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Breast Hematomas

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Updated May 20, 2014

Breast Hematomas Defined:

A hematoma is a blood-filled swelling that has been caused by trauma to your breast. It is not cancerous, but can sometimes lead to inflammation, fever, skin discoloration, and may leave behind scar tissue that mimics the shape of a breast tumor. It is usually visible on mammograms.

What It Looks Like:

You can usually see and feel a hematoma, because it is often just below broken skin, where blood has collected and clotted. The pooled blood may absorb bacteria and the surrounding tissue become inflamed, resulting in swelling. The skin above a hematoma will appear to be bruised as well as broken.

Causes of Hematomas:

  • Injury to the breast (sports injury, car accident)
  • Weak blood vessel breaking in response to a bump or jolt
  • Core needle breast biopsy (rare)
  • Breast implant surgery post-operative bleeding
  • Theraputic (not cosmetic) breast surgery
Most hematomas are small -- about the size of a grain of rice -- but some can be as big as plums.

Mammogram Detection:

A small hematoma probably won’t be seen on a mammogram. However if the hematoma is large enough to be picked up on a mammogram, it will appear as a well-defined oval mass. If it resolves on its own, it won’t show up on your next mammogram, but if it was large enough to cause scar tissue or to cause breast tissue to become re-arranged (architectural distortion) it might look like a tumor with a spiky outline.

Hematoma Versus Tumors:

In the case of a questionable breast mass, such as a hematoma that caused scar tissue and resembles a tumor, it is usually sufficient to do an ultrasound after the abnormal mammogram to see if there is a hematoma. In some cases a biopsy may be done. The pathology report can tell you whether the mass is benign (not cancer) or malignant (cancer).

What Happens Next:

Smaller breast hematomas will go away on their own, given enough time. Larger breast hematomas may need to be surgically removed. In some cases, a breast hematoma will spontaneously recur. Consult your health professional if you have a large hematoma, or one that appears to be unrelated to an injury to your breast. You may be sent for a breast ultrasound, to get a better image of the mass.

Aspirin and Hematomas:

If you are using aspirin for pain relief or as a blood thinner or to prevent heart problems, you will bleed more easily. If you are injured while on aspirin, a hematoma is more likely to occur.

Who Gets Breast Hematomas:

A breast hematoma can happen to anyone regardless of age or menopausal status.

Sources:

McGill Faculty of Medicine. Interactive Mammography Analysis Web Tutorial. Last Updated: 1999. Masses, page 2
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