Fat necrosis of the breast occurs as a result of trauma to the breast gland, usually in obese women. A small lump that can be felt through the skin causes anxiety and becomes a reason for visiting a doctor. Treatment of necrosis consists in removing the altered tissue.
Fat necrosis of the breast , experts estimate, affects 0.6% of all breast tumors. Most often, obese women with well-developed fat tissue in the breast area suffer. It arises as a consequence of an injury, and is rarely a consequence of rapid weight loss or treatment in the form of radiotherapy.
Fat necrosis of the breast: causes
The mechanism of breast fat necrosis is relatively simple. As a result of the injury, the capillaries are damaged, which leads to a disturbance of the blood supply to this area.
Prevention is extremely important, which consists in avoiding situations in which the delicate glandular tissue of the breast may be injured.
Permanently not nourished adipose tissue is subject to necrotic processes. An inflammatory rim forms around it. After some time, the necrotic tissues undergo the process of fibrosis, thus appearing bands of connective tissue, and with time scarring. Occasionally, in the affected areas, calcium ions accumulate, which in turn can cause calcification of necrotic foci, referred to as petrification.
Fat necrosis of the breast: symptoms
Most of the symptoms of necrosis are not very characteristic and may accompany many other disease processes, therefore any abnormality should be a reason for medical consultation. The most frequently reported irregularities include:
- painful swelling on palpation
- inflamed skin over the necrosis: takes on a red color, increased warmth
- Sometimes the nipple is retracted, especially when the fat necrosis is in close proximity
- body temperature is normal which differentiates between necrosis and inflammation of the breast
- slight deformation of the breast, with point areas with the so-called orange peel and enlargement of the surrounding lymph nodes means that fat necrosis may be misinterpreted as the beginning of the cancer process
Diagnosis of breast fat necrosis
A basic element in the diagnosis of fatty necrosis is to determine whether the changes observed are a consequence of an injury. Then the doctor proceeds to a palpation examination, which shows the presence of a relatively hard structure with uneven contours with local inflammation. An auxiliary examination is ultrasound, in which it is possible to confirm the developing inflammatory process. Of course, CT and MRI are excellent diagnostic tools, although they are selected as second-line examinations. Detailed assessment of the pathological lesion is extremely important in order not to overlook breast cancer. The differential diagnosis uses a biopsy, which involves taking the changed tissue and assessing the material under a microscope.
Treatment of fatty necrosis of the breast
Due to the focal nature of the pathological lesion, in most cases the doctor suggests removing the necrotic tissue. Due to rapid intervention, resection is confined to only a small area of the breast, while most of the glandular tissue is preserved. In fact, only postoperative histopathological evaluation can rule out cancer. A very common image is fatty cysts of various sizes, i.e. reservoirs filled with fluid. Around fat cells accumulate cells called lipophages, which are responsible for necrotic processes.