title: Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center.
abstract: OBJECTIVE
  Our purpose was to review needle aspiration of breast abscesses and identify factors associated with treatment by aspiration alone versus aspiration with surgical incision and drainage (I/D).
  
  
  METHODS
  This Institutional Review Board-approved, retrospective review of the breast ultrasound database from 2008 to 2010 identified 40 patients (41 abscesses) who underwent aspiration, with or without I/D. Demographics, imaging, number of aspirations, and microbiology were reviewed.
  
  
  RESULTS
  Twenty-two abscesses underwent aspiration only, 16 > 3 cm, 6 ≤ 3 cm (mean 4.3 cm, range 0.9-10 cm). Known risk factors included lactational (11), 3 weeks post partum (1), pregnancy (1), recent biopsy/lumpectomy (5). Nineteen abscesses underwent aspiration and I/D, 15 > 3 cm, 4 ≤ 3 cm (mean 4.1 cm, range 2.2-7.5 cm). Known risk factors included lactational (4), recurrent subareolar abscess (4), diabetes (3), hydradenitis suppuritiva (1), nipple piercing (2), smoking (1), pregnancy (1), HIV (1), and lumpectomy (1). Identified reasons for I/D included lack of improvement/recurrence (12), fistula (3), and one electively after clinical improvement of a recurrent subareolar abscess.
  
  
  CONCLUSIONS
  Abscesses associated with pregnancy and lactation or breast biopsy are effectively managed with aspiration, even when large. Recurrence, chronicity, or fistula may require surgical intervention.
authors: Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115.
authors: Catherine S
authors: CS
authors: Giess
authors: Mehra
authors: M
authors: Golshan
authors: Karen
authors: K
authors: Flaherty
authors: Robyn L
authors: RL
authors: Birdwell
mesh_terms: D000038:Abscess / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle / Q000379:methods; D046288:Body Piercing; D001941:Breast Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D001942:Breast Feeding; D003920:Diabetes Mellitus; D004322:Drainage / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008875:Middle Aged; D049590:Postpartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking; D013396:Suction; D016217:Ultrasonography, Mammary / Q000379:methods; D055815:Young Adult
keywords: aspiration; breast; breast abscess; ultrasound