Fat necrosis is the destruction of fat cells inside the body. It is usually benign, but it can be a symptom of a more serious underlying problem. People often report to the doctor for treatment because it results in the formation of a hard lump at the site of the destroyed cells and the patient may think that the lump is a tumor or another cause for medical concern. Treatment for fat necrosis varies, depending on the location and the underlying causes.
In fat necrosis, fat cells are broken down by the body, usually in response to trauma. It can happen after surgery, as a result of physical stress, in the wake of radiation therapy, and in association with chronic diseases like pancreatic disease. As the cells break down, a mass of rubbery tissue can form. This lump will be palpable to the patient if it is near the surface.
A common site for fat necrosis is in the breast. Patients usually view lumps in the breast as a cause for concern and may seek medical treatment when they identify the unusual deposit of tissue. Other areas where this condition can arise include the thighs, where a lump will also be palpable, and in the fat that surrounds the kidneys. In this last case, the necrosis will usually be identified by a doctor during other diagnostic testing involving the kidneys such as an imaging study.
In the case of lumps in sites like the breast and thighs, it is not uncommon for the skin above the site of the necrosis to become mottled or lumpy. The patient may feel pain or heat in the area as a result of inflammation, and sometimes discharges develop. Treatment for fat necroses can include warm compresses along with anti-inflammatory medications to reduce the pain and swelling associated with the lump. In the breasts, the lump may be biopsied if a doctor cannot confirm that it is caused by fat necrosis through medical imaging such as mammography.
When the fat around the kidneys is damaged, it is indicative of kidney disease. The patient will need treatment for the kidney disease, including monitoring of kidney function. Another type of fat necrosis can be seen in newborns after traumatic births. The newborn may be worked up for signs of undiagnosed complications from the birth and treatment will be provided to address the lump of scar tissue that forms at the necrosis site.
How Long Does Fat Necrosis Last?
Fat necrosis is relatively common after breast reconstruction for breast cancer. While it can be painful and a cause for concern, it is a benign complication.
Fat necrosis has been known to mimic tumor recurrence and as such, a doctor should monitor it. However, if your doctor confirms the presence of fat necrosis, you can expect it to run its course within two to three years.
Can Fat Necrosis Be Treated?
In most instances, fat necrosis is harmless and if left alone, the body will break it down on its own. Depending on the severity, this process could take anywhere from a few months to a few years.
In some cases, it’s not possible to conclusively diagnose fat necrosis, and treatment or further testing may be needed. If you start to notice the lump getting bigger after an initial diagnosis of fat necrosis, you should immediately consult your doctor.
Surgery is typically avoided to treat or diagnose fat necrosis since this can be a leading cause of it in the first place.
However, you may need an operation if any of the following situations occur:
- The original biopsy was insufficient to confirm a diagnosis of fat necrosis
- The fat necrosis is painful or tender to the touch
- The lumpy area continues to grow and does not go away promptly
What Type of Treatment Options Are There for Fat Necrosis?
If it is decided that you need treatment for fat necrosis, the routine surgery required will be an excision biopsy. This operation removes the damaged tissue, and doctors can choose to perform it with a local or general anesthetic. There is minimal scarring involved that will fade over time.
Another treatment option is a vacuum-assisted excision biopsy. After receiving a local anesthetic, a small cut is made on the skin. A vacuum device attached to a probe goes into the cut. The vacuum sucks tissue through the probe into a collecting chamber until removing all of the fat necrosis.
In less severe cases of fat necrosis, if surgery is not required, but pain persists, your doctor may prescribe pain relief medication like paracetamol or an anti-inflammatory drug such as ibuprofen.
How Do I Know If I Have Fat Necrosis?
As the most common location for fat necrosis is in the breast, most patients see their doctor out of fear of possible breast cancer.
Your GP will examine you but most likely refer you to a breast clinic for further testing. These tests include a mammogram, ultrasound scan, or biopsy. In some instances, it’s possible to diagnose fat necrosis right away.
However, fat necrosis is often confused with breast cancer even by experienced radiologists. If they can not eliminate breast cancer as a possibility, they will perform a biopsy.
Typically, after a biopsy, there will be a definitive diagnosis of whether it is fat necrosis or something else.
Can Fat Necrosis Cause Cancer?
Fat necrosis in the breast is a benign condition and has not proved to cause or develop into cancer. While it can be painful and last a few years after diagnosis, fat necrosis is a harmless condition that will break down over time.
Other cases of fat necrosis can be indicative of an underlying condition in some cases, but they do not cause cancer.
What Is the Most Common Cause of Fat Necrosis?
The most common cause of fat necrosis is trauma, particularly to the breast tissue during surgery. The trauma disrupts the oxygen supply to fat cells, leading to cell death. The result is lumps of tissue in the breast area.
Other types of fat necrosis occur in the body. These are also typically caused by some type of trauma that kills cells.
Radiation treatments in breast cancer patients can also cause fat necrosis. It is also common in other breast cancer treatments, such as a lumpectomy or a biopsy.
It has also been known to occur in other breast-related procedures. The most common of these are breast reduction or reconstruction surgery, removal of breast implants, and in some cases, breast augmentation.
The average age of fat necrosis patients is 50 years old.
