Comparison of Pain, Cosmetic Outcomes and Early Restoration of Breast Feeding in Multiple Percutaneous Needle Aspiration Vs Incision and Drainage for Small Breast Abscess Management

Breast abscesses disrupt postpartum women's well-being, hindering breastfeeding and affecting cosmetic outcomes. Traditional incision and drainage (ID) often causes significant discomfort and suboptimal aesthetics. Multiple percutaneous needle aspiration (MPNA) offers a minimally invasive alternative with potentially better outcomes. Objectives: To compare pain, cosmetic satisfaction, and breastfeeding restoration between MPNA and ID for breast abscess treatment. Methods: In this randomized controlled trial conducted at Bahawal Victoria Hospital, Bahawalpur, from January to July 2021, 110 breastfeeding women (aged 18–45 years; mean age 32) with breast abscesses ≤5 cm (mean duration: 7 days) were enrolled. Participants were randomized into two groups: MPNA (n=55) and ID (n=55). Outcomes, including pain (via a standardized scale), cosmetic satisfaction (patient surveys), and breastfeeding restoration, were assessed at baseline, one week, and one-month post-treatment. Results: The MPNA group reported lower mean pain scores (2.3 vs. 5.6 in the ID group). Cosmetic satisfaction was higher in the MPNA group, with 80% reporting "Highly Satisfactory" outcomes compared to 40% in the ID group. Additionally, 85% resumed breastfeeding within one-week post-treatment in the MPNA group, compared to 60% in the ID group. Conclusion: It was concluded that MPNA is a viable, less invasive alternative to ID for small breast abscesses in breastfeeding women, with significantly reduced pain, better cosmetic outcomes, and quicker breastfeeding restoration. MPNA should be considered a preferred first-line treatment in appropriate cases.