Breast gangrene

Abstract

Background: Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene.

Methods: A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed

Results: All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area.

Conclusion: Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.

Figure 1

(A) Gangrene breast after application of belladonna paste in a lactating female; (B): Breast after debridement and grafting.

Figure 2

(A) Gangrene of breast following tooth bite in a lactating female; (B) Typical gangrene patch on breast following tooth bite by infant in lactating female.

Figure 3

(A) Gangrene in a breast after she had needle aspiration for confirmation of pus and progressed to necrotizing fascitis in a lactating female; (B) Breast after serial debridements.

Figure 4

(A) Gangrene of breast in diabetic female which progressed to necroting fascitis; (B) Breast after control of blood sugar and serial debridements.

Figure 5

(A) Gangrene of breast in an elderly female of idiopathic cause; (B) Breast after antibiotic treatment with no debridement.