Outcomes of breast abscesses during lactation: a retrospective study

Abstract

INTRODUCTION: During breastfeeding one of the most common problems which can encounter is breast abscess. Our retrospective study aimed to assess the outcomes of breast abscesses among a cohort of lactating mothers. METHODS: A single-centre retrospective study was carried out. Randomly selected 2000 medical records of mothers, referred as outpatients and hospitalized from 2002 to 2022 were retrieved. There were 32 breastfeeding mothers with breast abscesses. The diagnosis of lactational breast abscess was made by documented signs of a localized inflammatory, palpable breast lump confirmed with an ultrasound findings. From the retrieved database, data on maternal, perinatal, and breastfeeding features, ultrasound scan reports, methods of interventions and outcomes and microbiological testing reports were evaluated. Ethics Committee Approval was received from Nawaloka Research and Education Unit. No conflict of interest. RESULTS: The mean age of the 32 patients was 28.7 ± 5.7 years. There were 85% primiparous and 15% multiparous. Exclusive breastfeeding at diagnosis was present in 20/32 (63%). Most of the women developed breast abscesses during the initial 40 days (36.3 ± 1.4 days) after delivery. The majority of 26/32 (81.3%) of the breast abscesses were <5cm in diameter in the ultrasound examination. The majority of the patients 28/32 (87%) underwent ultrasound-guided aspiration while on antibiotic coverage according to the standard clinical guidelines. Four patients had repeated ultrasound-guided aspiration. Four patients who had abscesses >5cm, with overlying skin necrosis underwent incising and drainage. None of the patients developed mammary fistulae or sinuses. All of the incision and drainage abscesses were healed within 3 to 5 weeks with repeated wound dressings. Ninety-one percent of the cultures revealed S. aureus positive. None of the patients stops breastfeeding during the acute phase.CONCLUSION: Our retrospective study showed that needle aspiration may be performed, regardless of the size of the breast abscesses in most instances.