Ultrasound Guided Needle Aspiration versus Surgical Drainage in the management of breast abscesses: a Ugandan experience

B Chandika
M Gakwaya
L Chalya
Date of Publication: 
May 2012

Background: Despite breast abscess becoming less common in developed countries, it has remained one of the
leading causes of morbidity in women in developing countries. A randomized controlled trial was conducted at
Mulago hospital complex in Kampala Uganda to establish whether ultrasound guided needle aspiration is a
feasible alternative treatment option for breast abscesses.

Results: A total of 65 females with breast abscess were analyzed, of these 33 patients were randomized into the
ultrasound guided needle aspiration and 32 patients in the Incision and drainage arm. The mean age was 23.12,
most of them were lactating (66.2%), primipararous (44.6%) with peripheral abscesses (73.8%) located in the upper
lateral quadrant (56%).The mean breast size was 3.49 cm. The two groups were comparably in demographic
characteristic and breast abscess size. Survival analysis showed no difference in breast abscess healing rate
between the two groups (Log rank 0.24 df 1 and P = 0.63). Incision and drainage was found to be more costly
than ultrasound guided aspiration (cost effective ratio of 2.85).

Conclusion: Ultrasound guided needle aspiration is therefore a feasible and cost effective treatment option for
both lactating and non-lactating breast abscesses with a diameter up to 5 cm by ultrasound in an immune
competent patient

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