Shoulder restraint injury of the female breast.

Female breast trauma occasionally occurs while using a three-point lap-diagonal seat belt while involved in a motor vehicle collision. Breast trauma is either a crush injury or an avulsion injury. Breast traumatic injury is infrequently reported. The records and complete follow-up results from all patients who were treated for breast trauma caused by lap-diagonal seat belt injury over a 25-year period were reviewed and reported. A series of 19 female patients were treated for breast trauma that occurred during a motor vehicle collision in which the patient was using a three-point lap-diagonal seat belt restraint. Patient age range at the time of injury was 18-75 years. The patients' breast injuries were classified according to the type and severity of breast trauma. Fourteen patients had a class I mild crush injury. All recovered completely with conservative breast care. Four patients had a class II moderate crush injury. All four patients had an area of painful chronic fat necrosis removed. Two of four patients with a class II injury continue to have mild to moderate chronic breast pain. A single patient with a class III severe crush injury was successfully treated nonsurgically. The breast healed with a diagonal furrow. No chronic breast pain has been associated with this class III breast crush injury. No class IV avulsion breast injuries were treated in this clinical series. A classification of breast trauma from a motor vehicle collision in which the female was wearing a three-point lap-diagonal seat belt restraint has been developed. Results of treatment of 19 patients are reported with breast trauma, with a clinical guide for immediate and long-term care. Chronic breast pain persists in two patients in this series with a class II breast injury who had an area of traumatic fat necrosis. No breast cancer occurred in long-term complete follow-up in this series of 19 patients with breast trauma.