Ultrasound, biopsy & aspiration question?

Meganrenee

I have been struggling with a hard painful tender lump that grew huge over the course of a few days. They did three ultrasounds & didn't believe it was an abcess but wanted to biopsy it as it wasn't responding to antibiotics.

On Friday the biopsy was scheduled & the radiologist decided to try to aspirate it a little. He got a pus/blood mixture from it.. He decided not to do the biopsy. But he did send it for a culture.

He told me he was not worried about cancer especially with the pus, the mass got smaller after it was aspirated. I just took the bandage off today as directed and the lump is hard and huge still but doesn't hurt anymore.

I guess my question is- what do they test for with a culture like that? And does the presence of pus mean no cancer since the mass decreased in size on the screen after being aspirated?

I suppose I am still worried. I am new to all of this.

MelissaDallas

Yes, they are testing the pus for what bacteria caused the infection to make sure they are using the best antibiotic. not cancer

Meganrenee

I guess I am just mainly worried because the lump is still there. Its just not painful anymore.

MelissaDallas

I'm guessing it takes quite some time for a big infection/abcess to reabsorb and I think sometimes those infections are hard to get rid of. It might take a different or another round of antibiotics, or even to be drained

Meganrenee

The doctor called today and the pus did not grow anything. Ao now I am even more worried.

Tomboy

12 or more years ago, My non cancer breast became hot and red and swollen, almost over night. i didn't have a computer then so I didn't know how worried to be. So, I had to do a mammo first, then an ultra sound. Then he said he wanted to aspirate it. and he did! It was a big ol syringe, and i could see the syringe, and I could see the monitor. As it went into the needle, the spot got smaller! It looked like mostly pus to me, yuk. So the spot blipped away. And when he said i had an inflammation, i said you mean infection, right? and he was all indignant and said no an inflammation!! And threw the syringe in the tray! I don't think they even cultured it, he must have believed it was just my white blood cells. Cancer is not liquid unless its leukemia. i think you are good to go. I have never had a problem since, on that breast. Hope this helps.

Meganrenee

That was similar to mine. The lump got smaller on the screen & almost immediately the pain within the lump vanished. But now it is still there and hard still, so I am not 100% certain.

Meganrenee

Note: I do have a followup on Thursday with my doctor.

Here is the report from my procedure (the cultures on the drainage showed no growth):

EXAM: US BREAST CYST ASPIRATION

CLINICIAN'S HISTORY: RIGHT BREAST MASS SEEN ON RECENT ULTRASOUND

ADDITIONAL CLINICAL INDICATIONS: Patient had been seen in the emergency room for an erythematous tender mass of the right breast. She has been started antibiotics with decreasing erythema and some decrease in size of the palpable fullness or mass.

COMPARISON: Ultrasound evaluation 7/26/2015

TECHNIQUE: RIGHT BREAST ULTRASOUND GUIDED ABSCESS ASPIRATION

INDICATIONS: Female patient, 26 years of age referred for aspiration of a abscess at the nine o'clock position of the right breast
.
PROCEDURE: Informed written and verbal consent has been obtained. The risks, benefits and alternatives to the procedure have been discussed with the patient. The patient or designee understands and has signed the consent.

A sterile surgical supply tray was used for the procedure. The patient was positioned on the ultrasound table with the ipsilateral arm raised over the head. The breast was prepped with ChloraPrep and draped using sterile towels. Sterile ultrasound
jelly was placed on the breast. Under continuous ultrasound guidance, 1% Lidocaine buffered with sodium bicarbonate was injected for superficial anesthesia and to anesthetize the skin and the subcutaneous tissues to the abscess wall at the 9 o'clock
position. 18-G aspiration needle was used to puncture the abscess cavity.

Approximately 2 ml of purulent colored fluid was removed with incomplete disappearance of the lesion on ultrasound. No underlying mass was identified.

Pressure was held over the site utilizing sterile 4x4 gauze until all bleeding subsided. A repeat ultrasound was performed and no active bleeding or hematoma formation was apparent. A sterile Band-Aid was placed over the puncture site. Post-procedural
instructions were reviewed and a copy given to the patient. The patient tolerated the procedure well and was discharged in a stable condition.
The fluid was sent for Gram stain, culture and sensitivity analysis.

IMPRESSION SUCCESSFUL ABSCESS ASPIRATION OF THE RIGHT BREAST AS DESCRIBED.

COMMENTS: Although not a stereo typical appearance for abscess it was obviously complicated fluid and purulent in nature. The overall response to antibiotics may be indicative of a bacterial infection, versus possible granulomatous mastitis. The patient
will continue on her current antibiotic regimen through the weekend and follow-up with Dr. Reid's office next week. Biopsy did not appear mandated at this time. The findings and recommendations reviewed with the patient at time of today's exam