A 26-year-old lactating mother presents with a fluctuant, tender swelling in the lower quadrant of the left breast with overlying erythema, unresponsive to five days of appropriate antibiotics. What is the next step in management?
- A Continue antibiotics and stop breastfeeding
- B Aspiration cytology to exclude carcinoma
- C Incision and drainage through a radial incision ✓
- D Start bromocriptine to suppress lactation
Correct answer: C. Incision and drainage through a radial incision
Explanation
An antibiotic-refractory fluctuant breast mass in a lactating woman is a breast abscess, and the definitive treatment is incision and drainage. A radial incision is preferred because it runs parallel to the lactiferous ducts and minimises damage to them. Antibiotics alone fail once pus has formed. Breastfeeding from the affected side can usually continue, and lactation suppression is reserved for severe or recurrent cases. Aspiration cytology is a diagnostic tool for solid lumps, not for established pus.
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.