AB200. 235. A comparative analysis of the pathophysiology of puerperal vs. nonpuerperal breast abscess

Background: Breast abscess (BA) is a poorly understood condition, with significant health and psychological sequelae. Demographic factors and best treatment practice remains controversial; although it is believed that there is a significant pathophysiological difference between puerperal breast abscess (PBA) and nonpuerperal breast abscess (NPBA). The aim of this study was to understand the characteristics of the disease population, their treatment and outcomes.

Material and Methods: A quantitative case review using a radiological database was conducted. Following ethical approval from the local ethics committee, radiographic reports between January 2014 and August 2016 with BREAST and ABSCESS in the text were searched. Inclusion criteria was any patient with a radiographic diagnosis of BA. Patients with infection following biopsy or surgery were excluded. Patient data were obtained from electronic records.

Results: There were 134 cases of BA diagnosed comprising of 133 individual patients. While the majority were female, one male was diagnosed. Thirty-six patients were diagnosed with PBA, the average number of weeks post-partum was 10.1. Fifty percent (n=67) were identified clinically with an abscess prior to imaging. The majority of cases (n=114) required ultrasound guided drainage and 53 patients needed this procedure more than once. Incision and drainage was needed for 21 patients. The most common organism identified on NPBA culture was mixed anaerobes (25%); staph aureus accounted for 82% of the organisms in PBA.

Conclusions: This study highlights the diagnostic and therapeutic challenges faced by this disease. It suggests that PBA patients are a particularly vulnerable group and may benefit from increased education about this complication.

Keywords: Puerperal; non-puerperal; breast; abscess