Catherine Colin1, Ana Gjorgjievska Delov2, Noémie Peyron-Faure3, Muriel Rabilloud4,5,6, Mathilde Charlot7. 1. Department of Radiology, Breast Imaging, Hospices Civils de Lyon, Centre Hospitalier Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France. catherine.colin01@chu-lyon.fr. 2. Department of Radiology, Breast Imaging, Hospices Civils de Lyon, Centre Hospitalier Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron, France. 3. Department of Radiology, Women Imaging, Private clinic Val d'Ouest, Charcot, 53 rue commandant Charcot, 69110, Sainte Foy-lès-Lyon, France. 4. Hospices Civils de Lyon, Service de Biostatistique et Bioinformatique, 69000, Lyon, France. 5. Université Lyon1, 69100, Villeurbanne, France. 6. CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, 69100, Villeurbanne, France. 7. Department of Radiology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France.
Abstract
BACKGROUND: Surgical incision with drainage remains the first-line therapy recommendation for breast abscesses greater than 5 cm. PURPOSE: To determine recovery with ultrasound guided (US-guided) procedures for treatment of lactational breast abscesses without surgical incision for drainage. MATERIAL AND METHODS: Institutional review board approval and written informed patient consent were obtained for this retrospective study. From May 1, 2009, to June 1, 2018, 92 consecutive women (mean age 30 years, range 18-45) with 105 abscesses were treated with oral antibiotics and US-guided percutaneous drainage under local anesthesia. A total number of 202 US-guided procedures were performed. Three techniques were used: needle aspiration (diameter 18 to 14G), pigtail catheter insertion (diameter 5 to 7F), and/or vacuum-assisted biopsy/aspiration (diameter 10G). When using needle aspiration or pigtail catheter, a saline irrigation of the cavity was performed according to pus viscosity. RESULTS: The median diameter of abscesses was 4.5 cm (range 1-15), 82/105 (78%) were larger than 3 cm and 40/105 (38%) larger than 5 cm. US-guided management was successful for 101/105 (96%; 95% CI, (91-99%)) abscesses regardless the size. After the first round of procedures, 49/105 (47%) abscesses were recovered, 56/105 (53%) needed more than one drainage with a median number drainages of 2.6 (2-6). In 4/105 cases (4%), women underwent additional surgery under general anesthesia. By excluding abscesses which occurred in the weaning phase (n = 17), breastfeeding carried on for 68/75 (91%) women. CONCLUSION: Unlike previous studies, US percutaneous guided management of lactational abscesses is effective even for abscesses greater than 5 cm and allows continued breastfeeding.
BACKGROUND: Surgical incision with drainage remains the first-line therapy recommendation for breast abscesses greater than 5 cm. PURPOSE: To determine recovery with ultrasound guided (US-guided) procedures for treatment of lactational breast abscesses without surgical incision for drainage. MATERIAL AND METHODS: Institutional review board approval and written informed patient consent were obtained for this retrospective study. From May 1, 2009, to June 1, 2018, 92 consecutive women (mean age 30 years, range 18-45) with 105 abscesses were treated with oral antibiotics and US-guided percutaneous drainage under local anesthesia. A total number of 202 US-guided procedures were performed. Three techniques were used: needle aspiration (diameter 18 to 14G), pigtail catheter insertion (diameter 5 to 7F), and/or vacuum-assisted biopsy/aspiration (diameter 10G). When using needle aspiration or pigtail catheter, a saline irrigation of the cavity was performed according to pus viscosity. RESULTS: The median diameter of abscesses was 4.5 cm (range 1-15), 82/105 (78%) were larger than 3 cm and 40/105 (38%) larger than 5 cm. US-guided management was successful for 101/105 (96%; 95% CI, (91-99%)) abscesses regardless the size. After the first round of procedures, 49/105 (47%) abscesses were recovered, 56/105 (53%) needed more than one drainage with a median number drainages of 2.6 (2-6). In 4/105 cases (4%), women underwent additional surgery under general anesthesia. By excluding abscesses which occurred in the weaning phase (n = 17), breastfeeding carried on for 68/75 (91%) women. CONCLUSION: Unlike previous studies, US percutaneous guided management of lactational abscesses is effective even for abscesses greater than 5 cm and allows continued breastfeeding.
Authors: Paola Pileri; Alessandra Sartani; Martina Ilaria Mazzocco; Sofia Giani; Sara Rimoldi; Gaia Pietropaolo; Anna Pertusati; Adriana Vella; Luca Bazzi; Irene Cetin Journal: Int J Environ Res Public Health Date: 2022-05-09 Impact factor: 4.614
Authors: Ulrich Bick; Rubina M Trimboli; Alexandra Athanasiou; Corinne Balleyguier; Pascal A T Baltzer; Maria Bernathova; Krisztina Borbély; Boris Brkljacic; Luca A Carbonaro; Paola Clauser; Enrico Cassano; Catherine Colin; Gul Esen; Andrew Evans; Eva M Fallenberg; Michael H Fuchsjaeger; Fiona J Gilbert; Thomas H Helbich; Sylvia H Heywang-Köbrunner; Michel Herranz; Karen Kinkel; Fleur Kilburn-Toppin; Christiane K Kuhl; Mihai Lesaru; Marc B I Lobbes; Ritse M Mann; Laura Martincich; Pietro Panizza; Federica Pediconi; Ruud M Pijnappel; Katja Pinker; Simone Schiaffino; Tamar Sella; Isabelle Thomassin-Naggara; Anne Tardivon; Chantal Van Ongeval; Matthew G Wallis; Sophia Zackrisson; Gabor Forrai; Julia Camps Herrero; Francesco Sardanelli Journal: Insights Imaging Date: 2020-02-05