18.05.2020 Second surgical breast abscess non-puerperalis

This was a case I haven't seen often.  A young patient, Fiononana, only 18 years old presented with an infection of the right breast just below the areola.  She wasn't breastfeeding so it was not due to clogged milk ducts as I usually see.  Ultrasound scan showed a partially consolidated abscess as seen in the image below.  The young woman lived about 2 hours outside of Antananarivo so had a very long journey to get here.  Since repeated puncture and drainage as I had done for a previous patient would probably not be possible due to the long distance, I decided to do an incision and put in a drainage in a small surgical procedure.  It went well and I was glad I didn't puncture as there was a lot of thick stringy material in addition to the pus which would not have drained well.  

Ultrasound image of subareolar abscess

I consulted with a retired gynecologist in Germany about the case and she agreed that surgical approach would yield better results.  Below is an edited image of the abscess.  It hardly appears large but it was very painful and had caused the nipple to be inverted, this is not shown.