Management challenges of complicated lactational breast abscess in a tertiary health facility in a resource-constrained environment

Background: Lactational breast abscess, if not promptly and appropriately treated, can become complicated with associated destruction of breast skin and tissue that may necessitate breast resurfacing or reconstruction. The study is aimed at highlighting management challenges of patients who presented with complicated lactational breast abscess to a tertiary health facility in a resource-constrained environment. Patients and Method: A retrospective review of patients who presented with complicated lactational breast abscess to a tertiary health facility in northwest Nigeria from April 2015 to March 2017 was carried out. Patients were identified using the hospital admission records and appropriate data were retrieved from their case notes and analyzed. Results: A total of 17 patients were included in the study and 10 (58.8%) were in the age range 21 to 30 years. Nine (52.9%) patients presented in the puerperal period and 10 (58.8%) patients were multiparous. Left breast was predominantly affected accounting for 10 (58.8%) cases whereas there was bilateral breast involvement in four (23.5%) patients. Sixteen (94.1%) patients presented after the symptoms have started for more than a week. Four (23.5%) of the patients had necrotizing infection. Six (35.3%) patients had surgical intervention for breast resurfacing or breast reconstruction whereas 11 (64.7%) patients declined surgery due to financial constraint. Conclusion: Complicated breast abscess is not uncommon among lactating women in our environment due to late presentation resulting from illiteracy, poverty, and cultural practice of seeking alternative medical practice and its management is challenging to the surgeon partly due to financial constraint for patients’ treatment.