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Category: Volume 06 Issue 07 July 2018
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Title: Optimal Management of Subareolar Breast Abscess

Author: Prema Mariappan

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i7.97

Abstract

Introduction: Subareolar breast abscess has the tendency to recur and result in mammary fistula. The ideal management of subareolar abscess needs a clear understanding of the underlying pathological changes in the ducts and the clinicopathological progress of events that ultimately result in mammary fistula. We present our experience with 35 cases of subareolar abscess with respect to recurrence pattern and management outcomes.

Materials and Methods: This is a retrospective descriptive study conducted in Raja Muthiah Medical College, chidambaram during june 2014 to october 2017. All new patients with clinically or radiologically proven subareolar breast abscess were chosen. Those with breast cancer, immunocompromised status, peripheral breast abscess, Tuberculous mastitis were excluded. History, clinical and radiological examination findings, microbiological profile, treatment given and outcomes like number of recurrence, time to recurrence were recorded and analyzed.

Results: Out of 35 new cases of subareolar abscess, all were females in age range 18-60 years, only 2 patients gave history of passive smoking. More than 90% of patients had underlying duct ectasia in either one or both breasts. Organisms were isolated in 14 out of 33 patients, mostly Staphylococci. Incision and Drainage with antibiotics was the commonly performed procedure. The average number of recurrence was 1.8 (range 0 to 3) and the average time to recurrence was 3 months (15 days to 18 months).

Conclusion: Incision and drainage alone is insufficient for optimal management of subareolar abscess. The underlying duct has to be excised partially or totally to prevent development of mammary fistula and nipple inversion.

Keywords:  subareolar abscess, duct ectasia, duct excision.

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Corresponding Author

Prema Mariappan

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