DESCRIPTIONA breast contusion is a bruising of the 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. The skin, nipple, subcutaneous fatty tissue, blood vessels (both large vessels and capillaries), muscles, and connective tissue of a male or female breast are involved.
Appropriate health care includes:
Doctor's care unless the contusion is quite small.
Self-care during recovery.
SIGNS & SYMPTOMSLocal swelling of the breast--either superficial or deep.
Pain in the child's breast or nipple.
Feeling of firmness when pressure is exerted on the injury area.
Discoloration under the child's skin, beginning with redness and progressing to the characteristic "black and blue" bruise.
Hard, tender ring surrounding the nipple.
Direct blow to the child's breast, usually by a blunt object.
RISK FACTORSContact sports such as wrestling, baseball, softball, or boxing, especially if the child's breast area has inadequate protection.
Medical history of any bleeding disorder such as hemophilia.
PREVENTING COMPLICATIONS OR RECURRENCE
Your child should wear appropriate protective gear for the chest during competition or other athletic activity if there is risk of contusion.
Your daughter should wear breast support--a sport brassiere, elasticized binder, or both--for participation in contact sports.
Your own observation of symptoms.
Medical history and physical exam by a doctor for all except minor injuries. The total extent of the child's injury may not be apparent for 48 to 72 hours following injury.
X-rays of the injured area to assess total injury to soft tissue and to rule out the possibility of an 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 the child's usual activities are resumed too soon.
Infection if the skin over the injury is broken.
Healing time varies from 2 to 6 weeks, depending on the extent of injury.
FIRST AIDUse instructions for R.I.C.E., the first letters of rest, ice, compression, and elevation. Elevate the foot of the child's bed. See Appendix 39 for details.
Instructions for your child:
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.
MEDICATIONFor minor discomfort, use non-prescription medicines such as acetaminophen or ibuprofen. Do not use aspirin for injuries involving bleeding.
Your doctor may prescribe stronger medicine for the child's pain, if needed.
Your child should begin activities slowly and stop exercise as soon as pain begins. The child can increase activity as healing progresses.
DIET & FLUIDS
Serve the child a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk, and eggs. Your child should increase fiber and fluid intake to prevent constipation that may result from decreased activity.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child's 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 the skin was broken.
Any firm nodules that may appear following the injury do not disappear in 3 months.