title: Rate of malignancies in breast abscesses and argument for ultrasound drainage.
abstract: BACKGROUND
  Biopsy of a breast abscess wall has been performed for years without evidence. Aspiration of breast abscesses has been increasing in popularity without widespread acceptance.
  
  
  METHODS
  A 10-year retrospective review of 206 surgical biopsies after incision and drainage of breast abscesses. A literature review of breast abscess treated with ultrasound-guided aspiration.
  
  
  RESULTS
  Over 10 years, 4.37% (9/206) patients were diagnosed with malignancy in the abscess cavity wall tissue. None of the 197 patients with a negative biopsy returned with breast cancer. Single, multiple, and combined aspiration success rates of 79.8% (364/458), 11.0% (50/458), and 90.9% (482/532) with surgical intervention necessary in 9.1% (50/532). Ultrasound versus hand guidance (92.5% versus 81.9 %, P < .01) improved success rate.
  
  
  CONCLUSIONS
  The rate of associated malignancies with breast abscess is very low and does not warrant mandatory surgical drainage. The use of ultrasound-directed aspiration of breast abscesses is effective and should be first-line therapy.
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza #404D, Houston, TX 77030, USA. Bgscott@bcm.edu <Bgscott@bcm.edu>
authors.forename: Bradford G
authors.initials: BG
authors.lastname: Scott
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Silberfein
authors.forename: Huang Q
authors.initials: HQ
authors.lastname: Pham
authors.forename: Mark A
authors.initials: MA
authors.lastname: Feanny
authors.forename: Brian K
authors.initials: BK
authors.lastname: Lassinger
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Welsh
authors.forename: Mathew M
authors.initials: MM
authors.lastname: Carrick
mesh_terms: D000038:Abscess / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000473:pathology / Q000601:surgery*; D001943:Breast Neoplasms / Q000473:pathology*; D002648:Child; D003937:Diagnosis, Differential; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014505:Urban Population