Comparison of needle aspiration and vacuum-assisted biopsy in the ultrasound-guided drainage of lactational breast abscesses

Abstract

Purpose:The purpose of this study was to compare needle aspiration and vacuum-assistedbiopsy in the ultrasound-guided treatment of lactational breast abscesses.Methods:Between January 2005 and December 2014, a total of 74 patients presented withlactational breast abscesses. Thirty of these patients underwent treatment with antibioticsalone, while the remaining 44 lactating women with breast abscesses were treated withneedle aspiration (n=25) or vacuum-assisted biopsy (n=19). Age, duration of lactation, abscess diameter, pus culture results, the number of interventions, the healing time, and the cure rate were reviewed and compared between these two groups. The Student’s t test and the chi-square test were used to compare the variables.Results:No significant difference was found in the cure rate between the needle aspirationgroup (22/25, 88%) and the vacuum-assisted biopsy group (18/19, 94.7%) (P=0.441). However, the mean healing time was significantly shorter in the vacuum-assisted biopsy group (6.7 days) than in the needle aspiration group (9.0 days) (P=0.001).Conclusion:Vacuum-assisted biopsy is a viable option for the management of lactational breast abscesses and was found to lead to a shorter healing time than needle aspiration. However, further study is necessary to establish the clinical efficacy of vacuum-assisted biopsy in the management of lactational breast abscesses.

Trends in non‐lactation breast abscesses in a tertiary hospital setting

“…However, more recently non‐operative management with percutaneous needle aspiration usually under ultrasound guidance has been shown to be successful and associated with a better cosmetic outcome. Indeed, some recent reports have advocated the use of larger needle techniques such as the use of vacuum‐assisted biopsy devices …”

Breast lesions during pregnancy and lactation: a pictorial essay

“…Ultrasound-guided fine-needle aspiration, vacuum-associated biopsy, or surgical drainage can be effective treatment options in the case of abscess formation [15,16]. However, if the patient does not respond to antibiotic therapy for puerperal mastitis, the possibility of cancer should be considered and further evaluation should be performed [2,4].…”

Sonographic features of inflammatory conditions of the breast

“…Pus can be aspirated from the abscess under ultrasound vision, and this may need to be repeated every 2–3 days until no further fluid is obtained. Large bore (18G) needles are advantageous in these circumstances, and there have also been reports of the use of vacuum‐assisted biopsy needles to drain abscess under ultrasound guidance . This sonographically mediated type of needle intervention has the advantage that breastfeeding can usually continue unabated, whereas when surgical intervention is undertaken this often results in cessation of lactation as a consequence of post‐operative pain.…”

“…Marinopoulos and Akcay describe the classical appearance of an ill‐defined and irregular marginated mass. It is typically hypoechoic.…”