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

Yun-Dan Kang, You Me Kim, Yun-Dan Kang, You Me Kim

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.

Keywords: Abscess; Aspiration, vacuum-assisted; Biopsy, needle; Breast; Image-guided biopsy; Ultrasonography.

Conflict of interest statement

No potential conflict of interest to this article was reported.

Figures

Fig. 1.. A 36-year-old woman with puerperal…
Fig. 1.. A 36-year-old woman with puerperal abscess 12 weeks after delivery.
Breast sonogram shows 5×3 cm slightly lobulated, hypoechoic collections with posterior enhancement within the right lower outer quadrant and inserted needle for aspiration.
Fig. 2.. A 28-year-old woman with puerperal…
Fig. 2.. A 28-year-old woman with puerperal abscess 8 weeks after delivery.
Breast sonogram shows 6×4 cm hypoechoic collection within the left lower outer quadrant and inserted vacuum-assisted biopsy needle.

References

    1. Trop I, Dugas A, David J, El Khoury M, Boileau JF, Larouche N, et al. Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics. 2011;31:1683–1699.
    1. Benson EA. Management of breast abscesses. World J Surg. 1989;13:753–756.
    1. Schwarz RJ, Shrestha R. Needle aspiration of breast abscesses. Am J Surg. 2001;182:117–119.
    1. Karstrup S, Solvig J, Nolsoe CP, Nilsson P, Khattar S, Loren I, et al. Acute puerperal breast abscesses: US-guided drainage. Radiology. 1993;188:807–809.
    1. Eryilmaz R, Sahin M, Hakan Tekelioglu M, Daldal E. Management of lactational breast abscesses. Breast. 2005;14:375–379.
    1. Nakano S, Sakamoto H, Ohtsuka M, Mibu A, Sakata H, Yamamoto M. Evaluation and indications of ultrasound-guided vacuum-assisted core needle breast biopsy. Breast Cancer. 2007;14:292–296.
    1. Varey AH, Shere MH, Cawthorn SJ. Treatment of loculated lactational breast abscess with a vacuum biopsy system. Br J Surg. 2005;92:1225–1226.
    1. Wang K, Ye Y, Sun G, Xu Z. The Mammotome biopsy system is an effective treatment strategy for breast abscess. Am J Surg. 2013;205:35–38.
    1. Marchant DJ. Inflammation of the breast. Obstet Gynecol Clin North Am. 2002;29:89–102.
    1. Marshall BR, Hepper JK, Zirbel CC. Sporadic puerperal mastitis: an infection that need not interrupt lactation. JAMA. 1975;233:1377–1379.
    1. Dener C, Inan A. Breast abscesses in lactating women. World J Surg. 2003;27:130–133.
    1. Dixon JM. Repeated aspiration of breast abscesses in lactating women. BMJ. 1988;297:1517–1518.
    1. Thirumalaikumar S, Kommu S. Best evidence topic reports: aspiration of breast abscesses. Emerg Med J. 2004;21:333–334.
    1. Smith T. Non-operative management of breast abscess. N Z Med J. 2009;122:95–96.
    1. Hook GW, Ikeda DM. Treatment of breast abscesses with US-guided percutaneous needle drainage without indwelling catheter placement. Radiology. 1999;213:579–582.
    1. Ulitzsch D, Nyman MK, Carlson RA. Breast abscess in lactating women: US-guided treatment. Radiology. 2004;232:904–909.
    1. Giess CS, Golshan M, Flaherty K, Birdwell RL. Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center. J Clin Ultrasound. 2014;42:513–521.
    1. Chen SC, Yang HR, Hwang TL, Chen MF, Cheung YC, Hsueh S. Intraoperative ultrasonographically guided excisional biopsy or vacuum-assisted core needle biopsy for nonpalpable breast lesions. Ann Surg. 2003;238:738–742.
    1. Grady I, Gorsuch H, Wilburn-Bailey S. Long-term outcome of benign fibroadenomas treated by ultrasound-guided percutaneous excision. Breast J. 2008;14:275–278.
    1. O'Hara RJ, Dexter SP, Fox JN. Conservative management of infective mastitis and breast abscesses after ultrasonographic assessment. Br J Surg. 1996;83:1413–1414.
    1. Christensen AF, Al-Suliman N, Nielsen KR, Vejborg I, Severinsen N, Christensen H, et al. Ultrasound-guided drainage of breast abscesses: results in 151 patients. Br J Radiol. 2005;78:186–188.

Source: PubMed

3
订阅