Treatment of fatty necrosis of the breast. Fat necrosis Breast fat necrosis 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 their breasts should be protected from squeezing with a bra, cover their breasts with their hands during a massive crowd of people, and in every possible way avoid even the most minimal chest injuries. This is because the mammary gland consists of extremely sensitive tissues, which, at the slightest impact, can change their structure. The mammary glands are very susceptible to such pathological processes as mastopathy, fibroadenoma, mastitis, papillomas. There may also be fat necrosis of the breast.

Fatty necrosis of the mammary gland. Causes of lipogranuloma

Fatty necrosis of the mammary gland is an aseptic focal necrosis of fatty tissue. In this case, adipose 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. Fat necrosis of the mammary glands is more susceptible to patients with large breasts than with small ones.

Traumatic factors that can provoke fatty necrosis of the mammary glands: accidental bumps 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 augmentation or mastectomy.

What happens in breast tissue during fat necrosis?

With injuries to the breast tissue, small capillaries of the fatty tissue area are damaged. Further, breast tissues react to this process by the appearance of an inflammatory reaction. A demarcation zone is formed, which limits the dead tissue. After the 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 is formed. In the future, calcium salts are deposited in such areas of necrosis of the adipose tissue of the mammary gland, and petrification of the foci occurs. In rare cases, ossification processes are observed.

Symptoms of fatty necrosis of the breast

After a chest injury, a painful swelling appears, which is soldered to the skin. It has a dense texture and a rounded shape. Later, the affected area of adipose tissue begins to lose sensitivity. Outwardly, the gland may change in color - the skin of the gland may acquire a bluish or red tint, the nipple may be somewhat retracted. Such a picture often resembles mastitis and misleads women, but it is very easy to distinguish fatty necrosis from mastitis - with mastitis, there will be an increase in body temperature to febrile numbers.

With all this, fat necrosis can be clinically similar to breast cancer. Deformation of the mammary gland, the 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 neglected states, fat necrosis can occur in the form of sequestration and tissue melting.

Diagnosis of fatty necrosis of the breast

In the diagnosis of fatty necrosis, it is of great importance to indicate the patient's history of a chest injury that has occurred recently. On palpation, a mammologist determines a painful induration that does not have clear contours and can fluctuate.

When conducting ultrasound of the mammary glands, CT or MRI, a heterogeneous formation of a nodular nature is detected, which has stringy 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 looks like a spherical calcification of the "eggshell" type. This allows you to exclude the malignancy of the process.

For differential diagnosis, it is advisable to conduct a biopsy of the gland tissues with subsequent histological examination. Breast biopsy is performed under ultrasound guidance.

Treatment and prevention of fatty necrosis of the breast

In the presence of fat necrosis, only surgical treatment is indicated - organ-preserving sectoral resection of the mammary gland. After that, 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 a serous and oily fluid.

If the gland is injured, it is necessary to give it an elevated position 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 the subcutaneous adipose 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 may look like breast cancer. An accurate diagnosis is established by biopsy. Other names for the pathology are lipogranuloma and fatty necrosis of the mammary gland. This is not a tumor and not a wen (lipoma).

Pathology is not harmful to health and is often asymptomatic and disappears on its own over time. However, with the appearance of a nodular formation in the chest, 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 finds a seal in her chest is that it is an oncological disease. often accompanied by the following symptoms:

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

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

A fatty cyst can form inside the lipogranuloma - a benign formation consisting of soft adipose tissue surrounded by a dense wall, which can be calcified. Such cysts form for no apparent reason, as well as after operations on the gland or its injuries. They pass 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 the operation leads to a violation 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 break down dead cells. As a result of their activity, inflammation first occurs, and then scar tissue forms at the site of the lesion. From dead cells, fat is also released, which fills the cystic cavity. As a result of these two processes, a seal is formed, called an oleogranuloma.

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

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

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

Much less often, lipogranuloma develops when:

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

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

Symptoms

The knot is formed 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, retraction of the skin. In this case, a thorough diagnosis is required to rule out cancer.

Diagnostics

Often, the patient herself discovers the oleogranuloma. 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 less than 2 cm in size. Sometimes it is surrounded by a thin, dense capsule, which makes it possible to first distinguish it from a cancerous tumor. With a thickening or unevenness of such a shell, the doctor must definitely exclude a malignant process. Often find calcifications - accumulations of lime in the granuloma.

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

One of the main ways to diagnose oleogranuloma is mammography.

An MRI study is not prescribed because it does not provide conclusive evidence of the absence of cancer, but 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 an oleogranuloma may be the presence of liquid fat, fibrous tissue around it, and inflammation. Calcifications begin to be determined 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 resolves spontaneously. If pain occurs, you can take an anesthetic (Ibuprofen), do a light massage, apply a warm compress. Warm compresses can be used repeatedly, applying them for 30 minutes every 4 hours.

Removal of an oleogranuloma of the mammary gland is carried out very rarely, only with a large size of the formation or increased anxiety of the patient. During the operation, a small area of tissue containing a granulomatous node is excised.

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

Treatment with folk remedies is aimed only at relieving minor pain. Compresses with a golden mustache, onion gruel, cabbage leaf are used.

How is an oleogranuloma removed?

Before the operation, the usual 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.

The mammary gland is performed without removal of 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 bred to the sides.

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 resection of the mammary gland

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

The operation takes about half an hour. Technically, it is simple and rarely causes complications. After it, the patient is 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, edema, redness of the gland, increased pain in it within a month after the intervention, it is necessary to urgently contact the surgeon.

Forecast and consequences

In most women, the compacted focus goes away on its own. If this does not happen, it is removed surgically. After the disappearance or removal of fat necrosis, 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, the preservation of the focus for a long time and increasing pain.

Fat necrosis is focal necrosis of adipose tissue due to trauma in some area of the breast. The disease is usually referred to as benign changes in the mammary gland, but this does not stop it from being a disease that needs to be treated.

Why does the disease appear

Fat necrosis usually provokes trauma, as a result of which small vessels are damaged, adipose tissue ceases to be supplied with blood, necrosis develops. Such an injury can be an accidental elbow strike in public transport, a serious bruise on the door jamb. Sometimes necrosis occurs due to exposure to radiation therapy. The condition can be manifested by the appearance of a painless tumor in the mammary gland, which can be easily palpated (by palpation).

What is dangerous necrosis

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, and the demarcation zone is called the demarcation zone. In this area, the blood vessels are able to expand, plethora, edema appear, a large number of leukocytes are formed, which release the hydrolytic enzyme and melt the necrotic mass. The necrotic mass is resorbed by macrophages. This is followed by the process of reproduction of connective tissue cells, which is able to replace the site 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 on the site of necrosis. The process of fouling of the area of necrosis with connective tissues leads to its encapsulation. In the dead mass in the case of dry necrosis and in the center of necrosis, which has undergone organization, calcium salts are deposited. Calcification (petrification) of the focus of necrosis gradually develops. In some cases, the process of ossification takes place at the site of necrosis.

If necrosis is not treated

An unfavorable outcome of necrosis is septic (purulent) melting of the focus of necrosis. Sequestration is observed - the process of formation of 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 that fatty necrosis is not able to turn into a malignant tumor, but successfully simulates it. A mammologist performs palpation of fat necrosis, performs an ultrasound scan and mammography. Often, a biopsy is performed to distinguish fat necrosis from malignancy. The disease is treated by removing the focus of fat necrosis - by the method of sectoral resection of the mammary gland.

Fatty 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 foci. By external signs and sensations, it is quite difficult to differentiate fat necrosis or cancer. In both cases, pain occurs 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 zone is extremely rare. This fact is due to the lack of a sufficient amount of adipose tissue. However, 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).

Causes

The main reason for the development of necrosis of adipose tissue of the breast is trauma to the mammary glands resulting from:

injury;
surgical intervention;
sampling during a biopsy.

Rapid weight loss contributes to the appearance of fat necrosis. Weight loss occurs against the background of severe systemic pathologies or while following a strict diet.

Among the factors that provoke necrosis of adipose tissue of the breast include:

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

Also, the possibility of developing necrosis after radiation therapy and against the background of cardiovascular pathologies is not excluded.

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 repair tissue. Because of this, foci of inflammation appear in the problem area, separated from healthy areas. As the process progresses, tissue necrosis starts. But due to the activity of the body, the affected cells are removed naturally. And the necrotic focus is tightened by fibrous tissue.

Symptoms

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

the appearance of seals in the chest;
retraction of the nipple;
pain, aggravated by contact;
deterioration in the general condition of the body.

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

As the necrotic process progresses, the intensity of pain may decrease due to skin numbness. Covers over the focus of inflammation acquire a red or cyanotic hue.

The deterioration of the general condition is associated with the fact that the decay products that occur in the process of necrosis spread throughout the body, provoking intoxication. Because of this, a decrease in appetite, poor sleep, and lethargy are possible. Body temperature remains within the normal range 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, a material is taken (biopsy) followed by histological and cytological examination of tissues. 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 attachment of bacterial microflora and suppuration of tissues, which can cause the development of sepsis.

In advanced cases, gangrene occurs in patients with adipose tissue necrosis.

Methods of treatment

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

Broad spectrum antibiotics. Drugs not only suppress infections, but also prevent infection.
Vitamin complexes. Stimulates the repair of damaged tissues.

Surgery for necrosis is used due to the difficulty in differentiating such a lesion from a cancerous tumor. Besides, tissue does not regenerate after death.

The type of operation is selected depending on the localization of the necrotic process. Sectoral is mainly used, in which only part of the mammary gland is removed. Tissues after excision are sent for histological examination in order to exclude a malignant tumor.

Forecast and prevention

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

The prognosis is poor 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 breast injuries. To do this, you should wear comfortable underwear, give up contact sports, and avoid strict diets. Women (especially of reproductive age) need to treat breast diseases and endocrine pathologies in a timely manner. In addition, it is important to regularly (once every six months) be examined by a mammologist and immediately consult a doctor if palpation reveals seals in the chest.

Fatty 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.

For this pathology, a dense painful formation, retraction of the skin and a change in its color are characteristic - such signs make one suspect the presence of a tumor process.

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

Table of contents:

Total information

Fatty 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, 0.6% of all diagnosed clinical cases fall on it.

When this pathology is mentioned, the disease in women is meant. With the defeat of the male representatives, the diagnosis sounds like “Fatty necrosis of the breast” (mammary glands are only in women). In men, this disease occurs very rarely - due to the scarcity of fatty tissue of the mammary glands. An exception may be gynecomastia - the development in male patients of the mammary glands according to the female type.

Mostly women of the childbearing period get sick - the age category from 25 to 35 years is mainly affected.

Pathology has other names - it is oleogranuloma, lipogranuloma and steatogranuloma.

Causes

The occurrence of fatty necrosis of the mammary gland can provoke fundamentally different reasons - for convenience, they are divided into groups:

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

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

when performing medical manipulations (in this case it is also called iatrogenic);
outside of the healing process.

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

diagnostic;
actually curative.

Such diagnostic manipulations include the sampling of breast tissue for examination under a microscope. She happens:

puncture - the skin and underlying tissues of the mammary gland are pierced, suspicious contents are sucked out with a syringe;
sectional - cut off a section of suspicious tissues. Most often, such a biopsy is performed during surgery on the mammary gland for cancer.

Cases have been described when a biopsy was performed in case of suspected development of breast fat necrosis, which did not confirm the diagnosis - however, fatty necrosis developed later as a result of the biopsy.

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

suction of purulent contents from (recently practiced very rarely as a controversial and ineffective method of treatment);
opening and emptying the purulent focus of this organ;
removal of a fragment of the mammary gland due to a particular disease - necrosis, benign or malignant tumor, tuberculous focus, and so on;
plastic surgery. Fat necrosis of the mammary gland can occur in women who, after mastectomy (radical removal of the 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 tissues - for example, when removing large sections of it, stopping bleeding with the help of diathermocoagulation (“cauterization” of the destroyed walls of blood vessels with electric current);
gross inaccurate diagnostic or therapeutic manipulations, which is fraught with damage to the glandular tissue of the mammary gland, as well as its blood vessels and nerve endings.

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

torn;
bruised;
bitten;
chipped;
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 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:

Prolonged compression of the gland is considered to be a special type of trauma to the tissues of the mammary gland, against which its fatty necrosis may develop. Most often it occurs during disasters:

natural - these are soil collapses 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 in traffic accidents, when people are trapped in a vehicle before the arrival of rescuers and doctors. Basically, this type of trauma is observed during:

car or bus accident;
train wreck.

Occupational injuries of the mammary gland, contributing to the development of its fatty necrosis, are less common than domestic ones. They are mainly associated with violation of labor protection rules (falling on slippery steps that lead to the office space) or ignoring safety regulations (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 have chosen strength sports or those that are associated with the risk of falls. This:

women's boxing;
all kinds of wrestling;
women's football;
volleyball;
basketball;
tennis;
running with obstacles

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 quickly losing weight before any important event - a wedding, a beauty contest, sports competitions (especially of a high rank, where a certain weight is an important condition for participation).

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

rapidly progressing oncological diseases (in particular, the defeat of their especially aggressive forms);
- an infectious lesion caused by Mycobacterium tuberculosis (Koch's wand);
- a violation of the metabolism of carbohydrates, provoked 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;
insufficiency of the adrenal cortex (other names - Addison's syndrome, hypocorticism);
- senile dementia;
(Hodgkin's disease) - a malignant lesion of the lymphoid tissue;
any chronic intoxication in which and are regularly observed.

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

radiation therapy - in particular, the effect on malignant neoplasms of the mammary gland;
frequent passage of diagnostic procedures fraught with radiation exposure (, fluoroscopy and others);
contact with radioactive substances due to professional activity. It is fraught with pronounced radiation effects on the body in case of violation of labor protection rules or ignoring safety precautions (individual protective equipment);
unauthorized access to radioactive substances.

A group of factors that are not direct provocateurs of the development of fatty necrosis of the mammary gland, but can contribute to the necrosis of its tissues, has also been identified. It does not mean that under the influence of such factors, the described pathology develops without fail - nevertheless, 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 tissues are disturbed;
blood diseases - the consequences are the same as with vascular pathology;
regular wearing of tight clothing.

Development of pathology

At the heart of the maximum majority of disorders that lead to the necrosis of breast tissue and the formation of areas of fatty necrosis is a violation of blood supply and, as a result, a sharp deterioration in the nutrition of these tissues.

The mechanism of development of pathology is as follows. Damage to the capillaries (traumatic or against the background of a particular disease) leads to a sharp violation of the blood supply to a separate area of fatty tissue (therefore, fatty 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 the so-called demarcation line around it - it separates the affected tissues from healthy ones.

After some time, dead tissues disintegrate, the decay products are removed from the mammary gland with the bloodstream. If there are many or large necrotic foci in the mammary gland, an abundance of decay products can provoke the onset of an intoxication syndrome.

Since defense mechanisms are activated, 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 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 appear (. In some cases, this process is so intense that ossification (ossification) processes are triggered - a focus is formed in the mammary gland, in its structure and physical characteristics (density) resembling a piece of bone tissue.

In adverse cases, the progression of the described pathology of the mammary gland can take place with:

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

Symptoms of fatty necrosis of the breast

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

Symptoms of fatty necrosis of the breast are:

tumor formation;
retraction of the nipple;
pain syndrome;
signs of a violation of the general condition of the body.

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

in shape - round or ovoid (egg-shaped);
by consistency - dense, at the same time elastic;
by mobility - soldered to the skin, so its mobility is limited;
by 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 connected with the fact that in the process of necrosis the nerve endings also become dead;
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.

Retraction of the nipple is observed if the focus of fatty necrosis is formed in the thickness of the mammary gland in the area of the areola.

Characteristics of the pain syndrome:

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

deterioration in general condition, feeling unwell;
general weakness and lethargy;
worsening 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 fatty necrosis of the mammary gland is made on the basis of complaints, anamnesis and the results of additional examination methods.

The physical examination determines the following:

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

note

In some cases, changes similar to signs can be observed - its deformation, the formation of "dimples" on the skin, a dense infiltrate, as well as an increase in peripheral lymph nodes.

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

- a set of methods that are used specifically to study the state of the mammary gland;
mammary gland - make tissue sampling with subsequent study under a microscope.

During a mammogram, 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 for obtaining a tomographic image of the breast;
optical mammography - when it is carried out, optical equipment is used.

Informative in the diagnosis of fatty necrosis of the mammary gland are the following laboratory research methods: