Case report: Poorly differentiated breast carcinoma presenting as a breast abscess.

We report a case of 31-year-old female with no past medical history who presented with sudden onset discharging skin ulcer in left inframammary fold with erythema and swelling immediately after she came back from holiday for which she presented to the breast one stop clinic and underwent ultrasound-guided aspiration of the detected cystic lesion in the left breast with impression of breast abscess. Afterwards, as the result of cytology reporting as C5, ultrasound-guided Core-Needle Biopsy was performed, which confirmed poorly differentiated carcinoma of breast. Furthermore, similar necrotizing masses were found in axillary lymph nodes and Liver. The final diagnosis was concluded as poorly differentiated breast carcinoma with metastasis to axillary lymph nodes and the liver. This case reports a very uncommon presentation of breast carcinoma in a young patient with no past medical history, presenting with cystic necrotizing mass which is extremely rare in breast cancer. At the time of presentation, carcinoma had spread to the liver and axillary nodes.

Stepwise transvenous lead extraction due to pacemaker pocket infection following lactational mastitis complicated with breast abscess.

BACKGROUND: Lactational mastitis is a common painful and debilitating inflammation of breast tissue, generally treated conservatively or with pus puncture in case of breast abscess. However, treating mastitis in patients with implantable surgical material located in the affected breast region can be extremely challenging. We present an unusual case of lactational mastitis complicated by pacemaker pocket infection in a breastfeeding mother. CASE PRESENTATION: A 35-year-old pacemaker-dependent female developed lactational mastitis seven weeks postpartum. Initially, the condition was treated conservatively with analgesics and antibiotics. After abscess formation, pus was aspirated using fine-needle aspiration technique. Four weeks after mastitis resolution, pacemaker pocket infection developed. According to current cardiovascular implantable electronic device infection treatment guidelines a complete surgical extraction of the entire electronic system, followed by targeted antibiotic treatment and reimplantation of a new device after infection resolution, was recommended. However, after thorough discussion with the young woman and her family and after detailed review of surgery-related risks, she declined a potentially high-risk surgical procedure. Thus, only the pulse generator was explanted; pacing leads positioned in the sub-pectoral pocket; new pacemaker implanted on the contralateral side and broad-spectrum antibiotic therapy continued for six weeks. After breastfeeding cessation, and with chronic fistula development at the primary pacemaker implantation site, the possibility of delayed surgical intervention including complete extraction of retained pacemaker leads was again thoroughly discussed with her. After thoughtful consideration the woman consented to the proposed treatment strategy. A surgical procedure including transvenous lead extraction through the primary implantation venous entry site, using hand-powered bidirectional rotational sheaths, was successfully performed, removing all retained leads through the left subclavian venous entry site, and leaving the fully functional and clinically uninfected pacemaker on the contralateral site intact. CONCLUSION: Although patients' decisions for delayed extraction in a case of cardiovascular implantable electronic device infection should be discouraged by attending physicians and members of interdisciplinary teams, our case shows that a stepwise treatment strategy may be successful as a bailout clinical scenario in patients with specific requests, demands and / or clinical needs.

Absceso mamario neonatal / Neonatal breast abscess: a case report

Presentamos el caso de una niña de 27 días de vida, sin antecedentes de interés, que acude a su pediatra por edema y hematoma en la mama derecha. La paciente acude al día siguiente a las urgencias hospitalarias por evolución del cuadro hacia un absceso mamario, teniendo que ser ingresada e iniciando tratamiento antibiótico intravenoso. Dada la mala evolución, y a pesar del tratamiento antibiótico, se decide intervención quirúrgica mediante drenaje y lavado de la cavidad. Finalmente, se resuelve el cuadro sin secuelas posteriores. (AU)

We present a 27-day-old girl with no significant medical history who attended pediatric consultation presenting with edema and hematoma in her right breast. The patient was admitted the next day following examination in ER due to the worsening of a starting breast abscess and was treated with intravenous antibiotic therapy. Due to the worsening of the condition and despite the intravenous antibiotic therapy, a surgical treatment was performed consisting in draining the abscess and washing the cavity. Finally, the problem was solved without any consequences. (AU)

Recurrent Unilateral E. coli Breast Infection in a Non-Lactating Women: A Rare Case Report.

Breast abscess is a common infection of the breast in humans, particularly affecting females who are lactating. Lactation mastitis is present in 2%-3% of women and approximately 5%-11% of patients may develop abscess. However, breast abscess in non-lactating women is extremely rare and there has only been limited literature published on this. Escherichia coli (E. coli) is usually found in the gastrointestinal and urogenital system, with no previous documentation of an E. coli infection in the breast. This case report summarizes the rare case of a fit and healthy adult female healthcare worker who presented with a recurrence of a unilateral E. coli breast abscess within three years. On review, there have not been any similar documented cases.

Assessment of the Effectiveness of Ultrasound-Guided Needle Aspiration of Lactating Breast Abscesses.

Objective: To evaluate the effectiveness of ultrasound-guided needle aspiration in treating lactating breast abscesses. Methods: This study was conducted in Bach Mai Hospital, from 6/2020 to 7/2021. Lactating patients with breast abscesses underwent ultrasound-guided aspiration followed by antibiotics therapy. Results: There were 59 lactating patients with 82 breast abscesses. Most of the abscesses had heterogeneous echogenicity, no capsule, and a size smaller than 5cm. Bacterial culture results showed that 85.4% of cases were Methicillin-resistant Staphylococcus aureus. The number of aspirations was from 1 to 5. The cure rate was 91.5%, and 5.3% of these cases had a complication associated with galactocele after treatment. Conclusion: Ultrasound-guided needle aspiration is a minimally invasive treatment option for lactating breast abscesses with a high complete cure rate and good cosmetic results.

An integrative ayurvedic approach in management of breast abscess - A case report.

A focus has been placed particularly on the description of breast abscesses (sthana vidradhi in Ayurveda terms). Breast inflammation known as mastitis has the potential to develop into a breastabscess in the future. The term "stana roga," refers to breast disorders and describes breast abscesses, is mentioned in the ancient works Sushruta Samhita, Madhava Nidana, and Bhavaprakasha. Breast abscesses are typically treated surgically by making an incision over the area of greatest fluctuation (or pain) and breaking the abscess septa with digits. For a few days, the abscess chamber is left untreated or gauze-packed, with dressing changes made as needed to facilitate wound granulation. The current report was aimed at management of the breast abscess through an integrated approach comprising surgical and medicinal intervetions as mentioned in Ayurveda classics. A 32-year-old female patient with pain and swelling in right breast was diagnosed with breast abscess in Shalya (Surgery) OPD and managed primarily by incision and drainage which was followed by regular dressing and ayurvedic medications which encouraged appreciable granulation in a short period of time with complete healing of the abscess. This case study presents the successful management of breast abscesses with both surgical & Ayurvedic management.

Male breast abscess: A rare entity.

Breast abscess in males is a rare condition, which accounts for 1%-3% of all documented breast diseases. Males with certain risk factors may develop a breast abscess. The ultrasonographic, mammographic, and pathological characteristics of this case will be highlighted in the report. A 51-year-old morbidly obese Saudi male who is a 160-pack-years smoker presented to our surgical clinic complaining of a right breast mass that presented a long time ago and was changing in size. The mass was painless until 5 days prior to presentation. On physical examination, a firm nonmobile 3 × 4 cm mass was felt at 10-12-o'clock, 1 cm away from the nipple. A bilateral X-ray mammogram and ultrasound were performed with fine needle aspiration and culture. The mammogram of the right breast showed a well-circumscribed subareolar mass with equal density, and it was also associated with overlying skin thickening and relative breast parenchymal edema. The fine needle aspiration grossly showed yellowish-green turbid content followed by turbid blood. The anaerobic culture results showed the gram-positive cocci, Finegoldia Magna. The patient was then instructed to take an antibiotic accordingly and return after 1 week. Fine needle aspiration and culture were performed again after antibiotics and grossly showed 2-3 cc of pus without any growth in culture. Male breast disorders are typically benign, with gynecomastia being the most prevalent, and malignancy being the most serious despite its rarity. Breast abscesses are a challenging clinical condition, and radiologists have a pivotal role in evaluation and follow-up of these lesions.

Five Coffin Nails to Informed Consent: An Autoethnography of Suffering Complications in Breastfeeding.

This autoethnography describes an illness episode caused by breastfeeding complications. It focuses on informed consent processes accompanying this illness episode. Informed consent is a cornerstone of ethical medical practice and has to be obtained before a medical intervention can legally be implemented. It is therefore not trivial that in practice, informed consent processes often fail to achieve what they are set out to. With this autoethnography, I want to provide a review of how informed consent processes can fail in the context of breastfeeding, but also draw attention to what these situations can mean and feel like for those affected. I provide in-depth descriptions of five scenes from my illness episode each representing a different barrier to informed consent. The scenes were developed based on emotional recall and written to grant access to the emotional dimensions of my experience in the tradition of evocative autoethnography. As part of my story, I engage with various issues like practices of prescribing, communicative requirements in vulnerable situations to ensure understanding, the dual purpose of informed consent in the moral and legal realm, and the moralized breastfeeding discourse. Possible routes for change to abolish or reduce described barriers to informed consent are discussed.

Spontaneous, idiopathic granulomatous mastitis in a pregnant patient: A case report and review of the literature.

Idiopathic granulomatous mastitis is a rare breast condition of unclear etiology. Its course is often rapidly progressive, slow to resolve, and can have a high rate of recurrence. Clinical presentation can mimic breast abscess, infectious mastitis, and carcinoma of the breast, generating a diagnostic challenge. Histopathological analysis is required to make the diagnosis after common conditions are excluded. There is no standard treatment, however surgical excision, steroid treatment, and observation are commonly reported approaches. Here, we describe a complex case of a multiparous patient presenting with idiopathic granulomatous mastitis at 32 weeks gestation. In this review, we highlight the importance of collaboration amongst a multidisciplinary team for effective diagnosis and treatment. We discuss the use of oral corticosteroids in the antenatal period and illustrate the patient support required to both facilitate successful breastfeeding in the postpartum period and promote recovery.

A Rare Case of Tuberculous Nodular Breast Abscess in an Immunocompetent Indian Female.

In underdeveloped countries, Mycobacterium tuberculosis infection is common and typically manifests as pulmonary tuberculosis. Nevertheless, reports of tuberculous extrapulmonary involvement are also documented. Tuberculous breast abscess is a rare presentation, especially in immunocompetent hosts. Herein, a case of primary tuberculous breast abscess is presented. The patient came with complaints of pain in her right breast and a discharging sinus. A thorough diagnostic workup resulted in the establishment of a diagnosis with the detection of Mycobacterium tuberculosis on smear microscopy of pus, a cartridge-based nucleic acid amplification test, a line probe assay, and culture. Ultimately, she was put on anti-tubercular treatment.

Non-puerperal Breast Actinomycosis: A Case Report.

Breast abscesses can be a complication of infectious mastitis or the first presentation of a breast infection, presenting as pain, erythema, and a lump. Actinomycosis is a rare chronic disease caused by anaerobic branched filamentous gram-positive bacteria belonging to the Actinomyces genus. It is usually found in the human mouth, digestive tract, and genital tract but can also cause breast abscesses. Actinomycosis affecting the breast is a rare condition that typically occurs as a secondary infection resulting from a pulmonary infection. It is primary when inoculation occurs through the nipple. This report describes the case of a 48-year-old institutionalized female with periareolar swelling in the right breast that had been evolving for approximately two months. The abscess was drained, and the aspirated material contained Actinomyces neuii, a gram-positive bacterium. Actinomycosis of the breast can manifest as either a sinus tract or mass-like features that closely resemble malignancy. The clinical presentation can pose challenges in distinguishing between primary actinomycosis, mastitis, and inflammatory carcinoma. Treatment consists of drainage with needle aspiration or surgical drainage and antibiotic therapy.

Persistent Pediatric Breast Abscesses Following Initial Treatment at Tertiary and Community Centers.

INTRODUCTION: Little data exist on the management of pediatric breast abscesses that fail initial treatment. Therefore, this study aimed to evaluate and report outcomes in these patients. METHODS: All patients <18-year-old treated for a breast abscess between January 2008 and December 2018 were included. Patients were divided into two groups: initial treatment at our institution (Group 1) and initial treatment at referring centers (Group 2). The primary outcome was disease persistence following treatment at our institution. Secondary outcomes included treatment modalities and patient characteristics. RESULTS: In total, 145 patients were identified: 111 in Group 1 and 34 in Group 2. Antibiotics alone were the initial treatment in 52.3% (n = 58) of Group 1 patients and 64.7% (n = 22) of Group 2 patients. Invasive treatment was more common in Group 1 (45.9% vs 5.8%; P < 0.00001). Patients with persistent disease in Group 1 were treated with aspiration (n = 7, 50%), incision and drainage (n = 5, 35.7%), antibiotics (n = 1, 7.14%), and manual expression (n = 1, 7.14%.), while Group 2 patients were treated with antibiotics (50%, n = 17), aspiration (26.47%, n = 9), incision and drainage (17.65%, n = 6), and manual expression (5.88%, n = 2). Group 2 patients with persistent disease were more likely to be treated with antibiotics or a change in antibiotics (50% vs 7.14%; P = 0.005). Following treatment at our institution, the rate of persistent disease was similar between groups (12.6% vs 11.8%). CONCLUSIONS: Persistent breast abscesses may be treated with antibiotics in appropriate cases. Damage to the developing breast bud should be minimized. Disease persistence is similar once treated at tertiary care centers.

Subareolar Breast Abscess in a Male: A Case Report.

A subareolar breast abscess (SBA) is caused by the formation of an inflammatory abscess around the milk duct. SBAs usually occur in females, and reports of SBAs in males are very rare. This study reports the case of a 62-year-old male patient who presented with a subcutaneous nodule and diffuse erythema around the left nipple. Ultrasonography revealed a mixed lesion measuring 2.5 x 1.5 cm, mostly cystic. A computed tomography scan of the chest showed an irregular, nodular structure in the same area. Magnetic resonance imaging with contrast enhancement suggested an abscess. A needle biopsy was performed on the lesion, and results showed moderate inflammatory cell infiltration, including lymphocytes, plasma cells, neutrophils, and abscess formation, thus leading to the diagnosis of SBA. The patient did not strongly desire a surgical procedure. He was treated with the cephem antibiotic cefaclor and antipyretic analgesics. During the six-month healing period, cefaclor was administered for a total of six weeks. Once he improved, recurrence was observed two years after the onset of the disease; however, the symptoms improved with conservative treatment, such as warm compresses. Preventive measures should be considered as SBAs are prone to recurrence.

Maternal obesity and the risk of postpartum infections according to mode of delivery.

OBJECTIVE: The aim of the present study was to assess the impact of different maternal Body Mass Index (BMI) classes on the risk of postpartum endometritis, wound infection, and breast abscess after different modes of delivery. Secondly to estimate how the risk of postpartum infection varies with different maternal BMI groups after induction of labor and after obstetric anal sphincter injuries. METHODS: A population-based observational study including women who gave birth during eight years (N = 841,780). Data were collected from three Swedish Medical Health Registers, the Swedish Medical Birth Register, the Swedish National Patient Register, and the Swedish Prescribed Drug Register. Outcomes were defined by ICD-10 codes given within eight weeks postpartum. The reference population was uninfected women. Odds ratios were determined using Mantel-Haenszel technique. Year of delivery, maternal age, parity and smoking in early pregnancy were considered as confounders. RESULTS: There was a dose-dependent relationship between an increasing maternal BMI and a higher risk for postpartum infections. Women in obesity class II and III had an increased risk for endometritis after normal vaginal delivery aOR 1.45 (95% CI: 1.29-1.63) and for wound infections after cesarean section aOR 3.83 (95% CI: 3.39-4.32). There was no difference in how maternal BMI affected the association between cesarean section and wound infection, regardless of whether it was planned or emergent. Women in obesity class II and III had a lower risk of breast abscess compared with normal-weight women, aOR 0.47 (95% CI: 0.38-0.58). The risk of endometritis after labor induction decreased with increasing maternal BMI. The risk of wound infection among women with an obstetrical sphincter injury decreased with increasing BMI. CONCLUSION: This study provides new knowledge about the impact of maternal BMI on the risk of postpartum infections after different modes of delivery. There was no difference in how BMI affected the association between cesarean section and wound infections, regardless of whether it was a planned cesarean section or an emergency cesarean section.

A rare spontaneous breast abscess due to Mycobacterium chelonae: a case report.

BACKGROUND: Mycobacterium chelonae, a nontuberculous mycobacterium, commonly causes skin, soft tissue, eye, pulmonary, catheter-related, and post-surgical infections in patients with immunosuppression or trauma. M. chelonae breast infections are rare, and most cases occur following cosmetic surgery. Here, we report the first case of spontaneous breast abscess due to M. chelonae. CASE PRESENTATION: A 22-year-old Japanese woman presented at our hospital with swelling and pain in the right breast for the past 2 weeks without any fever. She had a 19-month-old child and stopped breastfeeding 1 month after giving birth. The patient had no history of trauma or breast surgeries, no family history of breast cancer, and was not immunocompromised. Breast ultrasonography revealed a heterogeneous hypoechoic lesion with multiple fluid-filled areas suspected to be abscesses. Dynamic contrast-enhanced magnetic resonance imaging revealed a 64 × 58 × 62 mm, ill-defined, high-signal-intensity lesion with multiple ring enhancements in the upper half of the right breast. The first diagnosis was inflammatory breast cancer or granulomatous mastitis with abscess. A core needle biopsy led to drainage of pus. Gram staining did not reveal any bacteria in the pus, but the colonies from the biopsy grew on blood and chocolate agar cultures. Mass spectrometry detected M. chelonae in these colonies. Histopathological findings revealed mastitis without malignancy. The patient's treatment regimen was oral clarithromycin (CAM) based on susceptibility. Three weeks later, although the pus had reduced, the induration in the breast did not resolve; therefore, multidrug antibiotic treatment was initiated. The patient received amikacin and imipenem infusion therapy for 2 weeks, followed by continuation of CAM. Three weeks later, tenderness in the right breast recurred with slight pus discharge. Hence, minocycline (MINO) was added to the treatment. The patient stopped CAM and MINO treatment 2 weeks later. There was no recurrence 2 years after treatment. CONCLUSION: We report a case of M. chelonae breast infection and abscess formation in a 22-year-old Japanese woman without obvious risk factors. M. chelonae infection should be considered in cases of intractable breast abscess, even in patients without immunosuppression or trauma.

Predictive Risk Factors for Childbirth-Associated Breast Infections in the United States: A 10-Year Perspective.

Infectious mastitis is a common condition that affects up to 33% of lactating women. Several risk factors have been suggested to be strongly associated with breast abscess, nipple infection, and non-purulent mastitis associated with childbirth. In this retrospective cohort study, we gathered data from the National Inpatient Sample (NIS) between 2005 and 2014 and utilized data stratification and backward linear regression to analyze the predictive factors associated with patients hospitalized with breast infection after childbirth, with special consideration of risk factors affecting hospital length of stay (LOS). In the ten-year period, 4614 women were hospitalized with a primary diagnosis of breast abscess, nipple infection, or non-purulent mastitis associated with childbirth. Mean (SD) age was 26.75 (6) years. The highest frequency distribution of cases was observed in patients aged 22-30 years (49.82%). Mean (SD) LOS was 2.83 (1.95) days. Mean (SD) LOS in patients with procedure was 3.53 (2.47) days, which was significantly longer than that in those with no procedure (2.39 (1.36) days, p < 0.001). Primary diagnosis of breast abscess and occurrence of a hospital procedure were most significantly associated with prolonged LOS. Factors such as age, socioeconomic position, severity of functional loss, as well as comorbidities were also contributing risk factors to the development of breast infection and increased hospital LOS. Further studies should examine these findings, as they relate to breastfeeding practices and concentrate on establishing best practices for risk reduction and prevention of childbirth-associated breast and nipple infections and hospitalizations.

A Case of Pediatric Breast Abscess Caused by Rarely Observed Bacteria in a Three-Year-Old Boy With an Inverted Nipple: Peptoniphilus harei, Actinotignum sanguinis, and Porphyromonas somerae.

Mastitis and breast abscesses are most common in lactating women but can also be observed in non-lactating women, adolescent girls, and neonates. However, breast abscesses are extremely rare in young boys. Herein, we report the case of a three-year-old boy with a swollen and painful right nipple, later diagnosed with a breast abscess. In this case, we suspected that the patient's inverted nipple was the possible site of the infection. To our best knowledge, this is the first case report of breast abscess in a young boy after the neonatal period. Although Staphylococcus aureus is the most common pathogen, our patient showed three rare bacteria, namely, Peptoniphilus harei, Actinotignum sanguinis, and Porphyromonas somerae, in the culture of the aspirated pus. Furthermore, this case study is the first report of a breast abscess caused by Porphyromonas somerae.

The challenges of diagnosis and treatment of rare Prevotella-induced breast abscesses: A retrospective cohort study.

OBJECTIVE: Although the genus Prevotella is part of the general human microbiota, species of this anaerobic gram-negative bacterium have been described as causes of persisting nonpuerperal breast abscesses. Collecting punctate samples and testing these samples for anaerobic bacteria is not part of the common diagnostic workflow in atypical breast abscesses. The causative anaerobic micro-organism can remain unclear and patients can be treated with multiple inadequate antibiotics and/or extensive surgical procedures. The aim of this cohort study of Prevotella induced breast abscesses is to gain more insights into the diagnostic procedures and treatment. METHODS: Medical charts of patients with a Prevotella induced breast abscess between 2015 and 2021, were retrospectively reviewed on patient characteristics, diagnostic procedures, treatment and outcome. RESULTS: Twenty-one patients were included. Six subspecies of Prevotella were determined by culturing. High susceptibility was observed for amoxicillin/clavulanic acid (100%, n = 12). Nine patients (43%) were treated with antibiotics, eight patients (38%) with antibiotics and incision and drainage, and four patients (19%) with only incision and drainage. Recurrence was observed in nine patients (43%), of whom five patients were treated with antibiotics and three patients had surgery. The mean duration of antibiotic administration in patients with recurrence was significantly shorter compared to those without recurrence (5.6 days vs. 19.5 days, p = 0.039). CONCLUSION: Specific anaerobic culturing should be common practice in atypical breast abscesses to confirm Prevotella species. The high recurrence rate emphasizes the need of further research for optimal treatment. Prolonged duration of antibiotics could be considered and amoxicillin/clavulanic acid seems to be the first choice.

The effectiveness of needle aspiration versus traditional incision and drainage in the treatment of breast abscess: a meta-analysis.

BACKGROUND: Breast abscess is a common and intractable clinical condition and the use of needle aspiration (NA) or incision and drainage (ID) in treatment is controversial. This meta-analysis aimed to systematically compare the clinical effectiveness of NA and ID in treating breast abscesses. METHODS: The Web of Science, ScienceDirect, PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, and Wanfang Data were searched for randomized controlled trials (RCTs) published from inception to January 7, 2022. The ROB-2 tool assessed risk of bias; the GRADE methodology rated certainty in outcomes; and Stata 16.0 performed data analyses. RESULTS: Nine RCTs were included, including 703 patients. The results showed there was no significant difference in cure rate between the two groups (relative risk [RR] = 0.96, 95% confidence interval [CI] [0.86, 1.07]; p = .469), and after subgroup analysis, we found that it was not related to the use of ultrasound guidance or not. There was no significant difference in the recurrence rate (RR = 0.68, 95% CI [0.35, 1.30]; p = .241). Furthermore, the NA group was associated with shorter healing time (weighted mean differences = -11.02, 95% CI [-15.14, -6.90]; p < .001), lower incidence of breast fistula (RR = 0.21, 95% CI [0.06, 0.72]; p = .013), lower interrupted breastfeeding rate (RR = 0.28, 95% CI [0.20, 0.39]; p < .001), and higher satisfaction rate of appearance (RR = 1.51, 95% CI [1.03-2.21]; p = .035). CONCLUSION: NA has better advantages in terms of healing time, avoidance of breast fistula, continuous breastfeeding, and patient satisfaction. Although NA and ID have similar cure and recurrence rates, NA, with or without ultrasound guidance, could be used as a first-line treatment for breast abscesses. Patients with large volumes, multicompartmental abscesses, or those who have been ineffective against multiple NA, should be considered for ID.KEY MESSAGESBreast abscess is a common and intractable clinical condition in general surgery.Compared with ID for breast abscesses, NA has better advantages in terms of healing time, avoidance of breast fistula, continuous breastfeeding, and patient satisfaction and could be used as a first-line treatment for breast abscesses.Patients with large volumes, multicompartmental abscesses, or those who have been ineffective against multiple NA, should be considered for ID.

A comparison of the outcomes of a novel technique of Mini-Incision and Self-Express (MISE) for breast abscess with the conventional techniques: a retrospective comparative cohort study.

Conventional techniques for treatment of breast abscess, such as incision and drainage (I&D) and needle aspiration, have disadvantages. The authors aimed to compare the outcomes of a novel technique of bedside mini-incision and self-express (MISE) for breast abscess with the conventional techniques. Methods: Patients with a pathologically confirmed breast abscess were retrospectively identified. Patients with mastitis, granulomatous mastitis, breast fillers with infection, ruptured abscess prior to intervention, other interventions or bilateral breast infection were excluded. Data collected included patient demographics, radiological features such as size and number of abscess, treatment modality, microbiological results and clinical outcomes. These outcomes were then compared between the patients with MISE, I&D and needle aspiration. Results: Twenty-one patients were included. The mean age was 31.5 years old (range: 18-48). Mean abscess size was 57.4 mm (range: 24-126). 5 (23.8%), 11 (52.4%) and 5 (23.8%) had MISE, needle aspiration and I&D, respectively. Average duration of antibiotics was 1.8, 3.9 and 2.6 weeks for MISE, needle aspiration and I&D groups, respectively, which was statistically significant after adjusting for confounders (P=0.024). Mean duration of recovery was 2.8, 7.8 and 6.2 weeks for the MISE, needle aspiration and I&D groups, respectively (P=0.027), after adjusting for confounders. Conclusion: MISE, in suitable patients, results in shorter recovery time and lesser antibiotics usage, compared with the conventional techniques.