Additionally, suggestions are that a greater amount of venous outflow with additional venous anastomoses decreases the incidence of breast fat necrosis. Breast fat necrosis is nonviable adipose cells from injured or ischemic breast tissue that is replaced with scar tissue and presents as a palpable nodule. Breast fat necrosis has various etiologies and implications; therefore, a careful patient history is imperative to properly evaluate the patient. The most common etiology of fat necrosis is recent breast surgery; however, in non-operative patients, cancer or mechanical trauma to the breast tissue is often the culprit.
If your doctor confirms a diagnosis of breast fat necrosis, they may recommend waiting to see if it resolves without treatment, especially if it’s small and not causing you discomfort. It can take several months for the breast fat necrosis to break down. It’s important to note that if you’ve been diagnosed with breast fat necrosis, it doesn’t mean you have a higher risk of developing breast cancer. If much of the fat under your skin has died, it might appear dimpled or to sag.
It is a normal reaction for the body to form a fibrous capsule around it. After any surgery, it is normal for the area to produce fluid. You might have two or more drains into the wound to drain off the fluid. The drains are usually long thin tubes attached to vacuum bottles. Even if you have drains, fluid can sometimes collect under the wound and create a swelling. To help reduce the risk of blood clots you may have injections to thin the blood before, during and after your surgery.
Fat necrosis or oil cyst, when seen on ultrasound is a cystic lesion with echogenic internal bands, and its orientation is affected by the patient’s body position. The liquified fat (a.k.a. oil cysts) can also cause lumps. Oil cysts are fluid-filled sacs that feel smooth and squishy under the skin and can grow over time.
Even on a mammogram, your doctor may not be able to tell the difference between fat necrosis and tumors caused by breast cancer. You are likely to have emotional ups and downs after surgery for breast cancer and breast reconstruction. Even months afterwards, many women find it helpful to talk about their feelings and ask about things that worry them. Besides the above-mentioned types, some other less common types of breast lumps are phyllodes tumor, adenosis, duct ectasia, etc.
Flaps experience a higher rate of fat necrosis when irradiated. The rate of symptomatic fat necrosis in brachytherapy and now accelerated partial breast irradiation is found to be 1 to 50%18. The incidence is related to volume encompassed by the given dose of radiation or how much tissue was irradiated by the maximum strength of radiation prescribed19. There is some evidence that interstitial brachytherapy may cause additional trauma due to the implanted needle, causing an increased incidence of fat necrosis19. Studies have also shown an increase in breast fat necrosis with brachytherapy in populations who also received treatment with adriamycin-based chemotherapy 20.
A common question I get is “How long will it take to improve? This is a difficult question to answer as no two cases are the same. I usually recommend 3-4 massage treatments to start and then re-assess the tissue to see how the patient is responding to the treatment to see where we go from there. Lymphatic drainage follows a unidirectional flow, from deep home remedies for matted human hair subcutaneous and intramammary vessels, towards axillary and internal mammary lymph nodes. Although the majority of the blood supply comes from the internal mammary artery, only 4% lymph flows go to internal mammary nodes, with the majority of the lymph flows to the axillary nodes. Fat necrosis can be found at any time after breast surgery or an injury.
Biopsy is not necessary for diagnosis unless smaller clusters of calcifications are present that are of sufficient concern for possible malignancy. Susha has a Bachelor of Science (B.Sc.) degree in Chemistry and Master of Science (M.Sc) degree in Biochemistry from the University of Calicut, India. She always had a keen interest in medical and health science.
Typically, one observes with fat necrosis quite a bit of liquefied fat and the presence of calcifications. But at other times, depending on the age of the pseudo-mass, fat necrosis may show more of a ‘fibrotic‘ reaction. Fat necrosis tends to have an irregular or rounded outline.