Fat Necrosis in the Breast

Fat necrosis of the breast occurs when injured or damaged cells in fatty breast tissue gradually harden into scar tissue, or collect as liquid within what is called an oil cyst, resulting in lumps that feel round and hard. Fat necrosis of the breast usually has an external cause such as surgery on, or a blow to, the breast. A lump caused by fat necrosis is usually benign and often painless, although the skin around it may look red, dimpled or bruised. A lump of this kind may be misdiagnosed as malignant. Fat necrosis of the breast most often affects middle-aged women who have fairly large breasts.

Causes of Fat Necrosis of the Breast

There are a number of causes of fat necrosis in the breast. They may include:

  • A blow to the breast
  • Breast surgery of any kind, including cosmetic
  • Breast radiation treatment
  • Silicone injections
  • Forceful compression from a seatbelt

Symptoms of Fat Necrosis of the Breast

In addition to the lump itself, symptoms of fat necrosis of the breast may include:

  • Red, dimpled or bruised skin around the lump
  • Pain or tenderness near the lump
  • Nipple drainage
  • Retraction of the nipple

Diagnosis of Fat Necrosis of the Breast

A breast lump caused by fat necrosis often feels the same as a lump caused by a malignancy. If a woman discovers a lump in her breast, she should have a clinical breast exam as soon as possible. Based on that exam, the following tests may be recommended:

  • Mammogram
  • MRI scan
  • Ultrasound
  • Biopsy

Treatment of Fat Necrosis of the Breast

Fat necrosis of the breast often does not require treatment, and may go away on its own. If the lump is from a recent injury and is causing pain, massage and warm compresses may help. Over-the-counter nonsteroidal-anti-inflammatory medications may also be taken. If fat necrosis has caused a large and very painful lump, it may be surgically removed with a lumpectomy or in a vacuum-assisted core-needle procedure. If an oil cyst has formed, it can be drained with a fine needle or be surgically removed.

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