Fat Necrosis (Breast)

Fat necrosis (breast) is a condition where fatty tissue in the breast becomes damaged and dies, often due to injury or trauma. This affects the breast tissue, which is part of the body's integumentary system. The damaged fat can cause a lump or area of firmness that may be felt during a physical exam. Sometimes, this lump can be mistaken for breast cancer because it feels firm and irregular. The condition may also cause skin changes or mild pain in the affected area. Although it can be concerning, fat necrosis is generally a benign process and does not increase the risk of breast cancer. It mainly affects breast health by causing localized changes that may require evaluation to rule out malignancy.

Fat necrosis (breast) is a benign inflammatory process characterized by the death of adipocytes within the breast tissue, typically resulting from trauma, surgery, or radiation. The core pathology involves disruption of fat cells leading to release of fatty acids, which combine with calcium to form saponification. This incites a local inflammatory response with infiltration by macrophages and multinucleated giant cells, often resulting in a palpable mass or skin retraction. It is clinically significant because it can mimic breast carcinoma both on physical exam and imaging, leading to diagnostic challenges. Histologically, fat necrosis shows necrotic adipocytes, lipid-laden macrophages, and fibrosis. The condition is important to recognize to avoid unnecessary aggressive treatment and to differentiate it from malignant lesions.