Abscesses of the breast. US-guided serial percutaneous aspiration and local antibiotic therapy after unsuccessful systemic antibiotic therapy.
OBJECTIVE
The usual therapeutic approach to acute breast abscesses (ABAs) not responsive to systemic antibiotics is surgical incision and drainage. Our purpose was to assess the efficacy of treating ABAs with serial US-guided percutaneous aspiration and local injection of antibiotics.


METHODS
Twenty-six patients with 28 ABAs, in whom systemic antibiotic therapy had failed, underwent serial US-guided aspiration with local injection a of large-spectrum antibiotic. The treatment was repeated weekly until complete resolution was observed at clinical and US examination. The volume of the ABAs was calculated before each US-guided aspiration. Follow-up US examinations were performed at 1, 4, and 12 weeks after clinical and US resolution. A comparison betweeen costs of surgical and US-guided treatment of ABAs in our institution was done.


RESULTS
In 27 ABAs the treatment was successful: a progressive volume reduction and a complete resolution at clinical and US examination was observed within 1 to 7 weeks. In 1 case only, with a large ABA markedly increased in volume at the second examination, surgical drainage was performed.


CONCLUSIONS
US-guided aspiration with local antibiotic injection is a safe and effective approach to ABAs, cheaper than surgical drainage of these lesions.
National Institute for Cancer Research, University of Genoa, Genoa, Italy.
A
A
Imperiale
F
F
Zandrino
M
M
Calabrese
G
G
Parodi
T
T
Massa
D000038:Abscess / Q000628:therapy*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001941:Breast Diseases / Q000628:therapy*; D003362:Cost-Benefit Analysis; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007267:Injections; D008875:Middle Aged; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary
D000900:Anti-Bacterial Agents