# Mastitis and Mammary Abscess Management Audit (MAMMA): A Survey of Patients’ Perspective on the Management of Mammary Abscesses in the UK

## TL;DR

This study surveyed UK women about their experiences with breast abscess treatments, finding that surgery led to worse cosmetic and breastfeeding outcomes compared to needle aspiration.

## Contribution

The first study to investigate patients’ experiences of breast abscess management and its impact on quality of life.

## Key findings

- Surgical treatment was associated with prolonged wound healing, permanent scarring, and negative cosmetic outcomes.
- Breastfeeding was disrupted in 58.12% of participants, with 40.17% unable to resume it after treatment.
- Surgery negatively impacted sexual well-being, mental health, and self-confidence in a significant proportion of patients.

## Abstract

The recent Mastitis and Mammary Abscess Management Audit demonstrated widespread variation in the management of breast abscesses across the United Kingdom (UK), with up to one‐fifth undergoing surgical drainage rather than image‐guided needle aspiration. The impact of these practices on patient’s perspective and quality of life is unclear. This study aimed to assess patients’ experiences following breast abscess treatment, focusing on treatment modality, cosmesis, breastfeeding and quality of life.

A cross‐sectional online survey was conducted between February and August 2024, aimed at UK‐wide adult women with a history of breast abscess. Descriptive and thematic analyses were performed using SPSS and NVivo software, with multiple imputation for missing data.

Of 172 participants, half underwent needle aspiration (50.58%), while 23.84% received surgical incision and drainage. Among those undergoing surgery, 68.29% reported prolonged wound healing, 85.37% experienced permanent scarring and a significant negative impact on their breast appearance (p = 0.029). Breastfeeding was disrupted in 58.12%, and 40.17% were unable to resume breastfeeding following treatment. Amongst participants who underwent surgery, 36.5% reported negative impacts on sexual well‐being, 31.7% on mental health, and 24.4% on self‐confidence. Thematic analysis revealed two major themes: repercussions of the treatment and issues with provision of care, highlighting delays in diagnosis, inadequate breastfeeding support, and negative cosmetic outcomes.

This study is the first to investigate patients’ experiences of breast abscess management, highlighting significant variability in practice and the association of worse cosmetic and breastfeeding outcomes with surgical treatment. Standardisation of care and improved patient counselling may improve patient experience and outcomes.