A 26-year-old lactating mother develops a painful, fluctuant 4 cm swelling in the right breast with overlying erythema, unresponsive to five days of oral flucloxacillin. What is the definitive management?

• A Stop breastfeeding and start broad spectrum antibiotics
• B Microdochectomy through a periareolar incision
• C Wide incision and drainage under general anaesthesia
• D Ultrasound-guided repeated aspiration along with antibiotics covering anaerobes ✓

Explanation

An abscess that persists despite antistaphylococcal therapy should be confirmed by ultrasound and drained by serial image-guided aspiration, which has replaced formal incision and drainage as first-line management because it avoids a scar and allows continued breastfeeding. Broadening cover to include anaerobes is advised when initial therapy fails. Breastfeeding from the affected breast should be encouraged, not stopped, as emptying aids resolution.

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.