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Treatment of fat necrosis of the breast

Fat necrosis of the mammary gland is the necrosis of its fatty tissue, followed by replacement with scar tissue. Such necrosis develops in the form of foci.

This pathology is characterized by a dense, painful formation, retraction of the skin and a change in its color - such signs make one suspect the presence of a tumor process.

When fat necrosis occurs, there is a need for sectoral resection (removal of a section) of the mammary gland.

Table of contents: 1. General data 2. Causes 3. Development of pathology 4. Symptoms of fat necrosis of the mammary gland 5. Diagnosis 6. Differential diagnosis 7. Complications 8. Treatment of fat necrosis of the mammary gland 9. Prevention 10. Prognosis

Total information

Fat necrosis of the mammary gland belongs to a number of so-called non-enzymatic necrosis. In mammology, of all nodular formations of the mammary gland, it accounts for 0.6% of all diagnosed clinical cases.

When mentioning this pathology, we mean the disease in women. When males are affected, the diagnosis sounds like “Fat necrosis” mammary gland"(only women have mammary glands). In men, this disease occurs very rarely - due to the scarcity of fatty tissue. mammary glands. An exception may be gynecomastia - the development of female-type mammary glands in male patients.

note

Fat necrosis of the mammary glands is more often diagnosed in patients with large breasts (macromastia) than in women with small breasts.

Women of the childbearing period are mostly affected; the age category from 25 to 35 years is predominantly affected.

The pathology has other names - oleogranuloma, lipogranuloma and steatogranuloma.

Causes

The occurrence of fat necrosis of the mammary gland can be provoked by different reasons– for convenience, they are divided into groups:

traumatic lesions;
rapid weight loss;
radiation exposure to breast tissue.

A traumatic injury that can lead to the development of this pathology can be observed:

when performing medical procedures (in this case it is also called iatrogenic);
outside the treatment process.

Medical procedures during which the integrity of breast tissue may be compromised with a subsequent risk of developing fat necrosis can be:

diagnostic;
actually medicinal.

Such diagnostic procedures include a biopsy - the removal of breast tissue for examination under a microscope. It happens:

puncture - the skin and underlying tissue of the mammary gland are punctured, and suspicious contents are sucked out with a syringe;
sectional - cut off an area of suspicious tissue. Most often, this biopsy is performed during surgical intervention on the mammary gland due to cancer.

Cases have been described where, when the development of fatty necrosis of the mammary gland was suspected, a biopsy was performed, which did not confirm the diagnosis - however, fatty necrosis developed later as a consequence of the biopsy.

Medical manipulations that can provoke the development of the described pathology include any invasive therapeutic effects. It can be:

suction of purulent contents from a breast abscess (recently practiced very rarely as a controversial and ineffective treatment method);
opening and emptying of the purulent focus of this organ;
removal of a fragment of the mammary gland due to a particular disease - necrosis, benign or malignant tumor, tuberculosis lesion, and so on;
plastic surgery. Fat necrosis of the breast can occur in women who have had a mastectomy ( radical removal affected breast) underwent reconstructive mammoplasty (breast restoration) with their own tissues.

The development of iatrogenic fat necrosis is associated with:

forced intraoperative traumatization of gland tissue - for example, when removing large sections of it, stopping bleeding using diathermocoagulation (“cauterization” of destroyed walls blood vessels electric shock);
gross inaccurate performance of diagnostic or therapeutic procedures, which is fraught with damage glandular tissue mammary gland, as well as its blood vessels and nerve endings.

Traumatic injury not related to medical procedures is one of the most common reasons the occurrence of fat necrosis of the mammary gland. According to the mechanism of development, such injuries are:

By origin, such injuries that can lead to the development of fatty necrosis of the mammary gland are:

household;
production;
sports.

Household injuries that can lead to the occurrence of the described disease can be facts of traumatization:

unintentional;
deliberate.

The most common form of injury to the mammary gland, which can lead to fatty necrosis of the mammary gland, is its bruises:

received due to everyday inconveniences (sharp corners of furniture, cramped living quarters, and so on);
caused by hyperactive or uncontrollable children;
received in transport (in public transport this is mainly a bruise from the handrail of the front seat, in a personal case - a blow to the mammary gland with the steering wheel during sudden braking of the car);
related to domestic violence.

A special type of trauma to breast tissue, against the background of which its fat necrosis can develop, is considered prolonged compression glands. Most often it occurs during disasters:

natural - these are landslides in the mountains, snow avalanches, suction in bogs, staying under fragments of buildings during earthquakes;
man-made - mainly collapses due to powerful industrial explosions.

Also, prolonged compression of the mammary glands can be observed during road traffic accidents, when people find themselves caught in vehicle before the arrival of rescuers and doctors. Basically, this type of trauma is observed during:

car or bus accident;
train crash.

Occupational injuries to the mammary gland, which contribute to the development of fat necrosis, are less common than household injuries. They are mainly related to violation of labor safety rules (falling on slippery steps that lead to the office premises) or ignoring safety regulations ( improper care for large farm animals that can hit the mammary gland with a hoof or horn).

Sports injuries are most often observed in women who choose strength sports or those that involve a risk of falls. This:

and others.

Rapid weight loss, against the background of which fat necrosis of the mammary gland can develop, can be observed with:

severe diseases and pathological conditions;
deliberate adherence to a strict diet aimed at fast weight loss before any important event– a wedding, a beauty contest, sports competitions (especially high-ranking ones, where an important condition participation is a certain weight).

Severe illnesses and pathological conditions, against the background of which rapid weight loss can occur, contributing to the development of fatty necrosis of the mammary gland, are:

rapidly progressing oncological diseases (in particular, affected by particularly aggressive forms);
pulmonary tuberculosis - infectious lesion caused by Mycobacterium tuberculosis (Koch's bacillus);
diabetes mellitus is a disorder of carbohydrate metabolism caused by a lack of insulin in the body;
thyrotoxicosis – intoxication (poisoning) of the body with hormones produced by its own thyroid gland;
gross violation of the psycho-emotional sphere;
adrenal insufficiency (other names: Addison's syndrome, hypocortisolism);
Alzheimer's disease - senile dementia;
lymphoma (Hodgkin's disease) – malignant lesion of lymphoid tissue;
drug addiction;
any chronic intoxication in which vomiting and diarrhea are regularly observed.

Radiation exposure to breast tissue, which can lead to the development of fat necrosis, is observed in such cases as:

radiation therapy– in particular, the impact on malignant neoplasms of the mammary gland;
frequent passage diagnostic procedures fraught with radiation exposure (radiography, fluoroscopy and others);
contact with radioactive substances due to professional activity. It is fraught with pronounced radiation exposure to the body if labor protection rules are violated or safety precautions are ignored ( individual funds protection);
unauthorized access to radioactive substances.

A group of factors has also been identified that are not direct provocateurs of the development of fatty necrosis of the mammary gland, but can contribute to the necrosis of its tissues. This does not mean that when exposed to such factors, the described pathology necessarily develops - however, the risks should be taken into account. These are diseases and conditions such as:

vascular pathology - because of it, microcirculation and nutrition of mammary gland tissue are disrupted;
blood diseases - the consequences are the same as with vascular pathology;
regularly wearing tight clothing.

Development of pathology

The majority of disorders that lead to necrosis of breast tissue and the formation of areas of fat necrosis are based on impaired blood supply and, as a result, sharp deterioration nutrition of these tissues.

The mechanism of pathology development is as follows. Damage to the capillaries (traumatic or due to a particular disease) leads to drastic violation blood supply to a separate area of fatty tissue (this is why fat necrosis develops in the form of foci). The body reacts to this process with reactive inflammation - initial stage it is aseptic (non-infectious). The mentioned inflammation develops in the damaged area with the formation of a so-called demarcation line around it - it separates the affected tissues from healthy ones.

Dead tissue disintegrates after some time, and decay products are removed from the mammary gland through the bloodstream. If there are many necrotic foci in the mammary gland or they are large, the abundance of decay products can provoke the occurrence of intoxication syndrome.

Since protective mechanisms are activated, the inflammation stops after a while. In the location where it arose, the process of fibrosis starts - connective tissue cells begin to develop, which finally displace the dead foci and form a connective tissue scar.

note

Sometimes necrotic areas do not have time to disintegrate, and calcium salts are deposited in them - foci of petrification (calcification) appear. In some cases, this process is so intense that the processes of ossification (ossification) are launched - a focus is formed in the mammary gland, which in its structure and physical characteristics (density) is similar to a section of bone tissue.

In unfavorable cases, the progression of the described breast pathology can occur with:

with septic melting of the focus;
sequestration - the formation of cavities in place of dead tissue.

Symptoms of fat necrosis of the breast

Since the formation of fat necrosis is preceded by traumatic exposure, the clinical picture begins to develop even before the formation of full-fledged necrotic foci.

Symptoms of fat necrosis of the mammary gland are:

tumor formation;
nipple retraction;
pain syndrome;
signs of impairment general condition body.

A tumor-like formation appears at the site of exposure to a pathogenic factor on breast tissue. Its characteristics:

shape – round or ovoid (egg-shaped);
consistency – dense, at the same time elastic;
in terms of mobility – it is fused to the skin, so its mobility is limited;
in terms of sensitivity – painful. Subsequently, with the formation of fat necrosis painful sensations may fade, and loss of soft tissue sensitivity may also increase. Both processes are associated with the fact that during the process of necrosis, nerve endings also die;
according to the characteristics of the integument - the skin over the tumor becomes cyanotic (bluish) or red, sometimes a combination of these two shades is possible.

Nipple retraction is observed if a focus of fat necrosis forms in the thickness of the mammary gland in the area of the areola.

Characteristics of pain syndrome:

by localization - in the area of formation of a necrotic focus;
by distribution - sometimes there may be a feeling that the entire mammary gland hurts;
by nature – the pain is often aching, when an infectious agent is attached with subsequent suppuration – jerking, “tearing”;
by intensity - as necrosis forms, they increase, then weaken;
by occurrence - observed almost from the very beginning of the disease.

Signs of deterioration in general condition are associated with the entry of necrotic elements into the bloodstream. These are the symptoms of classic intoxication syndrome, namely:

deterioration of general condition, feeling of malaise;
general weakness and lethargy;
deterioration of sleep up to insomnia;
deterioration of appetite, with the progression of pathology - its complete absence.

With fat necrosis of the mammary gland, the temperature is usually normal and increases only in the presence of large foci of necrosis.

Diagnostics

The diagnosis of fat necrosis of the mammary gland is made on the basis of complaints, anamnesis and results additional methods examinations.

A physical examination reveals the following:

upon examination - the affected mammary gland is enlarged, the tissues are swollen, the skin over the lesion is bluish or red;
upon palpation (palpation), the swelling is confirmed, and the soreness of the mammary gland is also determined. One or more foci of compaction are identified in the tissues.

note

In some cases, changes similar to signs of breast cancer may be observed - its deformation, the formation of “dimples” in the skin, a dense infiltrate, as well as an increase in peripheral lymph nodes.

In the diagnosis of fatty necrosis of the mammary gland, the following research methods are used:

Mammography is a set of methods that are used specifically to study the condition of the mammary gland;
Breast biopsy – tissue is taken and then examined under a microscope.

During mammography, the following are used:

x-ray mammography;
ultrasound mammography – helps to identify areas of necrosis, assess their size, quantity, as well as the condition of surrounding tissues;
tomosynthesis is the creation of a two-dimensional image of the mammary gland with all the changes in its tissues;
MRI mammography is a high-tech method of obtaining a tomographic image of the breast;
optical mammography – it uses optical equipment.

The following laboratory research methods are informative in the diagnosis of fat necrosis of the mammary gland:

cytological examination - the biopsy is examined under a microscope and evaluated cellular composition. First of all, the method is important for detecting atypical cells;
histological examination - the biopsy is examined for tissue structure;
general blood test - when an infectious agent is attached and the development inflammatory process the number of leukocytes increases (a phenomenon called leukocytosis) and ESR.

Differential diagnosis

Differential (distinctive) diagnosis of fat necrosis of the mammary gland is most often carried out with such diseases and pathological conditions, How:

acute mastitis - acute inflammatory damage to breast tissue;
abscess is a localized abscess of the mammary gland. Differential diagnosis should be carried out especially carefully in the case of the development of several abscesses;
phlegmon - diffuse purulent lesion of breast tissue;
syphilis of the mammary gland is a pathological process caused by Treponema pallidum;
tuberculosis of the mammary gland is a pathological process in it, provoked by Mycobacterium tuberculosis (Koch's bacillus);
actinomycosis – infection glands caused by actinomycetes (radiant fungi).

Complications

Complications that most often accompany fatty necrosis of the mammary gland are:

the addition of an infectious agent with the formation of infectious and inflammatory pathologies - mastitis, abscess, phlegmon;
fistulas (fistulas) - pathological passages that pass inside the tissues from the purulent area to the surface of the mammary gland;
sepsis – spread of infection throughout the body;
Gangrene of the mammary gland is its necrosis, accompanied by rotting processes. Develops when a putrefactive infection is attached.

Treatment of fat necrosis of the mammary gland (lipogranuloma)

The main thing in the treatment of fatty necrosis of the mammary gland is surgical method. The operation is advisable for reasons such as:

irreversibility of focal tissues in adipose tissue (tissues are not restored);
difficulty in differential diagnosis with a tumor process.

An organ-preserving operation is performed - sectoral resection of the mammary gland. The removed tissue is sent for histological examination - only this allows one to exclude the presence of a tumor in the mammary gland.

Conservative therapy is also used in the treatment of fatty necrosis of the mammary gland - it is prescribed in postoperative period. The appointments are based on:

antibacterial drugs - to prevent infectious complications;
vitamin therapy - to improve tissue repair (regeneration) processes.

Prevention

The basis for the prevention of fat necrosis of the mammary gland is the following measures:

avoiding injury to the mammary gland at home and at work;
accurate performance of medical procedures;
avoiding crash diets that lead to rapid weight loss;
compliance with safety precautions when working with radioactive substances;
avoidance of strength sports;
prevention, timely detection and treatment of pathologies that can contribute to the development of fatty necrosis of the mammary gland – endocrine disorders, oncological processes, tuberculosis, drug addiction, chronic intoxication;
wearing clothes (including underwear) that do not cause compression of the mammary glands;
regular preventive examinations with a mammologist (a doctor who deals with problems of the mammary glands) - even in the absence of any complaints.

Forecast

The prognosis for fat necrosis of the mammary gland is complex. On the one hand, rapid detection of pathology and surgical correction They allow you to get rid of the pathology, on the other hand, you have to remove part of the breast.

The prognosis worsens with:

late presentation and progression of pathology;
the occurrence of complications.

Kovtonyuk Oksana Vladimirovna, medical observer, surgeon, consultant doctor

Focal death of fatty tissue in the breast area is characterized by the appearance of a certain compaction in the tissue, which has increased pain on palpation.

This pathology is called fat necrosis of the mammary gland. As the disease progresses, dead cells are replaced connective tissue, which in turn is also a violation.

Usually the appearance of such an object suggests cancerous tumor, since the symptomatic indicators are similar.

Accordingly, there is a need to contact a medical institution to undergo an examination and carry out the required diagnostic procedures.

The pathological disorder called fat necrosis of breast tissue is classified as a necrotic process of the unfermented type, which can be caused by traumatic injuries.

According to statistics compiled from the clinical frequency of cases in mammology, fat necrosis occurs in 0.6% of women with identified nodular formations.

For reference!

Experts note that in women with small breast sizes this pathology is much less common.

Among the reasons for the development of necrosis, the following are particularly distinguished:

Household injuries to breast tissue - bruises, compression, penetrating injuries, etc.
Consequences of medical manipulations - excessive pressure during palpation, minimally invasive diagnostics, etc.
Injuries due to physical activity - bruises, sprains in the chest area, etc.
As a result of rapid weight loss.
Reactive tissue inflammation when blood flow to the local area is disrupted.
Undergoing procedures related to radiation exposure.
Impaired regeneration after reconstructive mammoplasty with one’s own tissues.

After healed areas in the area of necrotic lesions, the development of ossification and petrification processes is possible.

Symptoms of the necrotic process

The occurrence of a focus of necrosis of adipose tissue is characterized by the formation of a painful compaction, which upon palpation is defined as an object of rounded outline and dense structure welded to adjacent tissues.

In addition, the following signs are observed:

change in skin color over the area (redness or bluishness);
the appearance of depressions on the skin of the chest;
nipple retraction with alveolar localization;
lymph nodes are defined as enlarged.

Body temperatures rarely exceed normal values, which distinguishes fat necrosis from mastitis.

The external appearance of such a process is very similar to the signs of a malignant neoplasm, which requires careful diagnosis.

With unfavorable development of necrosis, septic expansion of the area of necrotic lesion is possible.

Diagnostic techniques for fat necrosis of the mammary glands

In the diagnostic process, the patient’s medical history is important, since an indication of a recent incident traumatic injury more clearly indicates a necrotic form of formation.

The use of ultrasound examination to determine necrosis is not sufficient, since this technique does not reveal characteristic signs.

During a palpation examination, a mammologist specialist discovered a lump with unclear boundaries and increased pain.

In the future, for diagnostics it is necessary to carry out such hardware studies, depending on the available clinical picture, the doctor may omit some of them:

Received data on initial stages diseases have a similar picture to malignant neoplasms areas.

As the process progresses to calcification, the images reveal calcified deposits with spherical outlines, which make it possible to accurately determine the non-malignancy of the disease.

Differential diagnosis

To differentiate the diagnosis, the mammologist may prescribe the collection of biopsy material for further histological and cytological laboratory testing.

This procedure is carried out under fluoroscopic or ultrasound control to determine the exact location of the necrotic object.

Treatment and preventive measures

Taking into account irreversibility pathological disorder and the difficulties of accurately differentiating the necrotic process of adipose tissue of the mammary glands, treatment requires surgical intervention.

The main focus of such an operation is organ-preserving resection of the affected area - sectoral.

During such an operation, the entire affected area (sector) of the mammary gland is excised with the maximum possible preservation of healthy tissue.

The excised part must be sent to the laboratory for additional histology. This measure allows you to accurately determine the origin of the tumor and exclude the malignancy of the process.

As preventative measure, it is necessary to reduce the likelihood of breast injury. If you receive an injury to this area, you need to contact a mammologist as soon as possible.

He will appoint necessary treatment, allowing to reduce the likelihood of necrotic changes to a minimum.

This usually involves wearing a breast lifting bandage, healing ointments, and anti-inflammatory medications.

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Fat necrosis of the mammary gland is focal necrosis of adipose tissue that occurs after various injuries. This pathology– these are benign changes in breast tissue. Under various damaging factors resulting from a violation of integrity small vessels The blood supply to the tissue area stops, after which necrosis develops. Injuries can be very different, for example, an elbow during sports training or a bruise on a door frame.

Necrosis can often occur as a result of radiation therapy and sudden weight loss. Usually pain symptoms fat necrosis or are absent, and changes in adipose tissue are detected only when medical examination by traditional palpation or manifested painful sensations, and upon visual examination of the breast, enlarged lymph nodes and irregularities in the form of dimples on the skin are visible.

Fat necrosis does not degenerate into a malignant tumor, but can only simulate it. With mammography or ultrasound examination fat necrosis is defined as a malignant tumor, which requires the use of a biopsy and, in some cases, sectoral resection. Fat necrosis of the mammary gland, also called oleogranuloma, lipogranuloma and steatogranuloma, refers to non-enzymatic necrosis.

Changes in tissue structure characterized by the development of reactive inflammation with the formation of a demarcation zone that separates dead tissue. The subsidence of inflammation is accompanied by the process of fibrosis, i.e., the replacement of necrotic masses with connective tissue. Scar tissue forms in areas of necrosis. There may be deposits of calcium salts in the area of fat necrosis and calcification of the necrosis focus.

Symptoms and diagnosis of fat necrosis of the mammary gland

The development of fat necrosis is preceded by a traumatic effect on any area of the mammary gland. If the blow is strong, then a painful tumor, cyanotic or red in color, round in shape and dense in consistency, quickly forms at the site of the injury. It bonds with the skin and sensitivity is lost.

Fat necrosis entails nipple retraction and occurs without an increase in body temperature. With an unfavorable development of the disease, septic melting of the focus and the process of rejection of the necrotic area (sequestrum) from the surrounding living tissues may occur. Diagnosis of fatty necrosis of the mammary gland necessarily begins with a questioning of the patient; the doctor must know the nature of the traumatic impact, the timing of the development of necrosis.

The mammologist, in the process of contact determination, reveals the degree of density, clarity of the contours of fat necrosis, symptoms of the presence of fluid (pus, blood). Survey mammography and MRI of the mammary glands help to detect heterogeneity of the structure and heavy, uneven contours.

X-ray, tomographic and echographic studies of fat necrosis often show symptoms of breast cancer. After calcification occurs, the focus of fat necrosis of the mammary gland resembles a spherical calcification of the “ eggshells“, this circumstance completely excludes the presence of a malignant tumor. Differential diagnosis involves performing a biopsy of the mammary gland, i.e., fine-needle puncture or trepanobiopsy, which makes it possible for subsequent cytological and histological examination of the obtained fragments.

The biopsy is always performed under ultrasound or x-ray guidance. Treatment and prevention of fat necrosis of the mammary gland has its own specifics and some difficulties. It is good when patients consult a doctor as soon as discomfort is detected. Because the focal changes in fatty tissue are irreversible, and there are also difficulties differential diagnosis, then organ-preserving surgery with removal of part of the mammary gland is indicated.

Repeated histological studies after surgery can completely exclude or confirm the process of oncological lesions. Under a microscope, fat necrosis appears as nodular growths granulation tissue from epithelioid cells, multinucleated giant phagocytic fats and lipids and cholesteryl ester-laden macrophages around fat inclusions.

Lipogranulomas contain fatty cysts in the form of thin-walled cavities filled with oily and serous fluid. The best prevention Necrosis of the mammary gland is caution and respect for your body parts. If you still cannot avoid injury, it is recommended to take first steps on your own. medical care, namely, lift the injured chest with a bandage and urgently contact a specialist.

Everyone knows that the female breast is a very delicate gland, the tissues of which should not yield physical influences(injuries, bruises). Girls should be aware that they need to protect their breasts from being squeezed by a bra, cover their breasts with their hands when there is a massive crowd of people, and avoid even the most minimal breast injuries in every possible way. This is because the mammary gland consists of extremely sensitive tissues, which can change their structure with the slightest influence. The mammary glands are very susceptible to such pathological processes, such as mastopathy, fibroadenoma, mastitis, papillomas. There may also be fat necrosis of the breast.

Fat necrosis of the mammary gland. Causes of lipogranuloma

Fat necrosis of the mammary gland is an aseptic focal necrosis of fatty tissue. Wherein adipose tissue replaced by scar tissue. Fat necrosis is also called oleogranuloma, lipogranuloma and steatogranuloma. Fat necrosis refers to non-enzymatic necrosis. The main cause of oleogranuloma is chest trauma. Patients with large breasts are more susceptible to fat necrosis of the mammary glands than those with small ones.

Traumatic factors that can provoke fatty necrosis of the mammary glands: accidental blows and bruises, for example in transport, sports training, medical manipulations. Sometimes the cause of oleonecrosis is rapid weight loss or radiation therapy. Sometimes necrosis occurs after breast surgery or mastectomy.

What happens in breast tissue during fat necrosis?

When breast tissue is injured, small capillaries in the area of fatty tissue are damaged. Next, the breast tissue reacts to this process with the appearance of an inflammatory reaction. A demarcation zone is formed that limits the dead tissue. After finishing inflammatory reaction the process of fibrosis begins, in which necrotic masses are replaced by connective tissue cells. This is how scar tissue forms. Subsequently, calcium salts are deposited in such areas of necrosis of the adipose tissue of the mammary gland, and petrification of the foci occurs. IN in rare cases processes of ossification are observed.

Symptoms of fat necrosis of the breast

After a chest injury, a painful swelling appears, which is fused to the skin. It has a dense consistency and round shape. Later, the affected area of adipose tissue begins to lose sensitivity. Externally, the gland may change in color - the skin of the gland may acquire a bluish or red tint, the nipple may be somewhat retracted. This picture often resembles mastitis and misleads women, but it is very simple to distinguish fat necrosis from mastitis - with mastitis there will be an increase in body temperature to febrile levels.

With all this, fat necrosis can be clinically similar to breast cancer. Deformation of the mammary gland, density of the infiltrate, the appearance of retracted areas on the skin of the gland and an increase in regional lymph nodes may resemble breast cancer. In advanced conditions, fat necrosis can occur in the form of sequestration and melting of tissue.

Diagnosis of fat necrosis of the mammary gland

In the diagnosis of fat necrosis great importance The patient has a history of a chest injury that occurred recently. Upon palpation, the mammologist determines painful lump, which does not have clear contours and can fluctuate.

When performing an ultrasound of the mammary glands, CT or MRI, a heterogeneous formation of a nodular nature is revealed, which has heavy, uneven contours. With these tests, the results are often very similar to breast cancer. But, after some time, when the focus of necrosis begins to calcify, on mammography the focus of fat necrosis appears in the form of spherical calcification like an “egg shell”. This allows us to exclude the malignancy of the process.

For differential diagnosis, it is advisable to perform a biopsy of gland tissue followed by histological examination. Breast biopsy is performed under ultrasound guidance.

Treatment and prevention of fat necrosis of the breast

In the presence of fat necrosis, only surgery– organ-preserving sectoral resection mammary gland. After this, the material is checked histologically. Microscopically, this material is represented by nodular growths of granulation tissue from epithelioid cells, large lipophages, and xanthoma cells around fatty inclusions. The main components of lipogranulomas are fatty cysts - cavities with thin walls that are filled with serous and oily fluid.

If the gland is injured, it is necessary to elevate it with a bandage and immediately consult a doctor.

For many women, the phrase “fat necrosis of the breast” sounds ominous. In fact, this condition is not so scary and does not even always require treatment. The terrible word “necrosis” in this case simply means the death of adipose tissue cells. Over time, the dead cells are replaced by a scar or form a cyst.

Why does fat necrosis of the mammary gland occur?

The most common reason is breast surgery. After all, any surgical intervention, especially extensive, is a tissue injury and leads to disruption of the blood supply. Moreover, fat necrosis does not always develop immediately after surgery; years may pass.

There are other possible reasons:

Chest injuries. Fat necrosis can occur after a car accident due to trauma to the chest from a seat belt.
Breast biopsy.
Radiation therapy for oncological diseases. Radiation can damage not only the tumor, but also healthy tissue, as a result, a complication develops - fat necrosis.
Among the patients, ladies with curvy figures predominate, who have more fatty tissue in their breasts. In Group increased risk middle-aged women with saggy, out-of-shape breasts.

What are the symptoms of the pathology?

Fat necrosis of the mammary gland can be asymptomatic, in which case it is detected only during examination, after mammography.

A painful swelling may appear in the chest, the skin over it becomes red or bluish, but the body temperature remains normal. Some women experience nipple discharge. The skin over the lesion is retracted, and in some cases the nipple is retracted.

Similar manifestations occur when malignant tumors mammary gland. Don't delay visiting the doctor. Timely examination helps to exclude cancer.

Fat necrosis of the breast- This is an aseptic focal necrosis of the fatty tissue of the mammary gland with its replacement by scar tissue. This disease has several names - steatogranuloma, lipogranuloma, oleogranuloma. The disease belongs to non-enzymatic necrosis, which is usually caused by various injuries breasts According to statistics collected modern doctors, fat necrosis is approximately half a percent of all other nodular formations of the mammary glands. Most often, fat necrosis is observed in women with large breasts; in women with small breasts it develops much less frequently.

Causes of fat necrosis of the mammary gland

As a traumatic factor for the occurrence of the disease, blows and bruises in transport or everyday life, sports training, various medical and surgical operations. Slightly less commonly, the cause of fat necrosis is radiation therapy or sudden and severe weight loss. In isolated cases, necrosis can be diagnosed in patients who have undergone reconstructive mammoplasty with their own tissues, that is, their mammary gland was restored using materials from their body.
Even slight damage capillaries sometimes leads to disruption of the blood supply to any part of the fatty tissue. Following this, the development of inflammation is observed, which limits the dead tissue into which blood does not flow. After the inflammation subsides, the necrotic masses are replaced by connective tissue - the process of fibrosis begins. In this case, scar tissue remains in the place where the necrosis was located. After some time, calcium salts begin to be deposited in the necrotic area.

Symptoms of fat necrosis of the breast

In almost 100% of cases, before the development of necrosis, the breast is injured in one way or another.

Bruise - at the site of this very injury, a tumor forms, quite painful to the touch, which is fused to the skin. It has a dense consistency and round shape. Gradually, over time, the area where fat necrosis of the mammary gland is located loses sensitivity.
Change in skin color - the skin over the formed tumor sometimes becomes red or cyanotic in color. If fatty necrosis of the mammary gland has formed in the area of the areola, then the nipple is also drawn into the process of death. Unlike mastitis, which is similar in course, during fat necrosis of the mammary gland, body temperature usually does not rise above normal.
Breast deformation - due to such signs as enlarged lymph nodes, the formation of a dense infiltrate and “dimples” on the skin of the breast, fat necrosis looks very similar to breast cancer. In especially unfavorable cases, fatty necrosis of the mammary gland occurs with melting of the necrosis focus and its subsequent rejection.

Treatment of fat necrosis of the breast

The only more or less effective treatment for fatty necrosis of the mammary gland is the removal of part of it, the dead necrotic sector. This is necessary because the disease causes irreversible changes in fat tissue that cannot be eliminated with medications.
An oncological process, due to the similarity of the clinical picture, can be excluded only after a postoperative examination of the extracted lesion has been carried out. Thus, there is no way to determine whether it is cancer or fat necrosis before surgery.

Prevention of fat necrosis of the mammary gland

In order to avoid fat necrosis of the mammary gland, you need to try to avoid injury to the mammary glands. If any, even minor damage does occur, you need to contact a mammologist as soon as possible. Immediately after an injury, before contacting a doctor, it is necessary to use a bandage to give the mammary gland a slightly elevated position.

Complications

If left untreated, necrosis can lead to purulent inflammation his hearth. In addition, the process of forming an area of dead tissue may begin. Over time, it is not replaced by its own connective tissue and can freely move to the area of healthy tissue.

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