Management of Breast Abscess during Breastfeeding

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Radiology

Background:

• Breast abscess (BA) often leads to breastfeeding cessation.
• Current treatments lack consensus, with antibiotics, needle aspiration, and incision/drainage (I&D) being common.
• No established clinical guidelines exist for optimal BA management.

Purpose of the Study:

• To assess ultrasound (US)-guided management of BA without surgery, irrespective of abscess size.
• To evaluate the efficacy of conservative treatment for breast abscesses.
• To characterize the microbiology, including Methicillin-Resistant *Staphylococcus aureus* (MRSA).

Main Methods:

• Retrospective observational study of 64 breastfeeding mothers with BA.
• Data collected on maternal, perinatal, and breastfeeding factors.
• All patients received oral antibiotics; 71.9% underwent US-guided fine needle aspiration (FNA), even for abscesses >5 cm.
• Microbiologic testing of milk/abscess samples.

Main Results:

• Most BAs occurred within 100 days postpartum; 13 mothers required hospitalization.
• 16 abscesses measured >5 cm; none required I&D.
• 40.6% of mothers continued breastfeeding for >6 months.
• No recurrences or cosmetic damage reported with FNA.

Conclusions:

• A conservative approach of antibiotic therapy and feasible needle aspiration is effective for BA, regardless of size.
• Needle aspiration is a cost-effective, repeatable outpatient procedure with minimal complications.
• This method facilitates quicker return to breastfeeding and avoids duct interruption.