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Trends in non‐lactation breast abscesses in a tertiary hospital setting
Author(s) -
Saboo Apoorva,
Bennett Ian
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14146
Subject(s) - medicine , percutaneous , abscess , breastfeeding , medical record , retrospective cohort study , anaerobic bacteria , mastitis , lactation , surgery , pediatrics , pregnancy , pathology , biology , bacteria , genetics
Background The aim of this paper was to retrospectively review non‐lactation breast abscesses treated in Princess Alexandra Hospital over a 10‐year period and to illustrate the trends in size, risk factors, microbiological profile and management. Methods A computerized search of the medical records was undertaken to identify all adult patients with a diagnosis of breast abscesses during June 2005–June 2015. Patients concurrently breastfeeding were excluded. A retrospectively review of the clinical records was performed. Results Eighty‐five abscesses were identified in 77 patients. The median patient age was 45 years and 93.7% were females. Smoking and diabetes mellitus were associated with a longer inpatient hospital stay. There was a significant difference in microbiology of abscesses in relation to size. Smaller abscesses (≤3.0 cm) predominantly had mixed anaerobes (54%), whereas larger abscesses had a dominance of Staphylococcus aureus (29%) and other aerobic microbes (33%) ( P < 0.05). Seven percent of all abscesses had methicillin‐resistant S. aureus . Flucloxacillin was prescribed solely in majority of the cases (45%) with addition of suitable mixed anaerobic cover in 12% cases. Of the 85 abscesses, 58.8% were managed non‐operatively with antibiotics ± percutaneous drainage. Percutaneous aspiration had a shorter inpatient stay compared with patients who underwent operative management. Conclusion This represents the first Australian study solely analysing non‐lactation breast abscess. Size was correlated significantly to characteristic bacteriology and empiric therapy should include both aerobic and anaerobic cover. The majority of non‐lactation breast abscesses can be managed non‐operatively with a combination of antibiotics and percutaneous aspiration.