Female breasts are vulnerable to direct blows or frictional injuries during sport; however, little research has investigated breast injuries experienced by female athletes. This study aimed to investigate the occurrence, causes and perceived performance effects of breast injuries in elite female athletes across a wide range of sports. A custom-designed survey was distributed to female athletes aged over 18 years who were competing nationally or internationally in their chosen sport. The survey included questions about breast injuries sustained during training and competition and any perceived performance effects of these injuries. 504 elite female athletes from 46 different sports completed the survey. 36% of participants (n = 182) reported experiencing breast injuries and 21% (n = 37) perceived that their breast injury negatively affected their performance. Contact breast injuries were reported by significantly more athletes involved in contact or combat sports and by athletes with larger breasts or a higher body mass index. Frictional breast injuries were reported by significantly more older athletes or those with larger breasts. Less than 10% of participants who experienced breast injuries reported their injury to a coach or medical professional and only half used any prevention strategies. Athletes, coaches and medical professionals associated with women’s sport need to be made aware of the occurrence and potential negative effects of breast injuries. It is critical to normalise conversations around breast health so that athletes can be encouraged to report and, when necessary, receive treatment for breast injuries. Further research is also required to better understand factors that affect breast injuries in sport in order to develop evidence-based breast injury prevention strategies.

• Elite female athletes experience contact breast injuries and frictional breast injuries during their sport.

• Contact breast injuries were reported by significantly more athletes involved in contact/combat sports (e.g. contact football codes, martial arts) and by athletes with a larger BMI or with larger breasts.

• Frictional breast injuries were reported by significantly more older athletes or those with larger breasts.

• Breast injuries were perceived to negatively affect performance in 21% of athletes who reported experiencing a breast injury.

• Only 10% of athletes reported their breast injury to a coach or medical professional and many athletes had no strategy to prevent breast injuries during their sport.