A 27-year-old lactating mother has a 5 x 4 cm fluctuant, tender swelling in the upper outer quadrant of the right breast despite 48 hours of appropriate antibiotics for mastitis. She is afebrile now. What is the next best step in management?

• A Ultrasound-guided needle aspiration, repeated as needed ✓
• B Continue antibiotics alone for a further week before any intervention
• C Stop feeding from the affected breast and start a galactagogue
• D Wide radial incision and drainage under general anaesthesia

Explanation

An established lactational abscess needs source control; antibiotics alone will not resolve a formed collection. Current practice, and Indian exam convention, favours serial ultrasound-guided aspiration because it avoids a scar, allows continued feeding, and has success rates comparable to surgery. Open drainage through a radial incision is reserved for failed aspiration, multiloculated or very large collections. Feeding from the affected breast should be encouraged, not stopped.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.