Breast fat necrosis is a non-cancerous breast condition that forms when there's damage to fatty breast tissue. Women of any age can develop breast fat necrosis in any area of the breast, but middle-aged women with larger breasts may be most at risk.
Breast fat necrosis is harmless, but you'll want to check with your doctor to rule out any chance of breast cancer.
Causes of Breast Fat Necrosis
The breast consists 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
While 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. Women 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 been diagnosed with breast fat necrosis, it doesn’t mean you have a higher risk of developing breast cancer.
Signs of Breast Fat Necrosis
Breast fat necrosis typically feels like a round, firm lump to the touch. Some women experience tenderness, bruising, or dimpling in the area where the breast fat necrosis appears. Sometimes it can pull in the nipple.
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.
With 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 diagnostic imaging (like 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.
Treatment for Breast Fat Necrosis
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 that you have surgery to remove the growth if:
- A biopsy can’t clarify whether you have breast fat necrosis
- You experience pain because of the 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.
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 performing 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.
