CT scan without IV contrast showed a large mass, again with a fluid-fluid level. The denser portion of the mass measured 60 HU, consistent with blood clot.


  • Common causes: post procedure (biopsy, surgery), direct trauma, coagulopathy
  • Breast hematoma occurs in approximately 2% – 10% after breast surgery
  • Risk factors: use of some medications (aspirin, NSAIDs, anticogulants)

US Findings:

  • Depends on stage of blood product
  • Clotted blood appears echogenic, lysed blood (serum) appears cystic.
  • No internal flow

Our case – follow up ultrasound was performed and the mass has evolved into a lysed hematoma and then disappeared. Diagnosis was breast hematoma related to anticoagulant use.

Vitug AF, Newman LA. Complications in breast surgery. Surg Clin N Am 2007;87:431-451.

Source: Case submitted by RadiologyinThai, Dr. Rathachai Kaewlai