Breast Fat Necrosis

What Causes Breast Fat Necrosis?

The breasts are made of a milk glands and ducts surrounded by fatty tissue. Any type of trauma to that fatty tissue can cause fat necrosis, or tissue death, to occur. Fat necrosis first appears as a lump. As the fat cells continue to die, they release their oily content and form an oil cyst. Over time, these cysts can begin to harden, break down and flatten.

Sources of trauma that can cause breast fat necrosis include:

• Breast surgery such as lumpectomy, breast enhancement, breast reduction or breast reconstruction
• Breast biopsy
• Lipomodelling (a procedure in which fat from another part of the body is injected into the breast)
• Mastectomy
• Radiation therapy
• Trauma from a car accident or blunt force injury to the chest

Fat Necrosis Symptoms

Breast fat necrosis feels like firm, round lumps under the skin. While usually painless, the lumps may feel tender or painful in some people. It may also cause thickened, red, bruised or dimpled skin around the lump. It may also cause the nipple to sink in.

Diagnosing Breast Fat Necrosis

If you notice a new or unusual breast lump, its important to see your healthcare provider. Though the majority of breast lumps are benign, they could also be a sign of breast cancer. Your provider will perform a breast exam to feel and evaluate the lump. They may order additional tests such as a mammogram, breast ultrasound or breast magnetic resonance imaging (MRI) test to get a better look at the lump.

A breast biopsy may also be performed to collect a tissue sample to examine in a lab. This can determine if any cancer cells are present.

Treating Breast Fat Necrosis

If a breast fat necrosis diagnosis is confirmed, your provider will discuss treatment options with you. They may recommend waiting to see if it resolves without treatment. Often, fat necrosis will resolve on its own over the course of several months. This can be a good strategy if the fat necrosis is small and not causing any bothersome symptoms.

However, surgery to remove the lump may be recommended if it is causing pain, doesn’t go away, or grows bigger. Removal may also be necessary if a biopsy wasn’t able to give a definitive diagnosis of fat necrosis. Options for removing the fat necrosis include cutting out damaged tissue or using liposuction or a vacuum-assisted core needle procedure to remove the tissue. Fine needle aspiration can also be used to drain an oil cyst and flatten the lump.