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 being squeezed by 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 mammary gland.
Fatty 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, 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 those 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 the breast tissue during fat necrosis?
In case of 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 fat 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. This picture often resembles mastitis and misleads women, but it is very easy to distinguish fat 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 conditions, fat necrosis can occur in the form of sequestration and tissue melting.
Diagnostics of breast fat necrosis
In the diagnosis of fat necrosis, the indication of the patient's history of a recent chest injury is of great importance. On palpation, the mammologist determines a painful induration that does not have clear contours and may fluctuate.
When performing 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 makes it possible to exclude the malignancy of the process.
For differential diagnosis, it is advisable to perform a biopsy of the gland tissues with subsequent histological examination. Breast biopsy is performed under ultrasound guidance.
Treatment and prevention of breast fat necrosis
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 - thin-walled cavities 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.
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