 2, 3.