Chronic breast abscess - an entity

ABSTRACT

Chronic breast abscesses [CBA] are different from acute breast abscesses in many respects. They are usually a sequelae of some underline breast pathology and unless the primary cause is removed simple drainage of pus results in recurrence or fistulae formation. Unlike acute breast abscess, overt signs of inflammation are often absent. In this series of 20 cases of CBA, there were six cases of duct ectasia, three of tuberculosis, three of nipple inversion, two of galactocoele and one of carcinoma, while five were the result of inadequate drainage of acute abscesses. Diagnosis was mainly by clinical assessment aided by aspiration of pus and FNAC. Ultrasound and mammography had low diagnostic accuracy of 32% and 43% respectively. Treatment included major duct excision in four cases, single duct excision in two, incision and drainage with biopsy in two, excision of abscess cavity in five, nipple eversion in three, quadrantectomy in two and mastectomy in one case. We conclude that CBA should be recognised as a separate entity necessitating diagnosis of the primary cause and a pathogensis based treatment