Comparison of the Outcome of Needle Aspiration Versus Traditional Incision and Drainage in the Treatment of Breast Abscess

Abstract

Background: Breast abscesses are localized purulent collections that have traditionally been treated using incision and drainage (I&D). Nonetheless, there is a tendency toward advanced minimally invasive procedures such as ultrasound-guided needle aspiration to decrease the morbidity of postoperative procedures and enhance aesthetic results.

Objectives: To compare the clinical and functional, as well as cosmetic outcomes of ultrasound-guided needle aspiration with the traditional I&D of the treatment of breast abscesses.

Duration: Three months (26-12-2025 to 02-04-2026).

Methodology: A randomized controlled trial was conducted in the Surgery Department at the DHQ Teaching Hospital, Mirpur. 106 female patients (30-80 years old) were recruited into the study with known cases of breast abscesses. Group 1 (n=53) underwent ultrasound-guided needle aspiration under local anaesthesia, and Group 2 (n=53) underwent the traditional I&D procedure under general anaesthesia. The main outcomes were length of stay, healing period, residual abscess on day 7, and recurrence on day 14, in the presence of metabolic comorbidities. Significance was set at p ≤ 0.05.

Results: Group 1 experienced a considerably shorter stay of 0-1 day than Group 2 (2-5 days) (p < 0.001). Group 1 (5-10 days) showed a faster healing process than Group 2 (12- 20 days). Although Group 1 had higher residual fluid on day 7 (43.4%), there were two recurrences at day 14 (3.8%), whereas Group 2 had four recurrences (7.5%) (p = 0.678). Group 1 demonstrated cosmetic results that were universally excellent or good, without scarring, unlike Group 2.

Conclusion: Ultrasound-guided needle aspiration is superior to conventional I&D. It significantly reduces hospitalisation and recovery time, minimises pathological recurrence, and achieves superior cosmetic outcomes. Ultrasound-guided needle aspiration is a safe and effective alternative.

Key Words: Breast Abscess, Cosmetic Outcome, Healing Kinetics, Incision and Drainage