Can KS lesions be minimized by lancing and draining?

I doubt that lancing and draining would be very effective. Such a procedure is commonly used for infected abscesses. The purpose of the lancing and draining of an abscess is to remove the pus and to facilitate healing. KS lesions are really quite different from abscesses. KS lesions are due to a proliferation of blood vessels brought on by the Kaposi's sarcoma herpes virus (also known as HHV-8). There's no reason to assume that lancing would help. In fact, I would be concerned that breaking the KS lesion open could either increase the likelihood of a skin infection or increase the likelihood of KS spread. There are so many other good treatments for KS that I would avoid lancing and drainage. These other treatments have been dealt with before on this website so I won't go over them in detail. I'll just mention them by name

For isolated lesions- Panretin gel, intralesional velban, radiotherapy

For more systemic involvment liposomal chemotherapy (DaunoXome, Doxil), Taxol, and in some settings interferon

Virtually all patients with KS should be taking highly active anti-retroviral therapy