Fat Necrosis

Question 1

What is fat necrosis of the breast?

Answer 1

Ischaemic necrosis of fat lobules caused by an acute inflammatory response in the breast.

Question 2

What are the most common causes of fat necrosis?

Answer 2

Trauma (reason it’s often referred to as traumatic fat necrosis):

• Blunt trauma (40% of cases)
• Previous surgical / radiological intervention

Question 3

What are the clinical features of fat necrosis?

Answer 3

• Typically asymptomatic
• May present with lump (may develop into solid, irregular lump overtime)

Less commonly:

• Fluid discharge
• Skin dimpling
• Pain
• Nipple inversion

Question 4

What investigations can confirm a diagnosis of fat necrosis?

Answer 4

1. USS
   * Hyperechoic mass visualised
2. Mammogram
   * More developed fibrotic lesions will mimic carcinoma on mammogram, appearing as calcified irregular speculated masses
3. Core biopsy
   * Often to categorically rule out malignancy.

Question 5

How is fat necrosis managed?

Answer 5

1. Analgesic management & reassurance (self-limiting)