Most breast bruising stems from trauma, and while it typically resolves within two weeks, this doesn’t automatically rule out cancer. A breast hematoma—where blood collects beneath the skin—often presents as a swollen, firm, painful mass that may linger far longer than a standard bruise, sometimes requiring medical evaluation if symptoms persist or worsen.
Get medical attention if the bruised or red area worsens over time, does not fade or change color, or if a lump does not shrink, since these patterns need evaluation. Regular self-exams to check for breast cancer are important for knowing what’s normal for you, so you can catch changes early.
While those checks include potential lumps and differences in skin density, you should also be looking for shifts in coloring and texture that can include a rash, dimpling, and bruises. Just like a lump doesn’t always mean breast cancer, in fact, most lumps tend to be benign, particularly in younger women, seeing an issue like bruising isn’t a sure sign of cancer, especially if it fades over the course of a couple weeks.
What’s a Breast Hematoma?
A bruise, also called a contusion, is produced when some type of injury causes the small veins and capillaries under the skin to break. With the chest area, that might happen from falling on the ground after you stumble, for example. A hematoma happens when blood pools outside the blood vessel, creating more swelling along the way.
Because of this, hematomas may also involve a lump as well as a dark, bruise-like area that’s painful. While bruises are flat against the skin, a hematoma tends to be raised and firm. Hematomas tend to occur with more serious injury, says Richard Reitherman, M.D., Ph.D., the medical director of breast imaging at MemorialCare Breast Center at Orange Coast Medical Center in Fountain Valley, CA.
For instance, some women get hematomas in the chest area during a car accident because of a seatbelt. But you can also have a small hematoma from a more precise injury, such as a biopsy or surgical procedure. A study in the journal In Vivo notes that hematoma is the most frequent complication after vacuum-assisted breast biopsy, occurring in 13% of those undergoing the procedure.
Bruises and hematomas often differ in how long they stick around, Dr. Reitherman adds. Bruises often take between five and 10 days to heal, but hematomas take longer, especially if there’s a particularly large lump. Some hematomas can take months to heal, says Dr. Reitherman, and may require some medical intervention like draining the blood from the area if the pain and swelling are significant or affect everyday activities.
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Risk Factors and Diagnosis
Any injury to the chest, especially serious ones, can potentially cause hematomas. However, according to commentary in American Family Physician, there are certain factors that might increase your risk of hematomas in general: older age, vitamin C or K deficiency, liver disease or liver damage, thrombocytopenia, viral infection, bleeding disorder, alcohol use disorder, and blood cancer like leukemia, lymphoma, or myeloma.
Hematomas are diagnosed through a clinical exam, but if the hematoma is deeper inside the body, for example, in the breast closer to the chest muscles than the skin, your doctor may use an ultrasound to determine the extent of the trauma. Dr. Reitherman notes that because hematomas can be deeper in the body than a bruise, it may take a few days for one to appear on the skin surface after a trauma to the area, and pain and swelling can be delayed as well.
In rare cases, bruising or a hematoma that doesn’t fade or change color may also be a sign of inflammatory breast cancer (IBC), which typically occurs in women younger than 40, but the average age at diagnosis is still around 59, according to the American Cancer Society. It makes up about 1% to 5% of all breast cancers.
Janie Grumley, M.D., a breast surgical oncologist and director of the Margie Petersen Breast Center at Providence Saint John’s Cancer Institute in Santa Monica, CA, notes that with this breast cancer, there can also be tenderness in the affected area, but not always, many women and men who develop the condition don’t have any pain or irritation at all, only redness.
One way to tell whether you’re dealing with a hematoma or IBC is whether the affected area is getting worse or better, Dr. Grumley says. With a hematoma, the bruising may look startling when it’s at its peak, but then begins to resolve while healing. With IBC, the opposite is often true, it can begin as a small area, even a tiny bump that looks like a mosquito bite, and then worsens over time. Sharon Rosenbaum Smith, M.D., associate chief of breast surgery at Lenox Hill Hospital in New York City, adds that if there’s a persistent lump after a hematoma fades, it should be examined.
Dr. Smith stresses that breast cancer doesn’t cause hematomas, and having one or more hematomas also won’t increase your risk of developing breast cancer in the future. However, scarring from a hematoma can leave a bump inside the breast that mimics a breast cancer lump, since it would likely be firm and well-defined, much like a tumor.
Dr. Grumley had seen a case where a woman’s hematoma didn’t resolve and was later diagnosed with breast cancer, although the hematoma didn’t cause the cancer. Dr. Smith had also seen cases where a hematoma was mistaken for a breast cancer tumor, but an ultrasound revealed that it was actually a hematoma.