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Emergency Radiology

, Volume 26, Issue 5, pp 507–514 | Cite as

Breast abscesses in lactating women: evidences for ultrasound-guided percutaneous drainage to avoid surgery

  • Catherine ColinEmail author
  • Ana Gjorgjievska Delov
  • Noémie Peyron-Faure
  • Muriel Rabilloud
  • Mathilde Charlot
Original Article
  • 91 Downloads

Abstract

Background

Surgical incision with drainage remains the first-line therapy recommendation for breast abscesses greater than 5 cm.

Purpose

To determine recovery with ultrasound guided (US-guided) procedures for treatment of lactational breast abscesses without surgical incision for drainage.

Material and methods

Institutional review board approval and written informed patient consent were obtained for this retrospective study. From May 1, 2009, to June 1, 2018, 92 consecutive women (mean age 30 years, range 18–45) with 105 abscesses were treated with oral antibiotics and US-guided percutaneous drainage under local anesthesia. A total number of 202 US-guided procedures were performed. Three techniques were used: needle aspiration (diameter 18 to 14G), pigtail catheter insertion (diameter 5 to 7F), and/or vacuum-assisted biopsy/aspiration (diameter 10G). When using needle aspiration or pigtail catheter, a saline irrigation of the cavity was performed according to pus viscosity.

Results

The median diameter of abscesses was 4.5 cm (range 1–15), 82/105 (78%) were larger than 3 cm and 40/105 (38%) larger than 5 cm. US-guided management was successful for 101/105 (96%; 95% CI, (91–99%)) abscesses regardless the size. After the first round of procedures, 49/105 (47%) abscesses were recovered, 56/105 (53%) needed more than one drainage with a median number drainages of 2.6 (2–6). In 4/105 cases (4%), women underwent additional surgery under general anesthesia. By excluding abscesses which occurred in the weaning phase (n = 17), breastfeeding carried on for 68/75 (91%) women.

Conclusion

Unlike previous studies, US percutaneous guided management of lactational abscesses is effective even for abscesses greater than 5 cm and allows continued breastfeeding.

Keywords

Breast Abscess Ultrasonography Drainage Lactation 

Abbreviations

BA

Breast abscess

US

Ultrasound

NA

Needle aspiration

PC

Pigtail catheter

SI

Saline irrigation

VAB

Vacuum-assisted biopsy

Notes

Compliance with ethical standards

The institutional review board Ethical Committee approved this study and the requirement of informed patient consent was obtained.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© American Society of Emergency Radiology 2019

Authors and Affiliations

  1. 1.Department of Radiology, Breast Imaging, Hospices Civils de LyonCentre Hospitalier Femme Mère EnfantBronFrance
  2. 2.Department of Radiology, Women ImagingPrivate clinic Val d’OuestSainte Foy-lès-LyonFrance
  3. 3.Hospices Civils de Lyon, Service de Biostatistique et BioinformatiqueLyonFrance
  4. 4.Université Lyon1VilleurbanneFrance
  5. 5.CNRS, UMR 5558, Laboratoire de Biométrie et Biologie EvolutiveVilleurbanneFrance
  6. 6.Department of Radiology, Hospices Civils de LyonCentre Hospitalier Lyon SudPierre BéniteFrance

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