The efficacy of primary closure following incision and drainage of lactational breast abscess over traditional open method

Background: The incidence of breast abscess ranges from 0.4 to 11% of all lactating mothers. Although breast abscess is a serious common complication of mastitis with high morbidity rate, there is a lack of high-quality randomized trial to demonstrate the best treatments.Methods: The Study was conducted in the Department of Surgery of Universal medical college and hospital, Dhaka, Bangladesh and MH Samorita hospital and medical college. It was a randomized controlled trial to see the efficacy of primary closure following incision and drainage of lactational breast abscess over traditional open method. Total 120 population were randomly selected in group A (60 patients) and group B (60 patients) and data was collected with their signed ethical consent. The study was conducted from January 2014 to December 2019. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using Statistical package for social sciences (SPSS) version 22.Results: In patients of group A, most breast abscesses healed successfully with a nicer circumareolar scar, earlier healing, lesser number of hospital visits and lower total cost as compared to patients in group B. There was early resumption of breastfeeding and better patient satisfaction seen in group A.Conclusions: Primary closure of lactational breast abscess following incision and drainage is an effective modality of treatment of lactational breast abscess and it should be the first line of treatment, especially for larger and multilocular breast abscesses while traditional incision and drainage should be reserved for abscesses with gangrenous skin changes, where primary closure is not justified.

An unusual case of breast abscess caused by Proteus mirabilis and Prevotella buccalis

A 56-year-old nulliparous woman presented to the emergency department with acute onset of redness, sensitivity, and local fever in the left breast. Mastitis with abscess was diagnosed. Unusual pathogens were identified in the culture obtained from the abscess - Proteus mirabilis and Prevotella buccalis. Keywords: breast abscess; Proteus mirabilis; Prevotella buccalis.

A Case of Unilateral Neonatal Mastauxe

<p>Enlargement of breast tissue in neonates is a condition seen as a physiological response to the decline in maternal hormonal levels postnatal. It is commonly seen in the initial weeks, but can progress in size within two months of life. We herein report a case diagnosed as neonatal mastauxe in a two months old female, which was followed up without any medical or surgical intervention. Neonatal mastauxe means enlargement of breast tissue in newborn, which is sometimes essential to be differentiated from breast abscess and mastitis in babies.</p>

PROPORTIONS OF VARIOUS BENIGN BREAST LESIONS AMONG WOMEN PRESENTING AT TERTIARY CARE INSTITUTE OF INDIA: A CROSS-SECTIONAL STUDY

Background and Aim: Benign Breast Diseases (BBDs) is a group of non-cancerous breast diseases. A triple assessment which is done by a clinical examination, imaging like ultrasonography (USG) or mammography and a pathological examination – FNAC or core needle biopsy, during the initial consultation, allows clinicians to give immediate reassurance to most of the patients. The aim of the study was to find out the proportions of various benign breast lesions among women aged 18 years and above. Material and Methods: A prospective study was conducted in the Department of Surgery, Tertiary care institute of India for a period of 20 Months. Based on the pilot study sample size derived was found to be 102. A performa was filled with patient particulars, history and clinical findings in female patient attending department of surgery OPD with breast related symptoms. Patients will be followed up with histopathological, cytological and radiological studies in indicated cases. The patients will be followed up for 1 year. Most common benign breast related symptoms and condition among the study group and probable risk factors for the same will be analyzed. Results:The commonest case among the study population was fibroadenoma 37 (36.27%). The next common was acute breast abscess, followed by fibrocystic disease (9). Lump alone detected either by patient herself or by the clinician was the most common presenting complaint in around 40 patients, followed by lump with pain in around 37, followed by either pain, nipple discharge. Fibroadenoma could be diagnosed clinically with an accuracy of about 89%. Abscess breast, phyllodes tumor and galactocele and few cases of granulomatous mastitis was also able to be diagnosed clinically. Conclusion: Fibrocystic disease is commonest amongst proliferative breast lesions followed by Sclerosing adenosis. Breast abscess is the commonest lesion amongst inflammatory breast lesions. Breast self-examination and health education to females is very important in cases of benign proliferative lesions. Key Words: Benign Breast Diseases, Fibroadenoma, Phyllodes tumor, Ultrasonography

Clinical characteristics of lactational breast abscess caused by methicillin-resistant Staphylococcus aureus: hospital-based study in China

Background This study aimed to identify the differences in clinical characteristics, puncture efficacy, antibiotic use, treatment duration, breastfeeding post-illness, and recurrence of patients with breast abscesses caused by methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-susceptible Staphylococcus aureus (MSSA) infection during lactation. Methods The clinical data of patients with breast abscesses during lactation who were treated from January 2014 to February 2017 at Haidian Maternal and Child Health Hospital, Beijing, were reviewed. According to bacterial culture results, they were divided into MRSA (n = 260) and MSSA (n = 962) groups. Hospitalization (whether or not the patients were hospitalized), postpartum period, maternal age, location of abscess cavities, number of abscess cavities, amount of pus, frequency of needle aspiration, failure of needle aspiration, antibiotic use, treatment duration, cessation of breastfeeding and recurrence were compared between the two groups using a t-test and a chi-squared test. Results We noted that only the cessation of breastfeeding was statistically significantly different between the two groups (P = 0.018). Hospitalization, postpartum period, maternal age, location of abscess cavities, number of abscess cavities, amount of pus, number of needle aspiration, failure of needle aspiration, antibiotic use, treatment duration and recurrence showed no statistically significant differences (P = 0.488, P = 0.328, P = 0.494, P = 0.218, P = 0.088, P = 0.102, P = 0.712, P = 0.336, P = 0.512, P = 0.386 and P = 0.359, respectively). Conclusions There was no difference in clinical characteristics between breast abscesses infected by MRSA and those infected by MSSA. Ultrasound-guided needle aspiration could be the first choice for MRSA-infected breast abscess treatment. There is no need to increase antibiotic use because of MRSA infection, unless it is necessary. The reason why more patients with MRSA infected breast abscesses terminated breastfeeding is unclear from this study.