Bosma Melissa S, Morden Kasey L, Klein Katherine A, Neal Colleen H, Knoepp Ursula S, Patterson Stephanie K
Department of Radiology, University of Michigan Health System, 2910H Taubman Center, 1500 E. Medical Center Dr., SPC 5326, Ann Arbor, MI, 48109-5326, USA.
Emerg Radiol. 2016 Feb;23(1):29-33. doi: 10.1007/s10140-015-1352-3. Epub 2015 Oct 3.
In our study, we sought to report the management, clinical outcomes, and follow-up rates of patients who presented for evaluation of breast abscess in the Emergency Department (ED) after hours. A retrospective search of ultrasound reports at our institution identified all patients from January 1, 2009 to June 30, 2013 who were scanned in the ED after hours to evaluate for breast abscess. Patient demographics, clinical information, imaging findings, follow-up rates, and outcomes were reviewed. One hundred eighty-five patients were included in the study. Forty-four percent (86/185) of the patients were diagnosed with abscess based on ultrasound findings in the ED. Twenty-seven percent (23/86) were recently post-operative, and 12 % (10/86) were postpartum/breastfeeding. Mastitis was the diagnosis in the remaining 54 % (99/185). Only 1/86 cases were associated with breast cancer. Seventy-seven percent (66/86) of patients were treated with an invasive procedure; 39 % (26/66) had surgical evacuation, 30 % (20/66) image-guided drainage, 23 % (15/66) bedside or clinic incision and drainage, and 8 % (5/66) palpation-guided fine needle aspiration (FNA). Seventy-seven percent (143/185) of patients had clinical and/or imaging follow-up. Forty-four percent (63/143) had long-term follow-up (≥ 3 months). Almost 50 % of the patients who presented to the ED for evaluation of abscess were diagnosed with abscess while the remaining patients were diagnosed with mastitis. Appropriate clinical and/or imaging follow-up occurred in 77 %. Long-term follow-up (≥ 3 months) occurred more frequently in patients older than 30 years of age. Appropriate follow-up does not occur in approximately one fourth of cases, suggesting that additional clinician and patient education is warranted.
在我们的研究中，我们试图报告那些在非工作时间到急诊科（ED）评估乳腺脓肿的患者的管理情况、临床结果及随访率。对我们机构的超声报告进行回顾性检索，确定了2009年1月1日至2013年6月30日期间所有在非工作时间到急诊科进行乳腺脓肿评估的患者。对患者的人口统计学资料、临床信息、影像学检查结果、随访率及结果进行了回顾。185例患者纳入研究。根据急诊科超声检查结果，44%（86/185）的患者被诊断为脓肿。其中27%（23/86）为近期术后患者，12%（10/86）为产后/哺乳期患者。其余54%（99/185）诊断为乳腺炎。仅1/86例与乳腺癌相关。77%（66/86）的患者接受了侵入性治疗；39%（26/66）进行了手术引流，30%（20/66）进行了影像引导下引流，23%（15/66）进行了床边或门诊切开引流，8%（5/66）进行了触诊引导下细针穿刺抽吸（FNA）。77%（143/185）的患者进行了临床和/或影像学随访。44%（63/143）进行了长期随访（≥3个月）。到急诊科评估脓肿的患者中，近50%被诊断为脓肿，其余患者被诊断为乳腺炎。77%的患者进行了适当的临床和/或影像学随访。30岁以上患者更常进行长期随访（≥3个月）。约四分之一的病例未进行适当随访，这表明有必要对临床医生和患者进行更多教育。
