Traumatic hematoma of the breast

Case contributed by Giorgio M Baratelli


Blunt direct trauma to the right breast, 3 days ago. She is concerned of a painful lump of about 10 cm in the medial quadrants of the right breast. On clinical examination, the lump is hard, tender and not fluctuating, with ill-defined margins.

Patient Data

Age: 50 years
Gender: Female

The breast ultrasound shows an 8 cm mixed echogenicity mass: clotted blood is echogenic, serum is detected as the anechoic area.


An extensive bluish discoloration of the skin of the breast is visible. Hematoma is surgically drained, after bleeding is stopped, under local anesthesia.

Case Discussion

The diagnosis of traumatic breast hematoma is easy due to history of a direct trauma and the ecchymotic suffusion of the skin. She has no history of coagulation disorders neither takes medications. The diagnostic blood tests (CBC, PT/INR, PTT) are normal.

It is important to keep in mind that:

  • hematoma may be related to coagulopathy or the use of some drugs (aspirin, NSAIDs, anticoagulants)
  • a hematoma without a history of trauma may be related to a tumor causing the hemorrhage
  • infection is a possible complication of hematoma

Treatment: hematomas should be surgically drained after bleeding is stopped if it is of large size or causing pain.

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