A 26-year-old lactating woman presents with a tender, fluctuant 4 cm swelling in the lower inner quadrant of the left breast with overlying erythema. She is afebrile. What is the current preferred management?

• A Repeated ultrasound-guided needle aspiration with antibiotics ✓
• B Stop breastfeeding immediately and start cloxacillin
• C Immediate incision and drainage under general anaesthesia
• D Radical excision of the abscess cavity with primary closure

Explanation

Lactational abscesses are now managed with repeated ultrasound-guided aspiration plus antibiotics covering Staphylococcus aureus, reserving incision and drainage for failed aspiration or multiloculated collections. Breastfeeding should be continued from the affected side because emptying aids resolution; stopping milk flow worsens engorgement. Incision and drainage leaves an unsightly scar and risks milk fistula, so it is no longer first line.

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.