Abstract:

Introduction: Despite breast abscesses becoming less common in developed countries, it has remained one of the leading causes of morbidity in women in developing countries. Traditionally breast abscesses have been managed by incision and drainage (I&D) which is associated with the need for general anesthesia, in-patient care, regular dressing and the possibility of unsatisfactory cosmetic outcome. Studies done elsewhere have reported that breast abscesses can be treated by U.S.S guided needle aspiration which has been found to be associated with less recurrence, excellent cosmetic results and cost effectiveness. No such study has been done in Uganda. Therefore the aim of this study was to establish whether U.S.S guided needle aspiration is a feasible alternative treatment option for breast abscesses.

Methods: The study was a randomized controlled trial with no blinding done between, October 2006 to March 2007. The study was done among women aged 14 years or more both lactating and non-lactating with breast abscesses< 5 in widest diameter. The participants were randomized to either have their breast abscess treated by U.S.S guided needle aspiration or incision and drainage.

Result: Data from 65 females with breast abscess was analysed. The mean age was 23.12. Most of them were lactating (66.2%), primiparous (44.6%) with peripheral abscesses (73.8%) located in the upper lateral quadrant (56 %.) the average breast abscesses size was 3.49cm. the two groups were comparable in demographic characteristics 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 more costly than U.S.S guided needle aspiration (Cost-effective ratio of 2.85).

Conclusion: U.S.S guided needle aspiration is a viable treatment option for both lactating and non-lactating breast abscesses with diameters of up to a maximum of 5cm by U.S.S, in a patient who is immune competent. U.S.S guided needle aspiration is more cost effective treatment when compared to incision and drainage.