The initial management of a breast abscess involves antibiotics to treat the underlying infection and drainage to evacuate the pus collection. Antibiotics alone are insufficient because the abscess cavity contains thick pus that needs to be physically removed to prevent persistence or spread of infection. Drainage can be performed via needle aspiration or surgical incision and drainage, depending on the size and location of the abscess. Early and adequate drainage promotes faster resolution and symptom relief while minimizing complications such as chronic abscess or fistula formation. Observation alone delays treatment and increases risk of progression. Chemotherapy and radiotherapy are irrelevant in this infectious context.

Reference: Bailey & Love's Short Practice of Surgery, R. C. Bailey, 27th Edition.