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. 2009 Dec;33(12):2582-6.
doi: 10.1007/s00268-009-0170-8.

Predictors of primary breast abscesses and recurrence

Ankit Bharat  1 , Feng Gao, Rebecca L Aft, William E Gillanders, Timothy J Eberlein, Julie A Margenthaler
Affiliations

Predictors of primary breast abscesses and recurrence

Ankit Bharat et al. World J Surg. 2009 Dec.

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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Figures

Fig. 1
Fig. 1
Comparison of the study population (Patient) versus the general Missouri population (Mo Pop) with respect to demographic and patient risk factors predisposing to the development of primary breast abscesses. These factors include race (a), tobacco smoking (b), and body mass index (BMI) > 25 (c)
Fig. 2
Fig. 2
Tobacco smoking is a strong predictor of breast abscess recurrence. Usage of alcohol, tobacco, and/or illicit drugs is recorded at the time of abscess diagnosis. Alcohol consumption includes any type of consumption (social, daily, or abuse). Non-Rec: nonrecurrent; Rec: recurrent
Fig. 3
Fig. 3
Microbial pattern in patients with nonlactational/nonrecurrent (a) and recurrent (b) primary breast abscesses. MSSA: methicillin-sensitive Staphylococcus aureus; MRSA: methicillin-resistant S. aureus. CONS: coagulase-negative Staphylococcus; Strep.: Streptococcus
See this image and copyright information in PMC

Comment in

References

    1. Maier WP, Au FC, Tang CK. Nonlactational breast infection. Am Surg. 1994;60:247–250. - PubMed
    1. Meguid MM, Oler A, Numann PJ, et al. Pathogenesis-based treatment of recurring subareolar breast abscesses. Surgery. 1995;118:775–782. - PubMed
    1. Watt-Boolsen S, Rasmussen NR, Blichert-Toft M. Primary periareolar abscess in the nonlactating breast: risk of recurrence. Am J Surg. 1987;153:571–573. - PubMed
    1. Moazzez A, Kelso RL, Towfigh S, et al. Breast abscess bacteriologic features in the era of community-acquired methicillin-resistant Staphylococcus aureus epidemics. Arch Surg. 2007;142:881–884. - PubMed
    1. Lantz PM. Smoking on the rise among young adults: implications for research and policy. Tob Control. 2003;12(Suppl 1):i60–i70. - PMC - PubMed