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fat necrosis of breast

ICD-10 Codes

Related ICD-10:

Description

What is Fat Necrosis of the Breast?

Fat necrosis of the breast is a benign condition that occurs when fatty tissue in the breast becomes damaged, inflamed, or dead due to injury, surgery, or radiation therapy. This damage leads to the formation of scar tissue, which can cause a palpable lump or nodule.

Causes and Risk Factors

  • Recent breast surgery
  • Radiation therapy
  • Injury or trauma to the breast tissue
  • Having more breast tissue (more common in women with larger breasts)
  • Breast cancer diagnosis (increases risk due to radiation therapy)

Symptoms and Characteristics

  • A firm, round lump (or lumps) that is usually painless
  • May feel tender or painful in some cases
  • The skin around the lump may appear normal or slightly thickened

Stages of Fat Necrosis

As the fat cells die, they release their contents, forming a sac-like collection of greasy fluid called an oil cyst. Over time, calcifications can form around the walls of the cyst, which can be seen on mammograms.

Diagnosis and Distinguishing from Cancer

Fat necrosis is often mistaken for breast cancer due to its similar appearance on mammograms. However, it can be distinguished through histological examination, where histiocytes are relatively uniform in size with round nuclei, fine intracytoplasmic vacuoles, and no indentation of the nucleus.

Prevalence and Demographics

Fat necrosis accounts for 2.75% of all breast lesions and is more common in women at or around menopause age.

References:

  • [1] Fat necrosis may appear as a solid, complex cystic and solid, or a cystic/anechoic mass. Complex cystic and solid masses may contain internal echogenicity or... (Search Result 7)
  • [2] A benign condition in which fat tissue in the breast or other organs is damaged by injury, surgery, or radiation therapy. (Search Result 8)
  • [3] Fat necrosis feels like a firm, round lump (or lumps) and is usually painless, but in some people it may feel tender or even painful. The skin around the lump... (Search Result 9)
  • [4] Breast fat necrosis is typically painless. Although, some people do report tenderness, says Beautriu Reig, M.D., an assistant professor of radiology at NYU Grossman School of Medicine in New York... (Search Result 13)

Additional Characteristics

  • A benign condition that occurs when fatty tissue in the breast becomes damaged, inflamed, or dead due to injury, surgery, or radiation therapy.
  • A firm, round lump (or lumps) that is usually painless
  • May feel tender or painful in some cases
  • The skin around the lump may appear normal or slightly thickened
  • As the fat cells die, they release their contents, forming a sac-like collection of greasy fluid called an oil cyst.
  • Over time, calcifications can form around the walls of the cyst, which can be seen on mammograms.
  • Fat necrosis is often mistaken for breast cancer due to its similar appearance on mammograms.
  • However, it can be distinguished through histological examination, where histiocytes are relatively uniform in size with round nuclei, fine intracytoplasmic vacuoles, and no indentation of the nucleus.
  • Fat necrosis accounts for 2.75% of all breast lesions and is more common in women at or around menopause age.

Signs and Symptoms

Fat necrosis of the breast can manifest in various ways, making it essential to be aware of its common signs and symptoms.

Common Signs and Symptoms:

  • A lump or nodule may feel hard and round or like a section of thick skin [8].
  • Pain is usually not associated with fat necrosis, but if present, it's often mild [1].
  • Lumps are often found around the areola, the part that surrounds the nipple [8].

Other Possible Signs:

  • A firm lump in the breast may be felt during a self-examination or a clinical examination by a healthcare provider [10].
  • In some cases, the affected area may feel like thick skin or a section of hardened tissue.

It's essential to note that fat necrosis can mimic the appearance and symptoms of cancer, which is why it's crucial to consult with a healthcare professional for an accurate diagnosis. A mammogram or ultrasound scan can help confirm the presence of fat necrosis and rule out other conditions [12].

References: [1] - Context result 1 [8] - Context result 8 [10] - Context result 10 [12] - Context result 12

Additional Symptoms

  • A lump or nodule may feel hard and round or like a section of thick skin
  • Pain is usually not associated with fat necrosis, but if present, it's often mild
  • Lumps are often found around the areola, the part that surrounds the nipple
  • A firm lump in the breast may be felt during a self-examination or a clinical examination by a healthcare provider
  • In some cases, the affected area may feel like thick skin or a section of hardened tissue

Diagnostic Tests

Diagnostic Tests for Fat Necrosis of the Breast

Fat necrosis of the breast can be challenging to diagnose, and a combination of clinical evaluation, imaging studies, and biopsy may be necessary to confirm the diagnosis.

  • Mammography: Mammography is often used as an initial screening tool for fat necrosis. However, it can be difficult to distinguish between lumps caused by fat necrosis and those caused by breast cancer [1]. Coarse calcifications, cysts, and microcalcifications are some of the common mammographic findings associated with fat necrosis [10].
  • Ultrasound: Ultrasound is another imaging modality that may be used to evaluate breast lesions. However, it can also have limitations in differentiating between benign and malignant conditions [1].
  • MRI: Magnetic Resonance Imaging (MRI) may be used in some cases to further evaluate the extent of fat necrosis or to rule out other breast abnormalities [4].
  • Fine-needle aspiration (FNA): FNA is a minimally invasive procedure that involves using a small needle to collect cells from the suspicious area. It can provide valuable information for diagnosis, especially when combined with imaging studies [12].
  • Biopsy: A biopsy may be necessary in some cases to confirm the diagnosis of fat necrosis. This involves removing a sample of tissue from the affected area and examining it under a microscope.

Key Points

  • A combination of clinical evaluation, imaging studies, and biopsy may be necessary to diagnose fat necrosis of the breast.
  • Mammography can have limitations in differentiating between lumps caused by fat necrosis and those caused by breast cancer.
  • Ultrasound and MRI may also be used to evaluate breast lesions associated with fat necrosis.
  • FNA and biopsy are minimally invasive procedures that can provide valuable information for diagnosis.

References

[1] Context 1: 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. [2] Any procedure that disrupts the breast's fatty tissue can lead to breast fat necrosis, including: Breast reconstruction Injecting fat into the breast from other parts of the body (called ...). [3] Fat necrosis is a benign (not cancer) condition that most commonly develops after an injury or trauma to the breast tissue. [4] It is important to diagnose fat necrosis because it can often mimic carcinoma of the breast. [5] It can be difficult to tell the difference between lumps caused by fat necrosis and lumps caused by breast cancer on a mammogram. [6] Breast fat necrosis has a multitude of appearances on mammography, sonography, and MRI. [7] Fine-needle aspiration (FNA) of the breast is an integral part of triple testing and has gained significant credibility in the diagnosis of breast diseases. Fat necrosis (FN) is a benign nonsuppurative inflammatory lesion that occurs within breast adipose tissue following accidental trauma or previous surgical biopsy.

Additional Diagnostic Tests

  • Biopsy
  • Ultrasound
  • MRI
  • Fine-needle aspiration (FNA)
  • Mammography

Treatment

Differential Diagnosis

Fat necrosis of the breast can be challenging to diagnose, as it presents similarly to other conditions. The differential diagnosis for fat necrosis includes:

  • Breast carcinoma: A type of cancer that can mimic histiocytes and have abundant foamy cytoplasm and small bland nuclei [11].
  • Hematoma or seroma: A collection of blood or fluid in the breast tissue, which can be caused by trauma or surgery [1, 13].
  • Fibrocystic disease: A non-cancerous condition characterized by lumpy or rope-like breast tissue, which can be mistaken for fat necrosis [1].
  • Suture or dermal calcifications: Calcium deposits in the skin or underlying tissues, which can be caused by previous surgery or trauma [1].
  • Scar tissue: A type of fibrous tissue that forms after injury or surgery, which can mimic fat necrosis [1].
  • Edema: Swelling of the breast tissue due to fluid accumulation, which can be mistaken for fat necrosis [1].
  • Abscess: A collection of pus in the breast tissue, which can be caused by bacterial infection and mimic fat necrosis [1].
  • Lipoma or fibroadenolipoma: A type of benign tumor that can occur in the breast, which can be mistaken for fat necrosis [2, 12].

To differentiate fat necrosis from these conditions, a thorough history and physical examination are essential. Imaging studies such as mammography, ultrasound, and MRI may also be used to aid in diagnosis.

In patients with a new palpable finding, eliciting the history of a traumatic event can be helpful in making the diagnosis of fat necrosis [10]. Additionally, biopsy may be recommended if there is suspicion of malignancy or if the diagnosis remains unclear after imaging studies [15].

References:

[1] Context result 1 [2] Context result 2 [10] Context result 10 [11] Context result 11 [13] Context result 13 [15] Context result 15

Additional Differential Diagnoses

Additional Information

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