Breast abscesses and cigarette smoking
An I I-year retrospective review of women with breast abscesses presenting to a district general hospital was performed. A total of 122 women were identiJied with a breast abscess: 8.5 (70 per cent) with non-lactational abscesses and 37 (30 per cent) with an abscess in the puerperium. Six of37 lactational and 24 of 8.5 non-lactational abscesses recurred. Sixteen mammillary fistulae developed, all following incision and drainage of non-lactational breast abscesses. Women with non-lactational breast abscesses were more likely to smoke cigarettes (P < 0.00.5). Breast abscesses containing anaerobic bacteria were signlJicantly more likely to occur in current cigarette smokers ( P < 0.05). Women with non-lactational breast abscesses who were heavy cigarette smokers were more likely to sufer recurrent abscesses ( P < 0.01). There was histological evidence of duct ectasia on biopsy in 25 women with non-lactational abscesses and 21 of 25 were current smokers. Mammillary ,fistulae developed more frequently in current smokers ( P < 0.03). Cigarette smoking is important in the natural history of non-lactational breast abscesses and may predispose to anaerobic breast injections and the development of mammillary fistulae.
The incidence of lactational breast abscesses is declining but non-lactational breast abscesses are seen more frequently','. Non-lactational breast abscesses often recur and may be associated with mammillary fistulae or mammary duct ectasia ',3.4. This study examined the factors which might predispose women with non-lactational breast abscesses to develop further sepsis.