title: Predictors of primary breast abscesses and recurrence.
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.
authors: Department of Surgery, Washington University School of Medicine, 660 S Euclid Avenue, Campus Box 8109, St Louis, MO 63110, USA.
authors: Ankit
authors: A
authors: Bharat
authors: Feng
authors: F
authors: Gao
authors: Rebecca L
authors: RL
authors: Aft
authors: William E
authors: WE
authors: Gillanders
authors: Timothy J
authors: TJ
authors: Eberlein
authors: Julie A
authors: JA
authors: Margenthaler
mesh_terms: D000038:Abscess / Q000453:epidemiology* / Q000382:microbiology / Q000601:surgery; D000328:Adult; D001941:Breast Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000601:surgery; D004322:Drainage; D005260:Female; D006801:Humans; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors