Treatment of lactational breast abscesses with cavity diameter larger than 5 cm via combined ultrasonography-guided percutaneous catheter placement and hydrostatic pressure irrigation

Abstract

This study reports on our experience of treating lactational breast abscesses larger than 5 cm via ultrasonography (US)-guided percutaneous catheter placement and hydrostatic pressure irrigation. Twelve cases of puerperal single breast abscesses larger than 5 cm were collected. These patients were treated with US-guided percutaneous catheter placement and hydrostatic pressure irrigation combined with oral antibiotics. All 12 patients using US-guided treatment were completely successful without conversion to open surgical drainage. The range of recovery time was 5–16 days, and no major complications occurred. The patients were satisfied with the appearance of the scar, and there were no reports of recurrence during the follow-up period.Overall, US-guided percutaneous catheter placement and hydrostatic pressure irrigation are successful strategies for the treatment of lactational breast abscesses larger than 5 cm. These methods not only reduce the treatment time and improve the patients’ clinical course but also provide cosmetic effects.

IMPACT STATEMENT

• What is already known on this subject? The current consensus on breast abscess treatment is that lesions <3 cm can be effectively treated by aspiration alone, lesions >3 cm require catheter drainage, lesions <5 cm have proven to be safe and effectively treated by US-guided ultrasound therapy, and lesions >5 cm, whether multi-loculated or longstanding, require surgical incision and drainage.

• What do the results of this study add? We tried to use this method to increase the cure rate of US-guided minimally invasive treatment for large abscesses. The results showed that all patients were cured successfully, requiring no further surgical intervention. Moreover, no complications occurred, and no patients developed sequelae. During the three-month follow-up period, there was no evidence of recurrence in any case.

• What are the implications of these findings for clinical practice and/or further research? Questions remain regarding the treatment’s generalisability, potentially lengthy hospitalisation, and technical limitations of the existing instrumentation. Long-term follow up and larger sample size Randomised clinical trials studies are still needed to rigorously and scientifically ensure the method’s benefits over conventional open surgery in the future.

Keywords:

• Breast abscess
• catheter placement
• hydrostatic pressure irrigation
• ultrasonography
• lactation

Acknowledgements

We would like to acknowledge the hard and dedicated work of all the staff that implemented the intervention and evaluation components of the study.

Disclosure statement

The authors declare that they have no competing interests.

Additional information

Funding

This research was financially supported by National Natural Science Foundation of China [NSFC-81771842].