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Fatty necrosis

Fatty necrosis – this is a benign breast disease that occurs when an area of adipose tissue is damaged, usually as a result of injuries. It can also occur after breast surgery or radiation therapy. Fat necrosis is more common in women with large mammary glands.

As a result of exposure to various traumatic factors, the death of breast fat cells and the release of their contents into the tissue occurs. This leads to the formation of an oil cyst (oleogranuloma).

Risk factors:

  • History of breast injury: fatty breast tissue can be damaged after any injury, such as from being hit by a ball, a seat belt, or an airbag during a car accident. In rare cases, fatty necrosis develops without any prior exposure. 
  • Breast radiation therapy: the use of ionizing radiation to treat cancer cells can sometimes cause necrosis of adipose tissue, which can be mistaken for a recurrence of breast cancer.
  • Surgical treatment: any surgical intervention on the mammary gland can lead to damage to adipose tissue.

Symptoms of fatty necrosis:

  • Defined by the touch of the seal: most often painless and feels like a subcutaneous thickening or rounded dense formation. In some cases, there may be a retraction of the skin over the palpable seal.
  • The presence of a hematoma (bruise) on the skin of the breast

List of necessary consultations and surveys:

  • consultation of an oncologist-mammologist, including discussion of disturbing symptoms, examination of the mammary glands
  • digital mammography (from 39-40 years). With a radiologically dense background, a mammologist may recommend tomosynthesis of the mammary glands.
  • ultrasound examination of the mammary glands (ultrasound)

The above methods of examination do not require special training.

In some cases, on the recommendation of an oncologist-mammologist, it is possible to conduct a puncture fine-needle aspiration biopsy (PTAB) or trepan biopsy under ultrasound control, followed by Cytological and/or pathomorphological examination.

Treatment of fat necrosis:
Fat necrosis and oil cysts usually do not need treatment. Sometimes fat necrosis goes away on its own. If during the diagnostic process a puncture fine-needle aspiration biopsy of an oil cyst is performed, this is also simultaneously a therapeutic manipulation.

If the formation increases or begins to disturb the patient, you can consider the option of surgical treatment.

Forecast: favorable.

There is no evidence that fat necrosis increases the risk of breast cancer later in life.

GBUZ Moscow Clinical Scientific Center named after Loginov MHD