A 26-year-old lactating mother presents with a tender, fluctuant 4 cm collection in the upper outer quadrant of the left breast with surrounding cellulitis. Ultrasound confirms liquefied pus. What is the most appropriate management?

• A Immediate cessation of breastfeeding from both breasts and oral cloxacillin alone
• B Wide incision and drainage under general anaesthesia with packing of the cavity
• C Ultrasound guided aspiration of pus combined with antistaphylococcal antibiotics, continuing feeding from the unaffected breast ✓
• D Microdochectomy of the affected segment followed by suppression of lactation

Explanation

A liquefied lactational abscess is best drained by repeated ultrasound guided aspiration with antibiotics active against Staphylococcus aureus, avoiding a scar on the breast. Breastfeeding should continue from the unaffected side and may resume on the affected side once drainage is complete. Incision and drainage is reserved for multiloculated or failed aspiration cases, making B the distractor to eliminate.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.