Review of Breast Abscess Cases at a Tertiary Hospital in Addis Ababa, Ethiopia

Figures & data

Table 1 Sociodemographic Characteristics of Breast Abscess Cases in a Tertiary Hospital in Addis Ababa, Ethiopia, 2020

Property		Percentage	Number
Age	15–30	81.3%	170
	31–45	17.7%	37
	> 46	1%	2
Region	Addis Ababa	49.8%	104
	Oromia	43.1%	90
	Others	7.2%	15
Educational status	No Formal education	2.9%	6
	Primary school (1–8)	21.5%	45
	Secondary school (9–12)	24.4%	51
	Technic/Diploma/College/University	12.9%	27
	Not Documented	38.3%	80

Table 2 Clinical Features of Patients on Presentation of Breast Abscess Cases in a Tertiary Hospital in Addis Ababa, Ethiopia, 2020

Characteristics		Percent	Number
Treatment before referral	Received treatment before	70.3%	147
	Did not receive treatment before referral	24.4%	51
	Treatment not specified on the referral	3.8%	8
	No referral	1.4%	3
Treatment Given	Antibiotics	74.8%	110
	Anti-Pain	6.1%	9
	Antibiotics + Anti pain	17.7%	26
	Other	1.4%	2
Side of Abscess	Left-side	47.4%	99
	Right-side	45.0%	94
	Bilateral	7.7%	16
Quadrant of abscess for unilateral abscess	Upper Outer Quadrant (UOQ)	24.9%	48
	Upper Inner Quadrant (UIQ)	18.1%	35
	Lower Outer Quadrant (LOQ)	25.4%	49
	Lower Inner Quadrant (LIQ)	5.2%	10
	Not specified	26.4%	51
Duration of symptoms	Median duration	11 days	2–150
	1–14 days	72.8%	155
	>14 days	24.4%	52
Type of Abscess	LBA	87.1%	182
	NLBA	12.9%	27
Age of Child in months in LBA (lactating only)	<2 months	35.9%	61
	>2 months	64.1%	109
Parity	Para 1	48.6%	84
	Para 2	28.9%	50
	Para 3	9.8%	17
	Para 4	4%	7
	Parity status not mentioned	8.7%	15
Tachycardia on presentation	<99	54.1%	113
	>100	45.9%	96
Abscess characteristics on physical examination	Ruptured	14.4%	30
	Erythematous	78.5%	164
	Swollen	69.9%	146
	Hot	32.1%	67
	Tender	77.5%	162
	Fluctuant	38.3%	80

Abbreviations: UOQ, Upper Outer Quadrant; UIQ, Upper Inner Quadrant; LOQ, Lower Outer Quadrant; LIQ, Lower Inner Quadrant; LBA, Lactational Breast Abscess; NLBA, Non-lactational breast abscess.

Table 3 Results of Investigations Sent for Breast Abscess Cases Who Received Treatment in a Tertiary Hospital in Addis Ababa, Ethiopia

Characteristics		Percent	Number
White Blood Cells	>10,000	75.6%	158
	<10,000	23%	48
Ultrasound done	Yes	66%	138
	No	33.5%	70
Ultrasound finding	Abscess	81.9%	113
	Mastitis	29%	40
	Other diagnoses	15.2%	21
FNAC done	Yes	13.9%	29
	No	86.1%	180
FNAC result	Abscess	62.1%	18
	Mastitis	10.3%	3
	Granulomatous Mastitis	10.3%	3
	Other	17.2%	5

Abbreviation: FNAC, Fine needle aspiration cytology.

Table 4 Risk Factors Identified in Breast Abscess Cases Who Received Treatment in a Tertiary Hospital in Addis Ababa, Ethiopia

Characteristics		Percent	Number
History of trauma	Present	4.8%	10
	Absent	69.4%	145
	Not Mentioned	25.8%	54
Comorbidity	DM	11.5%	24
	HTN	3.3%	7
	HIV	2.4%	5
	Other	1.4%	3
Comorbidity in NLBA (Non-lactating + Not pregnant)	DM	48.1%	13
	HTN	7.4%	2
	HIV	7.4%	2
	Other	3.7%	1

Abbreviations: DM, Diabetes Mellitus; HTN, Hypertension; HIV, Human immunodeficiency virus; NLBA, Non-lactational breast abscess.

Table 5 The Details of the Treatment Provided for Breast Abscess Cases in a Tertiary Hospital in Addis Ababa, Ethiopia

Characteristics		Percent	Number
Incision and Drainage	Done	100%	209
	Not done	0	0
Types of Incision	Periareolar	29.7%	62
	Radial	25.4%	53
	Curvilinear	17.2%	36
	Over the abscess	1.9%	3
	Cruciate	0.5%	1
	Not Mentioned	25.8%	54
Type of Anesthesia	Light Sedation	49.8%	104
	General anesthesia	49.8%	104
	Local anesthesia	0.5%	1
Abscess drained in LBA in mL	Median abscess drained in mL	60 mL (5–800 mL)
Abscess drained in NLBA	Median abscess drained in mL	50mL (10–200 mL)
Post-operative antibiotics	Intravenous	98.1%	205
	Per Os	1.9%	4
Postoperative Intravenous Antibiotics	Ceftriaxone	68.8%	141
	Metronidazole	26.5%	54
	Cloxacillin	30.7%	63
Antibiotics prescribed on discharge	Cloxacillin	80.3%	167
	Metronidazole	0.5%	1
	Augmentin	19.7%	41
Antibiotics prescribed on discharge in LBA (Lactating + Pregnant)	Cloxacillin	83.5%	152
	Metronidazole	0%	0
	Augmentin	16.5%	30
Antibiotics prescribed on discharge in NLBA	Cloxacillin	55.6%	15
	Cloxacillin + Metronidazole	3.7%	1
	Augmentin	40.7%	11
The total duration of IV antibiotics	One day	56.6%	116
	Two days	43.4%	89
Culture	Sent	19.1%	40
	Not sent	80.9%	169
Gram stain	Done	0.5%	1
	Not done	99.5%	208
Biopsy (LBA)	Sent	24.9%	52
	Not sent	75.1%	157
Biopsy collected	Collected	44.2%	23
	Not collected	55.8%	29
Biopsy Finding (LBA only)	Mastitis	21.7%	5
	Abscess	60.9%	14
	Lactational Adenoma	8.7%	2
	Duct Ectasia	4.3%	1
	Fat Necrosis	4.3%	1
Biopsy in NLBA	Sent for	51.9%	14
	Not sent	48.1%	13
	Collected	35.7%	5
	Not collected	64.3%	9
	Abscess	14.3%	4
Follow Up	Yes	100%	209
	No	0	0
Discharged from follow up	Discharged	96.2%	201
	Discontinued	3.8%	8
Recurrence	Yes	5.8%	12
	No	94.2%	196

Note: Italicized text is to indicate mentioned treatments and investigations are not easily available in the country.