Breast Fat Necrosis

Introduction

• Description: Trauma to the breast may result in necrosis of fatty tissues, leading to an ill-defined mass that can mimic cancer.

• Prevalence: Uncommon. Fat necrosis manifests in 0.8% of breast tumors and 1%–9% of breast reduction surgeries.

• Predominant Age: Reproductive age. Most at risk are middle-aged women; peak age 50 years.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Fat necrosis is most often the result of trauma, although the causative event cannot be identified (or recalled) in approximately half of patients. May also follow surgical intervention in the breast, such as biopsy or augmentation, or after radiation therapy for other indications.

• Risk Factors: Trauma to the breast.

Signs and Symptoms

• Solitary, irregular, ill-defined, tender mass that is easily confused with cancer

• Skin retraction sometimes present

• Fine, stippled calcification and stellate or infiltrative fibrosis often seen on mammograms

Diagnostic Approach