Breast abscesses in nonlactating women with diabetes: clinical features and outcome

The association between diabetes and breast abscess in nonlactating women has not been previously reported in the literature.

Retrospective analysis of all cases of breast abscess in nonlactating women in a community teaching hospital from 2000 to 2006. We analyzed their clinical characteristics, prevalence of diabetes mellitus (DM), management, and clinical outcome.

We identified 116 breast abscesses in 98 nonlactating women [age 48 +/- 14, (mean +/- SD), 89% African Americans]. At presentation, 63 patients (64%) had a known history of DM (duration: 8.5 +/- 5 years) and 8 patients (8%) had newly diagnosed DM. Among the remaining 27 women, 7 (26%) developed DM within 5 years of follow-up. The odds ratio of having diabetes in nonlactating women with breast abscess relative to those without breast abscess was estimated as 14.24 (95% confidence interval, 6.72-30.17). Most patients (89%) had a single abscess. Patients with DM had increased length of hospital stay (P < 0.01) and a more severe clinical course during follow-up. Most patients (70%) were treated with incision and drainage and antibiotics. Glycemic control was suboptimal with only 46% of subjects receiving insulin therapy during the hospital stay.

Our study indicates a strong association between DM and breast abscess in nonlactating women. The high prevalence of DM (72%) and their more severe clinical course suggest that breast abscesses in nonlactating women should be considered among the "typical" infections associated with DM. Increased awareness and intensified glycemic control might improve clinical outcome in nonlactating women with breast abscesses.