Treatment of fat necrosis of the mammary gland. Fat necrosis Fat necrosis of the breast or cancer

Everyone knows that the female breast is a very delicate gland, the tissues of which should not succumb to 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 in every possible way avoid even the most minimal injuries to the breasts. 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 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. In this case, the fatty tissue is 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 fatty 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 procedures. Oleonecrosis is sometimes caused by 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 completion of the 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 lesions occurs. In rare cases, ossification processes 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 breast, density of the infiltrate, the appearance of retracted areas on the skin of the gland and enlargement of 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, the patient’s history of a chest injury that occurred recently is of great importance. Upon palpation, the mammologist determines a painful lump that 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 surgical treatment is indicated - organ-preserving sectoral resection of the 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.

Oleogranuloma is a compact nodular formation that forms in response to damage to breast tissue. Under the influence of traumatic factors on subcutaneous fatty tissue, lipocytes (fat cells) become necrotic and cause inflammation. As a result of the inflammatory reaction, connective tissue is formed in the affected area. Oleogranuloma can be similar to breast cancer. An accurate diagnosis is established by biopsy. Other names for the pathology are lipogranuloma and fat necrosis of the mammary gland. This is not a tumor or a wen (lipoma).

The pathology does not harm health and is often asymptomatic and disappears on its own over time. However, if a nodular formation appears in the breast, it is still necessary to contact a mammologist to rule out cancer and other pathologies.

Differences from other diseases

The first thought when a woman discovers a lump in her breast is that it is cancer. often accompanied by the following symptoms:

nipple discharge;
areola retraction;
thickening or wrinkling of the skin on the surface of the breast.

The described symptoms do not occur with oleogranuloma, with the exception of possible nipple retraction.

A fatty cyst, a benign formation consisting of soft adipose tissue surrounded by a dense wall that can undergo calcification, can form inside the lipogranuloma. Such cysts form for no apparent reason, as well as after surgery or trauma to the gland. They go away on their own. If the cyst is painful, it is punctured and the contents are removed.

Causes of pathological changes and risk factors

The main causes of the process are surgery, radiation or trauma to the mammary gland. Traumatization of the tissues of the latter or surgery leads to disruption of the blood supply to the lobules of the gland. They do not receive the required amount of oxygen and die. The body releases special enzymes to destroy dead cells. As a result of their activity, inflammation first occurs, and then scar tissue forms at the site of the lesion. Fat is also released from dead cells, which fills the cystic cavity. As a result of these two processes, a compaction called oleogranuloma is formed.

The likelihood of the formation of fibrous lesions increases after procedures such as:

tissue biopsy;
lumpectomy;
breast surgery, including the use of expanders;
gland reduction and implant removal.

Older women with large breasts are more often affected. For example, they may develop oleogranuloma of a postoperative breast scar that occurs after removal of an organ for a malignant tumor. This condition is not dangerous.

Lipogranuloma develops much less frequently when:

long-term use of anticoagulants, for example, Warfarin;
dilation of the gland ducts;
polyarteritis nodosa;
Weber-Christian disease;
panniculitis.

The pathology is observed in 6-10 women out of 1000, accounting for 2.75% of all breast diseases. The average age of patients is 50 years.

Symptoms

A node forms under the skin of the gland or near the nipple. It is usually smooth, round and painless, up to 2 cm in diameter.

In more severe cases, the granuloma may be uneven and fixed to the skin, accompanied by redness, soreness, and retraction of the skin. In this case, careful diagnosis is required to rule out cancer.

Diagnostics

Often, oleogranuloma is discovered by the patient herself. In this case, you should consult a doctor who will prescribe or. To exclude a cancerous tumor, a puncture biopsy is performed.

On mammography, the formation has a round or irregular shape measuring less than 2 cm. Sometimes it is surrounded by a thin, dense capsule, which makes it possible to preliminarily distinguish it from a cancerous tumor. If such a membrane is thickened or uneven, the doctor must rule out a malignant process. Calcifications are often found - accumulations of lime in the granuloma.

By ultrasound, fat necrosis is defined as a subcutaneous lesion with increased echogenicity (density), uncharacteristic of cancer. Cavities - cysts - can be visualized inside it, or it can be homogeneous. Hyperechogenicity is characteristic of only 0.8% of all malignant breast tumors, among them invasive ductal and lobular cancer, lymphoma, angiosarcoma, liposarcoma.

One of the main methods for diagnosing oleogranuloma is mammography.

An MRI test is not prescribed because it does not provide convincing evidence of the absence of cancer and is more expensive. This study reveals a focus of fat necrosis with a thin rim around it.

Computed tomography is also not included in the standard examination for this pathology. If it is performed for another breast disease, signs of oleogranuloma may be the presence of liquid fat, fibrous tissue around it and inflammation. Calcifications begin to be detected only when they reach a large size.

The main diagnostic methods are mammography and biopsy with histological examination.

Treatment

Lipogranuloma in most cases does not require treatment and goes away spontaneously. If pain occurs, you can take a pain reliever (Ibuprofen), do a light massage, or apply a warm compress. Warming compresses can be used repeatedly, applying them for 30 minutes every 4 hours.

Removal of oleogranuloma of the mammary gland is performed very rarely, only when the formation is large or the patient has increased anxiety. During surgery, a small area of tissue containing the granulomatous nodule is excised.

Treatment can be supplemented with a puncture biopsy if there is a cyst with liquid contents inside the formation. After emptying the cavity, the cyst collapses, and the lipogranuloma decreases in size.

Treatment with folk remedies is aimed only at relieving minor pain. Compresses with golden mustache, onion pulp, and cabbage leaves are used.

How is oleogranuloma removed?

Before the operation, routine blood tests are taken - general, biochemical, for hepatitis and HIV infection, syphilis. Fluorography or chest x-ray and ECG are performed. Preparation includes not using blood thinners and not eating or drinking on the day of surgery.

It is performed on the breast without removing the lymph nodes. The operation is performed under local anesthesia using novocaine or other anesthetics.

Previously, markings are applied to the gland according to ultrasound data to accurately determine the location of the node. The seal is palpated and a skin incision is made over it in the form of an elongated oval. The edges of the wound are pulled apart.

After determining the boundaries of the node, one or more lobules are removed in the form of a wedge. The oleogranuloma is removed along with a small amount of healthy tissue. The resulting material is sent to the laboratory for histological examination, which is necessary to exclude cancer.

Sectoral breast resection

The crossed vessels are coagulated, stopping the bleeding, then several sutures are placed on the gland tissue, and then on the skin. A small drainage is left in the wound for 1-2 days.

The operation lasts about half an hour. It is technically simple and rarely causes complications. After this, the patient remains in the hospital for 2-3 days. In the immediate postoperative period, antibiotics and painkillers are prescribed. The stitches are removed after a week.

Possible complications are infection of the postoperative wound, the formation of a hygroma or a rough scar. If fever, swelling, redness of the gland, or increased pain in it appear within a month after the intervention, you should immediately consult a surgeon.

Forecast and consequences

In most women, the thickened lesion goes away on its own. If this does not happen, it is removed surgically. Once fat necrosis disappears or is removed, it does not recur and does not increase the risk of developing breast cancer.

Although lipogranuloma is a benign, harmless formation, a woman should pay attention to it and be examined by a doctor. This is especially necessary in the case of the appearance of several nodes, persistence of the lesion for a long time and increasing pain.

Fat necrosis is focal death of fatty tissue due to trauma in some area of the breast. The disease is usually classified as benign changes in the mammary gland, but this does not cease to be a disease that needs to be treated.

Why does the disease appear?

Fat necrosis is usually provoked by trauma, as a result of which small vessels are damaged, adipose tissue ceases to be supplied with blood, and necrosis develops. Such an injury could be an accidental elbow on public transport, or a serious bruise on a door frame. Sometimes necrosis occurs due to the effects of radiation therapy. The condition can manifest itself as a painless tumor in the mammary gland, which can be easily palpated (by palpation).

Why is necrosis dangerous?

Necrosis is an irreversible process. In the case of a relatively favorable outcome, reactive inflammation appears around the dead tissue, delimiting the dead tissue. Such inflammation is called demarcation inflammation, and the demarcation zone is called the demarcation zone. In this area, blood vessels are able to expand, plethora and edema appear, a large number of leukocytes are formed, which release a hydrolytic enzyme and melt the necrotic mass. The necrotic mass is resorbed by macrophages. This is followed by the process of proliferation of connective tissue cells, which are capable of replacing the area of necrosis. In the process of replacing dead masses with connective tissue, it is customary to talk about their organization. In these cases, a scar is formed at the site of necrosis. The process of overgrowing the area of necrosis with connective tissue leads to its encapsulation. In the case of dry necrosis and in the focus of necrosis that has undergone organization, calcium salts are deposited in the dead mass. Calcification (petrification) of the necrosis focus gradually develops. In some cases, the area of necrosis undergoes a process of ossification.

If necrosis is not treated

An unfavorable outcome of necrosis is septic (purulent) melting of the necrosis focus. Sequestration is observed - the process of forming a zone of dead tissue, which is not replaced by connective tissue, does not undergo autolysis, and is freely located among living tissues.

The results of various studies show: fat necrosis is not capable of turning into a malignant tumor, but successfully simulates it. The mammologist palpates the fat necrosis and performs an ultrasound and mammography on the patient. Often, a biopsy is performed to distinguish fat necrosis from malignancy. The disease is treated by removing the focus of fat necrosis - using the method of sectoral resection of the mammary gland.

Fat necrosis of the mammary gland is characterized by gradual necrosis of the tissue of the same name, followed by scarring of the problem area. This process develops in patches. It is quite difficult to differentiate between fat necrosis and cancer based on external signs and sensations. In both cases, painful sensations occur and the shape of the breast changes in both women and men.

General information

Fat necrosis is diagnosed in 0.6% of cases of breast growths. In men, this process in this area is detected extremely rarely. This fact is due to the lack of a sufficient amount of adipose tissue. Moreover, more often fat necrosis is diagnosed in overweight men.

The pathological process is most typical for women with large breasts. The risk zone includes patients of reproductive age (25-35 years).

Reasons

The main cause of necrosis of breast fatty tissue is trauma to the mammary glands resulting from:

bruise;
surgical intervention;
sampling material during biopsy.

The appearance of fat necrosis is promoted by rapid weight loss. Loss of body weight occurs against the background of severe systemic pathologies or when following a strict diet.

Factors that provoke necrosis of breast fatty tissue include:

tuberculosis;
malignant tumors;
endocrine disorders;
severe stress;
intoxication of the body.

It is also possible that necrosis will develop after radiation therapy and against the background of cardiovascular pathologies.

Tissue death occurs due to impaired blood circulation in the mammary glands. Because of this, the cells receive insufficient nutrients, which triggers the necrotic process.

When blood vessels are damaged, the body strives to restore tissue. Because of this, foci of inflammation appear in the problem area, separated from healthy areas. As the process progresses, tissue necrosis begins. But thanks to the activity of the body, the affected cells are removed naturally. And the necrotic focus is covered with fibrous tissue.

Symptoms

Due to the fact that necrosis develops after injury, signs of damage become noticeable before tissue death begins. The presence of a problem is indicated by:

the appearance of lumps in the chest;
nipple retraction;
painful sensations that intensify upon contact;
deterioration of the general condition of the body.

The tumor, which forms against the background of the inflammatory process, has an oval (rounded) shape. Upon palpation, an elastic structure is noted. The tumor is characterized by low mobility due to adhesion to neighboring tissues.

As the necrotic process progresses, the intensity of pain may decrease due to numbness of the skin. The skin over the source of inflammation acquires a red or bluish tint.

The deterioration of the general condition is associated with the fact that the decay products arising during the process of necrosis spread throughout the body, causing intoxication. Because of this, decreased appetite, poor sleep, and lethargy are possible. Body temperature remains within normal limits in most patients.

Diagnostic methods

If breast necrosis is suspected, information about the patient’s condition is first collected, and then the problem area is palpated. To make an accurate diagnosis, the following studies will be required:

X-ray;
tomosynthesis, which creates a two-dimensional image of the gland;
optical mammography.

To exclude a malignant tumor, material is taken (biopsy), followed by histological and cytological examination of the tissue. Additionally, a general blood test is prescribed to rule out bacterial infection.

Possible complications

Necrosis of adipose tissue provokes the formation of fistulas in the problem area. The course of the pathological process contributes to the addition of bacterial microflora and suppuration of tissues, which can cause the development of sepsis.

In advanced cases, patients with fat necrosis develop gangrene.

Treatment options

Elimination of necrosis of adipose tissue of the mammary glands is carried out through surgery. Conservative therapy and treatment with folk remedies are not applicable in this case. Medications are recommended to eliminate the consequences of surgery, as well as to suppress bacterial microflora. For this purpose:

Broad-spectrum antibiotics. The drugs not only suppress infections, but also prevent infection.
Vitamin complexes. Stimulates the restoration of damaged tissues.

Surgery for necrosis is used due to the difficulty of differentiating such a lesion from a cancerous tumor. Besides, After tissue death, tissues are not restored.

The type of operation is selected depending on the location of the necrotic process. Basically, sectoral is used, in which only part of the mammary gland is removed. After excision, tissues are sent for histological examination to exclude a malignant tumor.

Prognosis and prevention

The prognosis for adipose tissue necrosis is ambiguous. In most cases, there are no complications after surgery except that the woman is missing part of her breast. Tissue plastic surgery is used to restore the mammary gland.

The prognosis is unfavorable in cases of late presentation, when necrosis has caused systemic complications.

In order to prevent inflammation with subsequent death of breast tissue, it is recommended to avoid trauma to the breast. To do this, you should wear comfortable underwear, avoid contact sports, and avoid strict diets. Women (especially those of reproductive age) need to promptly treat breast diseases and endocrine pathologies. In addition, it is important to undergo regular examinations (once every six months) by a mammologist and immediately consult a doctor if palpation reveals lumps in 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:

General 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 is “Fat necrosis of the mammary gland” (only women have mammary glands). In men, this disease occurs very rarely - due to the scarcity of fatty tissue in the mammary glands. An exception may be gynecomastia - the development of female-type mammary glands in male patients.

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.

Reasons

The occurrence of fat necrosis of the mammary gland can be triggered by fundamentally 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 taking breast tissue to study it 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, such a biopsy is performed during breast surgery for 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 actions. These could be:

suction of purulent contents from (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 mammary gland can occur in women who, after a mastectomy (radical removal of the affected mammary gland), have undergone reconstructive mammoplasty (reconstruction of the mammary gland) 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 the destroyed walls of blood vessels with electric current);
grossly inaccurate diagnostic or therapeutic procedures, which can result in damage to the glandular tissue of the mammary gland, as well as its blood vessels and nerve endings.

Traumatic injury not associated with medical manipulation is one of the most common causes of fat necrosis of the mammary gland. According to the mechanism of development, such injuries are:

torn;
bruised;
bitten;
chopped;
chopped;
firearms.

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

household;
production;
sports.

Domestic injuries that can lead to the occurrence of the described disease can include 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:

A special type of trauma to breast tissue, against the background of which its fat necrosis can develop, is considered to be prolonged compression of the gland. 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 trapped in a vehicle before rescuers and doctors arrive. 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 associated with violation of labor safety rules (falling on slippery steps that lead to an office building) or ignoring safety rules (improper care of 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:

women's boxing;
all types of struggle;
women's football;
volleyball;
basketball;
tennis;
steeplechase

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 rapid weight loss before any important event - a wedding, a beauty contest, sports competitions (especially high-ranking ones, where a certain weight is an important condition for participation).

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, those affected by particularly aggressive forms);
– infectious lesion caused by Mycobacterium tuberculosis (Koch’s bacillus);
– disturbance of carbohydrate metabolism caused by a lack of insulin in the body;
– 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);
– senile dementia;
(Hodgkin's disease) – malignant lesion of lymphoid tissue;
any chronic intoxication in which and 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 effect on malignant neoplasms of the mammary gland;
frequent undergoing diagnostic procedures fraught with radiation exposure (fluoroscopy and others);
contact with radioactive substances due to professional activities. It is fraught with pronounced radiation exposure to the body if labor protection rules are violated or safety precautions (personal protective equipment) are ignored;
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, a sharp deterioration in the 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 a sharp disruption of the blood supply to a separate area of fatty tissue (this is why fat necrosis develops in the form of foci). The body reacts to such a process with reactive inflammation - at the 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.

Please note

Sometimes necrotic areas do not have time to disintegrate, and calcium salts are deposited in them - foci of petrification appear (. In some cases, this process is so intense that the processes of ossification (ossification) are launched - a foci is formed in the mammary gland, according to its structure and physical characteristics (density) similar to a piece 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 a violation of the general condition of the 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. In the future, with the formation of fat necrosis, pain may fade, and loss of sensitivity of soft tissues 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:

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;
deterioration of appetite, with the progression of pathology - its complete absence.

With fatty necrosis of the mammary gland, the temperature is usually normal and rises 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, medical history and the results of additional examination methods.

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.

Please note

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

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

– a set of methods that are used specifically to study the condition of the mammary gland;
mammary gland - 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: