DEFINITION--Bruising of skin and underlying tissues of the breast or nipple. Contusions cause bleeding from ruptured small capillaries that allow blood to infiltrate fatty tissue, muscles, tendons, nerves or other soft tissue.
BODY PARTS INVOLVED
Male or female breast.
Skin, nipple, subcutaneous fatty tissue, blood vessels (both large vessels and capillaries), muscles and connective tissue.
SIGNS & SYMPTOMS
Local swelling of the breast--either superficial or deep.
Pain in the breast or nipple.
Feeling of firmness when pressure is exerted on the injury area.
Discoloration under the skin, beginning with redness and progressing to the characteristic "black and blue" bruise.
Hard, tender ring surrounding the nipple.
CAUSESDirect blow to the breast, usually by a blunt object.
RISK INCREASES WITH
Contact sports such as wrestling, baseball, softball or boxing, especially if the breast area has inadequate protection.
Medical history of any bleeding disorder such as hemophilia.
HOW TO PREVENT
Wear appropriate protective gear for the chest during competition or other athletic activity if there is risk of contusion.
Women should wear breast support--a sport brassiere, elasticized binder or both--for participation in contact sports.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's care unless the contusion is quite small.
Self-care during recovery.
Your own observation of symptoms.
Physical exam and medical history by a doctor for all except minor injuries. Total extent of the injury may not be apparent for 48 to 72 hours following injury.
X-rays of injured area to assess total injury to soft tissue and to rule out the possibility of underlying fracture.
Follow-up exam to make sure that any lumps remaining 3 months after injury do not represent possible malignancy.
Excessive bleeding leading to disability. Infiltrative-type bleeding can (rarely) lead to calcification.
Prolonged healing time if usual activities are resumed too soon.
Infection if skin over the injury is broken.
PROBABLE OUTCOMEHealing time varies from 2 to 6 weeks, depending on the extent of injury.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDUse instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.
Continue to use ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
After 48 hours, apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
Take whirlpool treatments, if available.
Protect the injured area with pads or an elasticized-bandage wrap between treatments.
For minor discomfort, you may use non-prescription medicines such as acetaminophen or ibuprofen (available under many different brand names). Do not use aspirin for injuries involving bleeding.
Your doctor may prescribe stronger medicine for pain, if needed.
ACTIVITYBegin activities slowly and stop exercise as soon as pain begins. Increase activity as healing progresses.
DIETEat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
CALL YOUR DOCTOR IF
A breast contusion doesn't improve within a day or two.
Signs of infection (drainage from skin, headache, muscle aches, dizziness, fever or a general ill feeling) occur if skin was broken.
Firm nodules that appear following injury do not disappear in 3 months.