How does it arise
Breast fat tissue is sensitive to impaired blood supply. When struck, compressed, or during surgery, small vessels are damaged, the area of adipose tissue dies, and the body reacts with inflammation. Gradually, a dense focus of scar tissue forms in this place, sometimes with a cavity filled with oily contents - the so-called oil cyst. Over time, calcium salts are deposited in the lesion, which are visible on mammography. The process takes weeks and months, so the node is often discovered long after the injury, which the woman has already forgotten about.
- Bruise and compression of the chest
- Breast surgery
- Biopsy and implant placement
- Breast lipofilling
- Radiation therapy
- Spontaneously with large breasts and taking anticoagulants
How it manifests itself
Most often, a woman accidentally finds a dense, painless formation, usually superficially located, sometimes fused to the skin. Possible pain, a feeling of tension, and a change in the color of the skin over the node from bluish to yellowish in the first weeks after the injury. Sometimes the skin over the lesion is retracted, and the nipple moves towards the formation. Sizes range from a few millimeters to several centimeters. Some lesions decrease over time and disappear on their own, others persist for years without causing harm.
- Dense node, often painless
- Surface location
- Sometimes adhesion to the skin
- Skin retraction or nipple displacement
- Change in skin color after injury
- Possible self-reduction over time
Why is it confused with cancer?
Fat necrosis imitates a malignant tumor in several ways at once: it is dense, can be immobile, causes skin retraction, and on mammography often shows microcalcifications and a lesion with uneven contours. On ultrasound, the picture is also varied: from a typical oil cyst with a characteristic appearance to a formation with unclear boundaries and an acoustic shadow. This is why a diagnosis cannot be made based solely on past trauma. The presence of a bruise does not exclude that the node is of a different nature, and the doctor is obliged to check this.
- Dense, motionless consistency
- Skin retraction
- Microcalcifications on mammography
- Fuzzy contours on ultrasound
- A history of trauma does not exclude a tumor
- Diagnosis requires confirmation
Diagnostics
The examination begins with an examination by a mammologist and an ultrasound of the mammary glands. For women over 40 years old and with suspicious signs, a mammogram is performed, in which a typical oil cyst has a characteristic appearance and allows you to do without a biopsy. If the picture is ambiguous, the node is dense, growing, or the doctor sees suspicious signs, a biopsy is performed with histological examination - it is this that gives the final answer. In difficult cases, MRI of the mammary glands is used. It is important to save previous photographs: comparison in dynamics often resolves questions.
- Examination by a mammologist
- Ultrasound of the mammary glands
- Mammography by age and indications
- Biopsy with histological examination
- MRI of the mammary glands in complex cases
- Comparison with previous studies
Treatment and observation
If the diagnosis is confirmed, special treatment is usually not required: fat necrosis is benign, does not turn into cancer and does not increase the risk of its development. The doctor prescribes observation with a control ultrasound after a few months to make sure that the formation is stable or decreasing. Surgical removal is considered if the node is painful, cosmetically defective, continues to grow, or if examination results remain equivocal. A large oil cyst is sometimes emptied by puncture. Prevention comes down to chest protection when playing sports and proper use of a seat belt.
- Observation for confirmed diagnosis
- Control ultrasound at the appointed time
- Puncture of a large oil cyst
- Removal if pain, growth or unclear picture
- Regular preventive breast examination
- Chest protection for sports
