Trauma to the breast

Overview:

• Trauma to the breast is relatively rare, although sexual encounters and love bites may be responsible for local injury
• A blunt impact can interfere with local blood supply and, together with a haematoma, cause fat necrosis
• Another cause is the use of therapeutic anticoagulants in patients with very large and pendulous breasts in which very minor trauma may precipitate extensive haemorrhage which may go on to necrosis

Clinical features:

• Fat necrosis causes a hard, painful lump, usually following a story of minor local trauma
• A hard lump is often found, with some irregularity and occasionally tethering to the overlying skin
• The appearances are suggestive of a carcinoma but the condition can usually be distinguished because of the history of trauma, associated bruising and resolution of the lump with observation

Investigation and management:

• Investigation is the same as for any discrete lump
• The condition resolves with time and specific treatment is not required