Abstract
Background
We investigated the patients and microbiological risk factors that predispose to the development of primary breast abscesses and subsequent recurrence.
Methods
Patients with a primary breast abscess requiring surgical therapy between January 1, 2000 and December 31, 2006 were reviewed. Recurrent breast abscess was defined by the need for repeated drainage within 6 months. Patient characteristics were compared to the general population and between groups.
Results
A total of 89 patients with a primary breast abscess were identified; 12 (14%) were lactational and 77 (86%) were nonlactational. None of the lactational abscesses recurred, whereas 43 (57%) of the nonlactational abscesses did so (P < 0.01). Compared to the general population, patients with a primary breast abscess were predominantly African American (64% vs. 12%), had higher rates of obesity (body mass index > 30: 43% vs. 22%), and were tobacco smokers (45% vs, 23%) (P < 0.01 for all). The only factor significantly associated with recurrence in the multivariate logistic regression analysis was tobacco smoking (P = 0.003). Compared to patients who did not have a recurrence, patients with recurrent breast abscesses had a higher incidence of mixed bacteria (20.5% vs. 8.9%), anaerobes (4.5% vs. 0%), and Proteus (9.1% vs. 4.4%) but lower incidence of Staphylococcus (4.6% vs. 24.4%) (P < 0.05 for each).
Conclusions
Risk factors for developing a primary breast abscess include African American race, obesity, and tobacco smoking. Patients with recurrent breast abscesses are more likely to be smokers and have mixed bacterial and anaerobic infections. Broader antibiotic coverage should be considered for the higher risk groups.
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References
Maier WP, Au FC, Tang CK (1994) Nonlactational breast infection. Am Surg 60:247–250
Meguid MM, Oler A, Numann PJ et al (1995) Pathogenesis-based treatment of recurring subareolar breast abscesses. Surgery 118:775–782
Watt-Boolsen S, Rasmussen NR, Blichert-Toft M (1987) Primary periareolar abscess in the nonlactating breast: risk of recurrence. Am J Surg 153:571–573
Moazzez A, Kelso RL, Towfigh S et al (2007) Breast abscess bacteriologic features in the era of community-acquired methicillin-resistant Staphylococcus aureus epidemics. Arch Surg 142:881–884
Lantz PM (2003) Smoking on the rise among young adults: implications for research and policy. Tob Control 12(Suppl 1):i60–i70
Furlong AJ, al-Nakib L, Knox WF et al (1994) Periductal inflammation and cigarette smoke. J Am Coll Surg 179:417–420
Bundred NJ, Dover MS, Coley S et al (1992) Breast abscesses and cigarette smoking. Br J Surg 79:58–59
Schafer P, Furrer C, Mermillod B (1988) An association of cigarette smoking with recurrent subareolar breast abscess. Int J Epidemiol 17:810–813
Ohta T, Yamashita N, Maruyama M et al (1998) Cigarette smoking decreases interleukin-8 secretion by human alveolar macrophages. Respir Med 92:922–927
Wang Z, Leonard MH, Khamapirad T et al (2007) Bilateral extensive ductitis obliterans manifested by bloody nipple discharge in a patient with long-term diabetes mellitus. Breast J 13:599–602
Walker AP, Edmiston CE Jr, Krepel CJ et al (1988) A prospective study of the microflora of nonpuerperal breast abscess. Arch Surg 123:908–911
Christensen AF, Al-Suliman N, Nielsen KR et al (2005) Ultrasound-guided drainage of breast abscesses: results in 151 patients. Br J Radiol 78:186–188
Berna-Serna JD, Madrigal M, Berna-Serna JD (2004) Percutaneous management of breast abscesses: an experience of 39 cases. Ultrasound Med Biol 30:1–6
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Bharat, A., Gao, F., Aft, R.L. et al. Predictors of Primary Breast Abscesses and Recurrence. World J Surg 33, 2582–2586 (2009). https://doi.org/10.1007/s00268-009-0170-8
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DOI: https://doi.org/10.1007/s00268-009-0170-8