Seat-belt trauma of the breast in a pregnant woman causing milk-duct injury: a case report and review of the literature

Changes to breast structure and function across a woman's lifespan: Implications for managing and modeling female breast injuries

BACKGROUND

Female breasts change throughout a woman's life in response to fluctuating hormonal influences. Individuals managing active women and those modeling female breasts must understand these structural and functional changes across a female's lifespan because these changes affect breast injuries sustained by women.

METHODS

We initially review female breast structure and function and then describe how breast structure changes across a woman's lifespan. Key studies about direct contact and frictional breast injuries are then summarized. Limitations of current breast injury research, gaps in knowledge about breast injuries incurred by specific populations, and the lack of breast injury models are also highlighted.

FINDINGS

With minimal anatomical protection, it is unsurprising that breast injuries occur. Although research about breast injuries is scant, direct contact during blunt force trauma to the anterior chest wall and frictional breast injuries have been reported. There is a lack, however, of research documenting the incidence and severity of breast injuries incurred in occupational settings and in women's sports. Therefore, to design effective breast protective equipment, we recommend research to model and investigate the mechanisms and forces involved in breast injuries, particularly injuries sustained during sport.

INTERPRETATION

This unique review summarizes how female breasts change over a woman's life span, with implications for breast injuries sustained by females. Knowledge gaps about female breast injuries are highlighted. We conclude by recommending research required to develop evidence-based strategies to improve how we classify, prevent, and clinically manage breast injuries sustained by females.

SUMMARY

We review changes to the breast across a woman's lifespan, highlighting implications for managing and modeling female breast injuries.

Breast hematoma with active bleeding due to seat belt injury

Breast emergencies are not frequent but play an important part in routine breast imaging applications. Diagnosis and identification of seat belt injury in emergency department are essential for patient management and early treatment of advanced cases. Herein we reported imaging findings of a patient who had prominent swollen at her left breast accompanying tissue edema and painful palpable mass formed by active bleeding hematoma as a result of seat belt injury due to a car accident. Radiologic examinations revealed hematoma in the breast accompanying active bleeding.

Education for appropriate seatbelt use required for early-phase pregnant women drivers

Considerable numbers of pregnant women do not understand the correct way to use seatbelts; thus, they are inappropriately restrained when wearing seatbelts. To improve appropriate seatbelt wearing by pregnant women vehicle passengers, we examined their use by pregnant women drivers and the independent factors influencing appropriate use. We undertook a cross-sectional survey of 1,000 pregnant women in Shiga Prefecture, Japan. Among 774 returned questionnaires, we analysed those of 680 pregnant women who always wore a seatbelt. The mean participant age was 31.4 ± 5.0 years and mean gestational age 26.2 ± 8.2 weeks; 97.7% of subjects always wore a seatbelt; 86.9% wore a seatbelt correctly and 13.1% incorrectly. Multivariate analysis indicated that receiving information about correct seatbelt use (odds ratio, 2.25; P < 0.005) and gestational age (odds ratio, 1.06; P < 0.001) were significant independent factors for correct seatbelt use. Providing information about correct seatbelt use during the early term is required for pregnant women to protect both the mother and fetus.

Breast Injuries in Female Collegiate Basketball, Soccer, Softball and Volleyball Athletes: Prevalence, Type and Impact on Sports Participation

Objective

In 2015-2016, over 214,000 female athletes competed at the collegiate level in the United States (U.S.). The National Collegiate Athletic Association (NCAA) collects injury data; however, breast-related injuries do not have a specific reporting category. The exact sequelae of breast injury are unknown; however, a relationship between breast injury and fat necrosis, which mimics breast carcinoma, is documented outside of sports participation. Breast injuries related to motor vehicle collisions, seatbelt trauma, and blunt trauma have been reported. For these reasons, it is important to investigate female breast injuries in collegiate sports. The objectives of this study are to report the prevalence of self-reported breast injuries in female collegiate athletes, explore injury types and treatments, and investigate breast injury reporting and impact on sports participation.

Materials and Methods

A cross-sectional study of female collegiate athletes at four U.S. universities participating in basketball, soccer, softball, or volleyball. Main outcome measure was a questionnaire regarding breast injuries during sports participation.

Results

Almost half of the 194 participants (47.9%) reported a breast injury during their collegiate career, less than 10% reported their injury to health personnel with 2.1% receiving treatment. Breast injuries reported by breast injuries reported by sport include softball (59.5%), basketball (48.8%), soccer (46.7%), and volleyball (34.6%).

Conclusions

The long-term effects and sequelae of breast injuries reported by female collegiate athletes during sport play are unknown. Nearly 50% of participants had a breast injury during sports activities. Although 18.2% indicated that breast injury affected sports participation, only 9.6% of the injuries were reported to medical personnel with 2.1% receiving treatment.