Sunday, June 23, 2024

Are breast injuries sustained playing hockey a future risk for women?

The popularity of female contact sports such as football, rugby, and ice hockey has increased dramatically over the last decade, writes Dr Paul Darbyshire, chief scientific officer of MyBOOBRisk.

Since elite female athletes are now competing at such a high level, breast injury rates are continually on the rise. Consideration must also be given to young girls taking part in school sports or starting out on their sporting career, who will inevitably be subjected to continued levels of breast injury over a protracted length of time.

Common breast injuries sustained by female hockey players?

The most typical breast injuries sustained during female hockey are those that involve some form of direct contact between players, such as body checking and blocking. Being hit in the chest by a stick, ball, or puck is also a fairly common cause of breast trauma. Moreover, due to their position on the anterior chest wall, their lack of muscular protection, and their limited anatomical support, female breasts are particularly susceptible to injury from direct hits or knocks during high-impact sports. For this reason, it is hardly surprising that females involved in such sports, at any level, are likely to suffer some form of breast injury during their sporting activity.

Trauma to the breast has the potential to cause severe side effects due to surrounding structures within the breast that can be injured, for example, injuries to the blood supply, such as the arteries that provide blood flow to the breast tissue. Injury to the major blood supply to the breast can result in swelling and significant blood loss until treatment is received. More commonly, smaller superficial arteries along with veins can often become injured, leading to more localised injury and less serious bleeding and bruising.

Some women can even experience tearing or direct injury to the mammary ducts, which could affect the current and future flow of breast milk. These are rare, but potential, complications associated with breast injury and trauma. For younger players, one or more significant impacts on the breast bud, i.e., early breast tissue, which develops roughly two years prior to a period starting, could potentially increase the risk of breast asymmetry.

Although some variation in breast size is normal and, in fact, very common, a large variation at a younger age can easily lead to body image concerns and a lack of personal confidence. A huge number of girls enjoy contact sports, including hockey, from an early age, when their bodies are developing, so the potential for early- stage breast injuries and trauma is very likely.

Can sports-related breast injuries cause breast cancer?

Some researchers believe that a severe chest injury could lead to breast cancer because such injuries can cause a lump to develop after the impact. However, many argue that the majority of such lumps are simply due to what is called fat necrosis, and no direct evidence of a link between breast trauma and breast cancer currently exists. In general, medical practitioners recommend that any breast injury should be the subject of further consultation if it leads to any of the following conditions:

  • Breast pain or discomfort that worsens over time,
  • Changes in the appearance of the skin covering the breast, such as thickening, peeling, itching, or redness,
  • Bleeding or discharge from the nipple,
  • Persistent swelling or enlargement of the breast, or
  • Signs of infection, such as fever, redness, or continued warmth around the breast.

Although there is no direct evidence that repeated breast trauma can increase the risk of developing breast cancer, the long-term consequences of breast injuries on breast health need to be more thoroughly investigated. Moreover, sporting organisations such as England Hockey (and The English ice Hockey Association) have a duty of care to educate female players, coaches, and medical staff about breast injuries and to make real investments in their proper management and reporting.

Moreover, they have an obligation to thoroughly investigate the dangers of long-term breast trauma and explore methods to manage and mitigate the risks of breast injury. This obligation not only includes the care of players in elite female football but also stretches to younger women starting out in their careers or simply taking part in school sports days.

For a woman, especially those involved in female contact sports, it is extremely important to be breast-aware, which means being familiar with the way your breasts look and feel. Checking your breasts for any unusual changes can help you discover possible symptoms of breast cancer early, if you know what to look for and how to do it properly.

Moreover, to effectively monitor breast tissue recovery after a breast injury, female athletes need to be familiar with the normal shape and structure of their breasts, so they are aware if trauma is healing or whether to seek medical professional help if problems persist. Although physical examination is important and should be carried out on a regular basis, it is not enough on its own and should be supplemented by knowledge of your breast cancer risk.

MyBOOBRisk provides women aged 20 and older who have yet to receive their first breast screening mammogram with an online evaluation of their breast cancer risk in strict adherence to national clinical guidelines. By answering a series of clinically relevant questions covering topics such as medical conditions, family history of certain cancers, hormone treatments, and genetic inheritance, as well as a detailed section on high-impact sports and related injuries, a specific level of risk is identified, namely average, moderate, or high-risk of developing breast cancer over the next 10 years and lifetime.

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