Breast hematoma
Breast hematoma can result from preceding direct trauma, surgery, biopsy (rare) or contusion and can be easily misinterpreted as other lesions such as breast malignancy if the correct clinical context is not taken into account. They can rarely occur spontaneously, especially in those with coagulopathy.
There is usually but not always a history of trauma. Breast hematomas are a common finding post motor vehicle collision due to seat belt injuries.
Radiographic features
It is reported to have a variable radiographic spectrum on both mammography and ultrasound. The correct clinical context is crucial in image interpretation.
Mammography
The reported mammographic spectrum includes 2:
- single nodule
- patchy nodule
- diffusely increased glandular density (the most common appearance)
- radiolucent nodule(s)
- nodule(s) with calcification
Through the passing of time, there may evidence of fat necrosis in the region.
Breast ultrasound
Ultrasound features can be variable. The reported sonographic spectrum includes:
- fluid collection
- solid nodule
- cystic nodule
- diffuse parenchymal abnormalities
- calcified nodule
Treatment and prognosis
Although benign, it requires careful interpretation in the correct clinical context. A hematoma may eventually evolve into a scar or cystosteatonecrosis (fat necrosis). Most hematomas resolve within 2-4 weeks 5. Some hematomas may undergo liquefaction and develop into a breast seroma.
In the typical clinical setting, often no further evaluation is required. However, in unusual cases (e.g. no definite antecedent trauma), short term (~6-8 week) follow-up is recommended.
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Breast imaging and pathology
- breast screening
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mammography
- breast imaging and the technologist
- forbidden (check) areas in mammography
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mammography views
- craniocaudal view
- mediolateral oblique view
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- true lateral view
- lateromedial oblique view
- late mediolateral view
- step oblique views
- spot view
- double spot compression view
- magnification view
- exaggerated craniocaudal (axillary) view
- cleavage view
- tangential views
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- bullseye CC view
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- 20° oblique projection
- inferomedial superolateral oblique projection
- Eklund technique
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breast cancer
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- gamuts
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breast cancer
- borderline breast disease / high risk breast lesion
- benign lesions
- adenosis of the breast
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- breast cyst
- breast hematoma
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- breast lipoma
- ductal adenoma of the breast
- epidermal inclusion cysts of the breast
- fat necrosis of the breast
- fibroadenoma
- granular cell tumor of the breast
- gynecomastia
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- oil cyst
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breast calcifications (approach)
- morphology
- distribution
- location
- lobular calcification within breast tissue
- intraductal calcification within breast tissue
- milk of calcium within a breast cyst
- vascular calcification in breast tissue
- skin (dermal) calcification in / around breast tissue
- suture calcification within breast tissue
- stromal calcification within breast tissue
- artifactual calcification from outside the breast
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- infection/inflammation
- vascular lesions
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- gamuts
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