Background

Robust surveillance of injury aetiology and epidemiology is recognised as fundamental for effective injury reduction and management programmes. However, while sex-specific differences in injury type and nature are noted in the literature, it is unclear if these are reflected in surveillance practices, and how the athlete is affected.

Objective

Therefore, this study aimed to systematically review contact breast injuries (CBIs) among adult female athletes.

Methods

The following databases were searched: PubMed, EMBASE, SPORTDiscus including MEDLINE, Web of Science and Scopus. The literature search was conducted in May 2023 and the search was limited to articles in the English and German language. Studies including female athletes, aged 18 years and above, in any sports (team or individual) at any level (amateur, semi-professional and professional), where an occurrence of CBI was documented were included. Studies were included irrespective of their investigated timeframes (e.g. the whole career, one or multiple seasons). Findings were categorised (e.g. sport, level of competition and investigated timeframe of the study) to enable possible comparisons. Case studies were excluded due to the non-generalisability of findings.

Results

Of the six studies included, rugby codes (rugby union, rugby league and rugby sevens) had the highest occurrence rate (62.0%) of CBIs among eight different investigated sports (rugby codes 62.0%, softball 59.5%, Australian Football League (AFL) 51.0%, water polo 50.0%, soccer 46.7%, basketball 27.6–48.8%, volleyball 34.6%, boxing 0.0%). Between 25.6% and 62.0% of participants reported incurring a CBI and between 0.0% and 42.9% of CBIs were reported to a medical professional or support staff. The reported treatment rate for CBIs ranged between 0.0% and 2.1%, The main mechanisms for CBIs (where reported) were contact with another athlete (AFL 37.6%, rugby codes 56%) the ball (AFL 31.6%, rugby codes 25.5%) and the ground (AFL 6.6%, rugby codes 22%). Between 18.2% and 48% of the participants reported that CBIs negatively affected their performance. Risk factors increasing CBIs were positional differences, larger breast size and higher body mass index (BMI). In-season injury data collection and surveillance supported through education of both players and medical staff were identified to be of relevance for future CBI prevention. None of the studies reported incidence rate.

Conclusion

Despite the frequent occurrence of CBIs among female athletes, reporting and treatment remains low. Awareness and education of all stakeholders are fundamental to ensuring better breast safety in female sport. Identifying the mechanics, severity and risk factors of CBIs through thorough injury surveillance must be a focus of further research.

Registration

The study was preregistered on Open Science Framework (OSF).

中文翻译：

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女运动员接触性乳房损伤：系统回顾

背景

对伤害病因学和流行病学的强有力监测被认为是有效减少伤害和管理计划的基础。然而，虽然文献中指出了损伤类型和性质的性别差异，但尚不清楚这些差异是否反映在监测实践中，以及运动员如何受到影响。

客观的

因此，本研究旨在系统评价成年女运动员的接触性乳房损伤（CBI）。

方法

检索了以下数据库：PubMed、EMBASE、SPORTDiscus（包括 MEDLINE）、Web of Science 和 Scopus。文献检索于2023年5月进行，检索仅限于英语和德语的文章。研究包括年龄 18 岁及以上、任何运动项目（团队或个人）、任何级别（业余、半职业和职业）的女性运动员，其中记录了 CBI 的发生。研究均被纳入，无论其调查时间范围如何（例如整个职业生涯、一个或多个赛季）。对结果进行分类（例如运动、竞争水平和研究的调查时间范围）以便进行可能的比较。由于研究结果的非普遍性，案例研究被排除在外。

结果

在纳入的六项研究中，橄榄球代码（联合式橄榄球、联盟式橄榄球和七人制橄榄球）在八种不同的调查运动中 CBI 发生率最高 (62.0%)（橄榄球代码 62.0%、垒球 59.5%、澳大利亚橄榄球联盟 (AFL) 51.0%、水球 50.0%、足球 46.7%、篮球 27.6–48.8%、排球 34.6%、拳击 0.0%）。 25.6% 至 62.0% 的参与者报告发生了 CBI，0.0% 至 42.9% 的 CBI 被报告给医疗专业人员或支持人员。报告的 CBI 治疗率在 0.0% 至 2.1% 之间，CBI（如有报告）的主要机制是与另一名运动员（AFL 37.6%，橄榄球代码 56%）接触球（AFL 31.6%，橄榄球代码 25.5%）和地面（AFL 6.6%，橄榄球代码 22%）。 18.2% 至 48% 的参与者表示 CBI 对他们的表现产生了负面影响。增加 CBI 的危险因素包括位置差异、较大的乳房尺寸和较高的体重指数 (BMI)。通过对球员和医务人员的教育支持的赛季中伤害数据收集和监测被认为与未来 CBI 预防相关。没有一项研究报告发病率。

结论

尽管女运动员中脑损伤的发生频率很高，但报告率和治疗率仍然很低。所有利益相关者的意识和教育对于确保女性运动中更好的乳房安全至关重要。通过彻底的伤害监测来确定 CBI 的机制、严重程度和风险因素必须成为进一步研究的重点。

登记

该研究已在开放科学框架（OSF）上预先注册。