Breast: Fat Necrosis

Fat Necrosis

Basics

  • Definition: Necrosis of Breast Adipose Tissue
  • Causes:
    • Idiopathic (Most Common)
    • Trauma
    • Surgery
    • Radiation

Presentation

  • Firm Round Lump
  • Usually Painless but Can Be Tender
  • Skin Dimpling
  • Nipple Retraction
  • Red/Bruised
  • *Can Present Similar to Malignancy

Diagnosis

  • Appearance on Mammogram:
    • Spiculated Mass
    • Microcalcifications
    • Architectural Distortion
  • May Require Core Needle Biopsy (CNB) to Rule Out Malignancy
    • Foam Cells – Lipid Laden Macrophages
  • *See Breast: Breast Mass Evaluation

Treatment

  • No Treatment Required

Fat Necrosis on Mammogram 1

Fat Necrosis Biopsy with Foam Cells 2

References

  1. Upadhyaya VS, Uppoor R, Shetty L. Mammographic and sonographic features of fat necrosis of the breast. Indian J Radiol Imaging. 2013 Oct;23(4):366-72. (License: CC BY-NC-SA-3.0)
  2. Burkholz KJ, Roberts CC, Lidner TK. Posttraumatic Pseudolipoma (Fat Necrosis) Mimicking Atypical Lipoma or Liposarcoma on MRI. Radiol Case Rep. 2015 Dec 7;2(2):56-60.(License: CC BY-NC-ND-3.0)