Breast fat necrosis is a noncancerous condition that occurs when there's damage to fatty breast tissue. You can develop breast fat necrosis at any age in any area of the breast, but if you're middle-aged with larger breasts, your risk may be higher.
Breast fat necrosis is harmless, but you'll want to check with your doctor to rule out any chance of breast cancer.
What Causes Breast Fat Necrosis?
Your breasts consist of milk-producing glands and ducts surrounded by fatty tissue. Lumps can form in this tissue when the breast is damaged or injured. 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 lipomodelling)
- Breast biopsy
- Radiation therapy
- Breast reduction
- Mastectomy
Fat necrosis of the breast also can happen after blunt force injury, such as from a car accident.
Although your body typically replaces damaged breast tissue with scar tissue, sometimes the fat cells end up dying. If they do, a greasy fluid is released and collects into an oil cyst, which feels like a lump in the breast. Those who undergo surgery can end up with breast fat necrosis up to 10 years after having a procedure.
It's important to note that if you’ve received a diagnosis of breast fat necrosis, it doesn’t mean you have a higher risk of developing breast cancer.
Breast Fat Necrosis Symptoms
Breast fat necrosis typically feels like a round, firm lump to the touch. You might experience tenderness, bruising, or dimpling in the area where the breast fat necrosis appears. Sometimes, it can pull in the nipple.
When dying fat cells release fluid, your skin may appear red, bruised, or thickened.
When you undergo a breast reconstruction that involves autologous reconstruction (using a flap of tissue from a different part of your body), the fat in that piece of tissue may not have sufficient blood flow and end up dying. Breast fat necrosis from the procedure may not become noticeable until months later.
Smaller breast fat necrosis formations can dissolve or go away without further treatment. However, some can become large and painful enough to distort the look and feel of the breast.
Diagnosing Breast Fat Necrosis
You may notice the lumps when performing a self-breast exam at home or come across them during a general inspection of your body. The skin may look redder or thicker around the lump. While it's typically not painful, it’s a good idea to see a doctor about any unusual lumps in your breast.
During a physical exam, your doctor may not be able to distinguish the symptoms of breast fat necrosis from cancer. If this is the case, they may recommend that you undergo a mammogram or diagnostic imaging (such as an MRI) so that they can get a better look at the shape and texture of the lump.
They may also suggest getting a biopsy to take a sample of your breast tissue to confirm whether there are cancerous cells in the area.
You might have an excisional biopsy, which involves cutting through your skin to remove tissue from the lump to examine under a microscope.
Your doctor may order a core needle biopsy, which uses a hollow needle to remove tissue from the suspicious area.
You might have what's called a fine needle biopsy or aspiration, which uses a smaller needle to draw tissue or fluid from the suspicious area. This is the least invasive type of biopsy.
Breast Fat Necrosis Treatment
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.
Your physician may recommend surgery to remove the growth if:
- A biopsy can’t clarify whether you have breast fat necrosis
- You experience pain because of breast fat necrosis
- The breast fat necrosis doesn’t go away or gets bigger
To remove the fat necrosis, a surgeon will cut out the damaged or dead tissue. Before the operation, they'll provide you with a local or general anesthetic. You may end up with a small scar, but this typically fades as time passes.
Liposuction is another option for removing the fat necrosis. Your surgeon will use a local anesthetic and make a small cut into your skin. They will then insert a vacuum device and use imaging as a guide to remove the dead and damaged tissue.
Fine needle aspiration can drain an oil cyst, which will make the lump flatten.
A vacuum-assisted core needle procedure uses a larger needle and a vacuum device to remove tissue. It's similar to liposuction.
Having liposuction reduces the chances of having a divot in the area where the damaged breast tissue has been removed. If you do end up with some dimpling or other unevenness in the breast, your surgeon may fill in the area by doing a small flap reconstruction or using fat injections to add volume.
You should continue monitoring any changes to your breasts that happen before or after you receive treatment for breast fat necrosis. Let your doctor know about any concerns you have about the overall health of your breasts.
Takeaways
Fat necrosis in the breast happens when fat tissue in your breast dies, usually because of an injury or procedure. It's not dangerous to your health, and you may not feel any discomfort. It's a slow process, and you may not notice any changes until months after the event that caused it. You'll feel a lump, and the skin may appear dimpled, red, bruised, or thickened. You should see a doctor for a diagnosis, which might require imaging or a biopsy. You may be able to wait for the tissue to heal on its own, or you might need a procedure to remove the area.
Breast Fat Necrosis FAQs
Does breast fat necrosis go away?
Yes, fat necrosis in your breast will usually go away on its own. If it doesn't bother you, it's fine to wait it out. However, if it's painful or if its appearance is causing you distress, you can have a procedure to remove it.
What does breast fat necrosis look like?
You'll notice a lump or hard nodule under your skin. If the fat cells have begun to die, you may see a dimple or sagging skin. Your skin also might look red, bruised, or thickened.
How do you prevent breast fat necrosis?
If you have surgery involving your breast, follow your postsurgery instructions carefully. Obesity can be a risk factor for breast fat necrosis. Eating a balanced diet and maintaining a healthy weight may make the condition less likely.
