Adipose tissue necrosis is a usually non-painful change in the fatty tissue in the breast that often occurs as a result of exposure to force. Adipose tissue necrosis does not pose a health risk and generally does not require treatment.
What is adipose tissue necrosis?
Not all lumps in the breast, indicate breast cancer. Nevertheless, they should be clarified in the mammogram. Fatty tissue necrosis is the death of fatty tissue in the breast. Necrosis (Greek “nékrosis”, German “the killing”) is the destruction of single or multiple cells in the living body. In adipose tissue necrosis, this destruction of cells affects the adipose tissue cells in the breast. The escaping fat is absorbed by surrounding connective tissue. If this happens to several cells, a mock cyst gradually develops that is filled with oily fluid. The cyst can calcify over time and becomes palpable as a lump in the breast. By purely external examination, the benign lumps that result from fatty tissue necrosis cannot be distinguished from a malignant tumor.
Causes
Fatty tissue necrosis in the breast can have a variety of causes. Frequently, fatty tissue necrosis occurs as a result of exposure to force. These can occur in the form of blows, bruises, and contusions, for example, after a car accident or a fall. In this case, the fatty tissue cells in the breast are directly damaged and die. Fatty tissue necrosis can also occur after breast surgery. If blood vessels are severed in the chest during an operation, blood supply to the affected area is no longer guaranteed. The blood supply to the fatty tissue cells is interrupted. The result is the death of the fatty tissue. Necrosis can also result from improper injection of drugs. However, this happens rather rarely in the breast.
Symptoms, complaints, and signs
In the case of fatty tissue necrosis in the breast, there are usually no particular complaints that negatively affect the daily life or health of the affected person. For this reason, fatty tissue necrosis in the breast often does not require treatment. The affected person primarily suffers from a lump that has formed in the breast. This lump is visible by a slight swelling and can have a negative effect on the aesthetics of the affected person. Furthermore, in the case of fatty tissue necrosis in the breast, the patient’s lymph nodes are also swollen, with the nodes under the armpits being particularly affected by the swelling. The aesthetic complaints can also lead to depression or other psychological upsets, although these are relatively rare. Although fatty tissue necrosis in the breast is primarily harmless, it can also indicate breast cancer and should therefore always be examined. Pain does not usually occur if the fatty tissue necrosis in the breast is benign and does not represent a malignant tumor. If it is a malignant tumor, then metastasis to the affected person’s body may occur without treatment.
Diagnosis and progression
Fatty tissue necrosis in the breast is initially detected by simply palpating the breast. The lumps that result from fat tissue necrosis are often easily palpable. They can vary in size – depending on how much fatty tissue cells have been destroyed. If palpation reveals a hardening or lump in the breast, further diagnosis is important. Although fatty tissue necrosis is basically harmless, the lumps in the breast can also indicate malignant tumors or breast cancer. Further diagnosis is made by ultrasound examination. If necessary, the lumps in the breast are surgically removed and examined to rule out the possibility of breast cancer. The course of fatty tissue necrosis is unproblematic in the majority of cases. Fatty tissue necrosis in the breast is benign and is rarely accompanied by discomfort or pain.
Complications
In most cases, there are no particular complications or discomforts from fatty tissue necrosis in the breast. There is also no pain, so the patient can live with the symptom completely symptom-free.Life expectancy is also not reduced or changed by fatty tissue necrosis in the breast, and it is not mandatory to undergo treatment for this disease. A health risk usually does not occur either. In this case, the lymph nodes are swollen in the armpit area and lumps form in the breast. However, as long as the patient does not complain of pain or other symptoms, there is no need for treatment. The situation is different if the fatty tissue necrosis in the breast is caused by a tumor. In this case, the tumor must be removed to prevent it from spreading to other regions of the body. The earlier this is diagnosed, the higher the chances of complete recovery. If surgery is necessary for aesthetic reasons, it can also be performed and will not lead to complications. In some cases, the deformities can lead to decreased self-esteem or inferiority complexes in patients.
When should you see a doctor?
Changes in the tissue in the breast should always be presented to a doctor and thoroughly examined by him. If there is a formation of lumps, swellings or growths, it is advisable for a doctor to examine them. If there is pain or discoloration of the skin on the breast, there is reason for concern. A doctor should be consulted as soon as possible so that the causes can be clarified. If the breast increases in size, this observation should be discussed with a doctor. Especially in phases outside of menstruation, an enlargement of the breast tissue is unusual. If there is growth of the lymph, these should be presented to a physician. Although fatty tissue necrosis in the breast is not considered to require treatment, a visit to the physician is necessary to rule out other serious and life-threatening conditions. Therefore, special care should be taken especially in the case of tissue changes in the breast as well as in its immediate surroundings If there is a diffuse feeling that something could be wrong, a feeling of illness sets in or anxiety arises, it is advisable for these sensations to be discussed with a doctor. In addition, the breast tissue should be palpated by a physician at regular intervals during check-ups. Women who have suffered from previous breast conditions in the past are advised to consult a doctor as soon as possible if any changes occur.
Treatment and therapy
Fatty tissue necrosis does not generally require therapy. The lumps in the fatty tissue of the breast are not dangerous and normally do not bring complications. Surgical removal of tissue samples is nevertheless necessary in all cases. The lumps formed in the breast are similar in shape and size to malignant tumors. Only a detailed examination of the removed tissue can rule out the possibility that the indurations are a sign of breast cancer. If the examination of the removed tissue sample has determined that it is a benign fatty tissue necrosis, further treatment and removal of the necroses are not necessary from a medical point of view. In case of extensive involvement of fatty tissue in the breast, surgical measures can be initiated. The death of fatty tissue in large parts of the breast can lead to deformations and dents, which are also clearly visible externally. Restoration may thus become necessary for aesthetic reasons. In this case, the dead fat cells are removed to restore the breast to its natural shape. However, this treatment is only for cosmetic restoration and has no medical effect.
Outlook and prognosis
The outlook and prognosis for existing fatty tissue necrosis in the breast looks quite positive. Affected individuals often do not even notice this clinical picture, so that medical and drug treatment can be dispensed with. The fatty tissue breaks down on its own, resulting in the formation of small nodules. The dead tissue cells do not pose any danger or risk. Even without medical treatment, no aggravation is to be expected. However, in very rare cases, the dead tissue is malignant. In such a case, if the affected person consults an appropriate doctor, no complications are to be expected. The tissue is removed with a surgical procedure. The outlook and prognosis for a complete recovery looks very good.The course of the disease is different if the affected person completely forgoes medical treatment in such a case. Under certain circumstances, the small nodules can block individual blood vessels, which can lead to an embolism. This is often a pulmonary embolism. An existing fatty tissue necrosis in the breast should be examined at least once by an appropriate physician. This can positively influence the overall course of the disease.
Prevention
Targeted prevention of fatty tissue necrosis in the breast is not possible, as it often occurs due to unforeseen and, above all, unintentional violent events. It makes sense to protect oneself as much as possible from falls or accidents. It is also advisable to refrain from breast surgery that does not serve a medical purpose, in order to minimize the risk of blood vessel injuries as a result of the operation.
Aftercare
As a rule, when fatty tissue necrosis occurs in the breast, the affected person is definitely in need of surgical intervention by a physician. This is the only way to completely relieve the discomfort and prevent further complications, since self-healing cannot occur with fatty tissue necrosis in the breast. The earlier this complaint is detected, the better is usually the further course of the disease. After such an operation, the patient should in any case rest and also take care of his body. Stressful, strenuous or sporting activities should be avoided in order not to put unnecessary strain on the body. Further measures or options for aftercare are usually not available to the patient and are not necessary. The tissue should still be checked after removal, as it could be malignant tissue. Furthermore, regular examinations are also useful in order to detect and treat tumors in the body at an early stage. Since fatty tissue necrosis in the breast can also lead to aesthetic and thus psychological discomfort, a visit to a psychologist is not infrequently also very useful. Whether fatty tissue necrosis in the breast leads to a reduced life expectancy cannot be universally predicted in this regard.
What you can do yourself
Because fatty tissue necrosis in the breast often results from exposure to violence, the patient should take care to clarify and correct the causes of the violence. If there are regular beatings or physical altercations with family members, friends or partners, it is advisable to seek help. There are various state-run drop-in centers where victims of physical violence are cared for and receive comprehensive assistance. If the fatty tissue necrosis in the breast developed as a result of a one-time event following an accident or fall, care should be taken to ensure that this incident is well processed emotionally. If nightmares develop or fears arise, the affected person is well advised to seek therapeutic help. In addition, he should talk about the experience with other people in order to be able to process it well. To avoid further illnesses, the breast can be palpated independently at regular intervals and checked for lumps or hardening. Until existing complaints have subsided, the breast tissue should be protected by the possibility of further external influence. Bruising, sleeping on the breast at night or intense physical activities such as jumping or running should be avoided. The breast is to be spared, provided with sufficient warmth and should be protected from strong vibration effects within the motion sequences.
