Mammographic manifestations and pathologic study of fat necrosis of the breast

Objective: To discuss mammographic findings and pathologic foundation of the fat necrosis of the breast and to improve the imaging diagnosis of the fat necrosis of the breast. Methods: The mammographic findings of 91 cases with pathologically proved breast fat necrosis were retrospectively analyzed, of which 2 cases were bilateral breast fat necrosis, and a comparison with pathological results was made. Results: The mammographic findings included (1) No abnomal mammographic findings (n=14, 15.4%); (2) Single and multiple lipid-cysts (n=6, 6.6%); (3) Masses (n=20, 22.0%), of which 1 case was bilateral breast mass; (4) Nodules (n=13, 14.3%); (5) Focal opacities like stars or pieces in the subcutaneous fat layer (n=28, 30.8%), of which 1 case was bilateral breast lesion; (6) Faint reticular opacity in the subcutaneous fat layer (n=5, 5.5%); (7) Structure distortion (n=5, 5.5%). The location of the liesions: (1) 55 lesions located in fat layer; (2) 13 lesions standed out to the fat layer or located the boundary of the fat layer and breast parenchyma. When routine mammography demonstrated the disease located the boundary of the fat layer and breast parenchyma, there will be helpful with tangent location mammography to show the disease in the subcutaneous fat layer; (3) 9 lesions located in the breast parenchyma; (4) 14 lesions did not find abnormity in the mammography. The pathologic appearance (1) A lipid cyst is the characteristic mammographic finding in the early stage of the lesion; (2) Asymmetry density masses or nodules in the subcutaneous fat layer is the characteristic mammographic finding in the metaphase stage of the lesion, which hinted necrotic fatty tissue gradually be rep laced by fibrous tissue; (3) Focal opacities like stars and irregular reticulation findings in the subcutaneous fat layer or superficial layer adenoid tissues are the characteristic mammographic findings in the later stage of the lesion, which hinted that necrotic fatty tissue was licked up, circumference remained some fibrous tissue. The mammographic findings of the different pathological stages often appear in the same time. Conclusion: The mammographic findings of fat necrosis of breast was different in its different stage. The mammography is very helpful for making the diagnosis of breast fat necrosis. (authors)