Breast Trauma

Blunt trauma to the breast produces 2 types of lesions that may be clinically difficult to distinguish from carcinoma ; breast hematoma & traumatic fat necrosis.
-Somtimes,this trauma may draw the attention of the patient to an arleady existing.

1-Breast Hematoma


-Following blunt trauma or breast surgery.
-If there is no external ,adeeply seated old hematoma may form a hard mass that greatly resembles breast carcinoma.
-Biopsy will confirm the diagnosis.

2-Traumatic Fat Necrosis
*Pathogensis:
-Trauma .....fat necrosis....release of fatty acids....F.A + Ca.....Ca Soaps.
-This soap invites foreign body reaction.
-The result is one of two forms
1-A cyst that contains thick oily fluid.
2-A hard mass "less frequent" that resembles breast carcinoma requiring biopsy to settle the diagnosis "cut section shows a characteristic chalky white appearence".

*Clinial Picture:
-History of trauma (only in 50% of cases)
-Hard ,irregular,painless mass.

D.D:
-Carcinoma as this mass will be (hard,dimpling if it occurs near coper's ligament , retracted nipple if near milk duct)

Investigations:
-Biopsy...foamy fat laden macrophages.there is abscense of yellow specks and gritty texture of carcinoma.
-Mammography is not conclusive.

Treatment:
excisional biopsy.