A breast hematoma is a localized collection of blood that has escaped from blood vessels and pooled within the breast tissue. This accumulation of blood happens outside of the normal circulatory system, essentially forming a deep bruise. While the discovery of any change in breast tissue can be concerning, a hematoma is a common finding and is almost always benign. The body’s natural processes are typically capable of slowly reabsorbing the blood over a period of time.
Visual and Physical Characteristics of a Breast Hematoma
A hematoma often presents with noticeable changes in both appearance and sensation. The most apparent visual sign is skin discoloration, which is the equivalent of a substantial bruise. Initially, the area may display dark purple or reddish hues, which then transition through stages of green, yellow, and brown as the body breaks down the trapped blood products.
The affected area usually feels tender and exhibits swelling, which can range from slight puffiness to a significant, localized enlargement of the breast. This swelling occurs because the volume of escaped blood creates pressure within the surrounding tissue. Pain is a frequent symptom, varying from mild discomfort to a more severe, throbbing sensation, which may worsen with movement or pressure on the site.
Under the skin, a breast hematoma may be felt as a distinct mass or lump. The consistency of this lump can change based on the age and size of the blood collection. A fresh hematoma may feel relatively firm, while an older or larger one might feel somewhat spongy or fluid-filled as the blood begins to liquefy. In certain cases, particularly with deeper hematomas, the collection of blood can create a tugging pressure on the surrounding structures, which may cause the overlying skin to appear dimpled or puckered.
Small hematomas may resolve within a few weeks, with the discoloration gradually fading. Larger collections take longer to reabsorb, and sometimes, the hematoma can organize into scar tissue, which may result in a persistent, hard lump.
Primary Causes and Contributing Factors
A breast hematoma forms when blood vessels within the breast tissue are damaged, allowing blood to leak out and pool. The most frequent cause is direct trauma or injury to the chest area. This can result from common incidents like sports injuries, a hard fall, or the sudden impact from a seatbelt during a motor vehicle accident.
Procedures that intentionally manipulate the breast tissue are another common cause. Hematomas are recognized as potential complications following various surgical procedures, including cosmetic operations like breast augmentation or reduction, as well as necessary procedures such as lumpectomies. Minimally invasive diagnostic interventions, such as core needle biopsies, also carry a small risk of causing a hematoma due to the disruption of vessels during the procedure.
Certain medical conditions and medications can increase the risk of hematoma formation. Individuals who take anticoagulant medications are more susceptible to bleeding and subsequent hematomas, even after minor trauma. Conditions that affect blood clotting, such as bleeding disorders, also make the formation of a hematoma more likely.
When and Why Medical Evaluation is Necessary
While most breast hematomas are temporary and resolve without specific intervention, medical evaluation is still important to confirm the diagnosis. The main reason for consulting a healthcare provider is to differentiate the palpable lump of a hematoma from other conditions, such as a malignant tumor or an abscess.
Imaging studies are often employed to clarify the nature of the lump, especially if the cause is not clearly related to recent trauma or surgery. An ultrasound is frequently used because it can clearly distinguish between a solid mass and a fluid-filled collection, which is characteristic of a hematoma. In some instances, a large hematoma might appear concerning on a mammogram, necessitating the use of ultrasound or even a biopsy to definitively rule out cancer.
Immediate medical attention is necessary if signs of infection develop, as a hematoma can sometimes provide a site for bacteria to grow. Warning signs include a sudden increase in pain, fever, significant and spreading redness, or the area feeling warm to the touch. A hematoma that is rapidly increasing in size or causing significant, unmanageable pain requires urgent evaluation. Treatment may involve simply monitoring the area, or in severe cases, intervening with aspiration or surgical drainage of the blood collection.