Comparison of Outcomes of Incision and Drainage vs Needle Aspiration of Breast Abscess

Narmeena Fakhar; Imran Aslam; Sajeel Ahmed; Akasha Adnan; Ali Akbar

doi:10.54112/bcsrj.v6i7.2294

Authors

Narmeena Fakhar Department of Surgery, Sir Ganga Ram Hospital, Lahore, Pakistan
Imran Aslam Department of Surgery, Sir Ganga Ram Hospital, Lahore, Pakistan
Sajeel Ahmed Department of Surgery, Sir Ganga Ram Hospital, Lahore, Pakistan
Akasha Adnan Department of Surgery, Sir Ganga Ram Hospital, Lahore, Pakistan
Ali Akbar Department of Surgery, Sir Ganga Ram Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i7.2294

Keywords:

Lactational Breast Abscess, Needle Aspiration, Incision and Drainage, Breastfeeding, Ultrasonography

Abstract

Lactational breast abscess is a common complication of breastfeeding, often resulting in pain, interrupted lactation, and potential morbidity. Standard management includes incision and drainage (I&D) or ultrasound-guided needle aspiration (USGNA), with varying outcomes reported in the literature. Objective: To compare the clinical outcomes of I&D versus USGNA in patients with lactational breast abscess. Methods: A randomized controlled trial was conducted at the Department of General Surgery, Sir Ganga Ram Hospital, Lahore, over six months from 16 November 2024 to 16 May 2025. A total of 68 lactating women with first-time breast abscesses measuring 2–10 cm was enrolled and randomly assigned to USGNA (n=34) or I&D (n=34). All patients received broad-spectrum antibiotics post-procedure, adjusted according to pus culture and sensitivity. Primary outcome was complete resolution of abscess at four weeks. Secondary outcomes included pain score, time to breastfeeding resumption, cosmetic satisfaction, and need for repeat aspiration. Data were analysed using SPSS version 25; categorical variables were compared using Chi-square test, and continuous variables using independent t-test, with p ≤ 0.05 considered significant. Results: Complete resolution was observed in 30 (88.2%) patients in the USGNA group and 33 (97.1%) in the I&D group (p = 0.18). USGNA patients experienced significantly lower pain scores (3.1 ± 0.9 vs. 6.4 ± 1.2, p < 0.001), faster resumption of breastfeeding (1.2 ± 0.5 vs. 3.8 ± 1.1 days, p < 0.001), and higher cosmetic satisfaction (8.7 ± 0.8 vs. 7.2 ± 1.0, p < 0.001). Repeat aspiration was required in 2 (6%) USGNA patients, while none in the I&D group needed additional intervention. Conclusion: Both I&D and USGNA are effective in treating lactational breast abscess. USGNA provides the advantages of reduced pain, better cosmetic outcomes, and earlier breastfeeding, making it a feasible outpatient alternative for unilocular abscesses. I&D remains preferred for multiloculated or large abscesses due to slightly higher resolution rates.

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