Fat Necrosis After Breast Surgery

Fat necrosis, a noncancerous lump in the breast that develops from dead or damaged breast tissue, commonly develops after breast surgery. When breast tissue is damaged, fat cells in the tissue die and release oils that form small sacs called cysts. Over time, these cysts can harden and lead to the formation of scar tissue.

Following a breast surgery of any kind (breast augmentation, breast lift or breast reduction), you may discover a lump in your breasts. Although it can be very worrying initially, these lumps isn’t cancerous, and it typically isn’t painful.

It can be difficult to tell the difference between lumps caused by fat necrosis and lumps caused by breast cancer. Even on a mammogram, your doctor may not be able to tell the difference between fat necrosis and tumours caused by breast cancer. Sometimes, the only way to tell the difference between these lumps and breast cancer is to do a breast biopsy.

What Are Breast Fat Necrosis Symptoms?

Fat necrosis causes a firm lump or mass to form in your breast. It’s usually painless, but it can feel tender to some people. You might also notice some redness or bruising around the lump, but there are rarely any other symptoms. It can be nearly impossible to tell the difference between a fat necrosis lump and a breast cancer lump by a physical exam or even with a mammogram. If you find a lump in your breast, it’s important you see a doctor right away.

Breast Fat Necrosis vs. Breast Cancer Symptoms

While it’s difficult to tell the difference between fat necrosis and breast cancer without a biopsy, there are some symptoms that may appear with breast cancer that you would not have with a lump caused by fat necrosis.

Possible signs of breast cancer can include:

• nipple discharge, which is an early sign

• changes to your nipple, such as turning inward

• scaling or thickening of the skin on your breast, which is also known as "peau d’orange"

• swollen lymph nodes under your arm or collarbone

It’s not likely that you would experience any of these symptoms with a lump caused by fat necrosis, so it’s best to see a doctor if you notice any of these signs.

Breast Fat Necrosis vs. Oil Cyst Symptoms

Oil cysts can also cause a lump in your breast and sometimes form along with fat necrosis.

Oil cysts are also noncancerous, fluid-filled sacs that form when the oils from decomposing fat cells collect in one place instead of hardening into scar tissue. Your body coats the oil sac with a layer of calcium (calcification), and the sac will feel:

• smooth

• squishy

• flexible

Similar to a lump caused by fat necrosis, a lump is probably the only symptom you’ll notice with an oil cyst. These cysts might show up on mammograms, but they’re usually diagnosed with a breast ultrasound.

Oil cysts usually go away on their own, but your doctor can drain the fluid inside the cyst with a needle aspirationTrusted Source if it’s causing you pain. This will deflate the cyst.

Who’s At Risk For Breast Fat Necrosis?

Fat necrosis is most common after breast surgery. Breast reconstruction after cancer surgery may also increase your risk of fat necrosis.

How is Breast Fat Necrosis Diagnosed?

You might find fat necrosis on your own if you feel a lump, or it might show up on your regular mammogram. If you find a lump yourself, your doctor will do a breast exam, and then a mammogram or ultrasound to determine if the lump is caused by fat necrosis or a tumor. They might also do a needle biopsy to see if there are cancer cells in the lump. If your doctor finds the lump on a mammogram, they might follow up with an ultrasound or biopsy. Usually, more than one test is necessary to make a definitive diagnosis of fat necrosis.

How is Breast Fat Necrosis Treated?

Fat necrosis usually doesn’t need treatment and will go away on its own in time. If you have pain or tenderness around the lump, over-the-counter anti-inflammatory medications like ibuprofen can help. You can also try massaging the area or applying a warm compress. Larger lumps that cause more discomfort can be removed surgically, but this isn’t common. If fat necrosis has led to the formation of an oil cyst, your doctor can drain the fluid with a needle and deflate the cyst.