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Emergency Radiology

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01-10-2019 | Ultrasound | Original Article

Breast abscesses in lactating women: evidences for ultrasound-guided percutaneous drainage to avoid surgery

Authors: Catherine Colin, Ana Gjorgjievska Delov, Noémie Peyron-Faure, Muriel Rabilloud, Mathilde Charlot

Published in: Emergency Radiology | Issue 5/2019

Abstract

Background

Surgical incision with drainage remains the first-line therapy recommendation for breast abscesses greater than 5 cm.

Purpose

To determine recovery with ultrasound guided (US-guided) procedures for treatment of lactational breast abscesses without surgical incision for drainage.

Material and methods

Institutional review board approval and written informed patient consent were obtained for this retrospective study. From May 1, 2009, to June 1, 2018, 92 consecutive women (mean age 30 years, range 18–45) with 105 abscesses were treated with oral antibiotics and US-guided percutaneous drainage under local anesthesia. A total number of 202 US-guided procedures were performed. Three techniques were used: needle aspiration (diameter 18 to 14G), pigtail catheter insertion (diameter 5 to 7F), and/or vacuum-assisted biopsy/aspiration (diameter 10G). When using needle aspiration or pigtail catheter, a saline irrigation of the cavity was performed according to pus viscosity.

Results

The median diameter of abscesses was 4.5 cm (range 1–15), 82/105 (78%) were larger than 3 cm and 40/105 (38%) larger than 5 cm. US-guided management was successful for 101/105 (96%; 95% CI, (91–99%)) abscesses regardless the size. After the first round of procedures, 49/105 (47%) abscesses were recovered, 56/105 (53%) needed more than one drainage with a median number drainages of 2.6 (2–6). In 4/105 cases (4%), women underwent additional surgery under general anesthesia. By excluding abscesses which occurred in the weaning phase (n = 17), breastfeeding carried on for 68/75 (91%) women.

Conclusion

Unlike previous studies, US percutaneous guided management of lactational abscesses is effective even for abscesses greater than 5 cm and allows continued breastfeeding.

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Title: Breast abscesses in lactating women: evidences for ultrasound-guided percutaneous drainage to avoid surgery
Authors: Catherine Colin
Ana Gjorgjievska Delov
Noémie Peyron-Faure
Muriel Rabilloud
Mathilde Charlot
Publication date: 01-10-2019
Publisher: Springer International Publishing
Keywords: Ultrasound
Foreign Body Aspiration
Foreign Body Aspiration
Aspiration
Ultrasound
Published in: Emergency Radiology / Issue 5/2019
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-019-01694-z

At a glance: The STEP trials

Springer Medicine

Breast abscesses in lactating women: evidences for ultrasound-guided percutaneous drainage to avoid surgery

Abstract

Background

Purpose

Material and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Purpose

Material and methods

Results

Conclusion

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