Fat Necrosis

Question 1

Explain fat necrosis

Answer 1

Common condition caused by an acute inflammatory response in the breast.

This leads to ischaemic necrosis of fat lobules.

Question 2

Causes

Answer 2

Often called traumatic fat necrosis as it is associated with trauma

Blunt trauma is the case in 40%

Previous surgical or radiological intervention make up the rest.

Question 3

Clinical features

Answer 3

Usually asymptomatic

Present as a lump

Might show as a lump, skin dimpling, pain and nipple inversion.

Chronic fibrotic changes can develop

Question 4

Investigations

Answer 4

+ve Traumatic history and USS

USS shows hyperechoic mass on ultrasound

Question 5

Why might it be difficult to differentiate between cancer and fat necrosis on mammogram?

Answer 5

Fibrotic lesions can mimic carcinoma on mammogram

They can appear as calcified irregular speculated masses.

In this case a core biopsy should be done to rule out malignancy

Question 6

Management

Answer 6

Self-limting

Analgesia and reassurance