TY - JOUR
T1 - A pictorial review
T2 - Multimodality imaging of benign and suspicious features of fat necrosis in the breast
AU - Tayyab, Sidra J.
AU - Adrada, Beatriz E.
AU - Rauch, Gaiane Margishvili
AU - Yang, Wei Tse
N1 - Publisher Copyright:
© 2018 The Authors.
PY - 2018
Y1 - 2018
N2 - Fat necrosis of the breast is a well-described benign entity that can result in unnecessary biopsy of breast lesions. The pathogenesis of fat necrosis is a non-suppurative inflammatory process of adipose tissue, which may be seen after trauma, surgery, biopsy, post-breast reconstruction, post-fat grafting, post-radiotherapy, infection, and duct ectasia, among other conditions. Clinically, these patients may be asymptomatic or may present with a palpable lump, skin tethering, induration, and occasionally axillary lymphadenopathy. Depending on the time at which diagnostic imaging is performed, fat necrosis can have highly variable appearances on different modalities as it evolves. This is directly related to whether inflammation or fibrosis is predominating within the lesion, and correlation with clinical history is paramount in evaluating these patients. This review aims to analyze benign and suspicious imaging features of fat necrosis confirmed by tissue sampling. Knowledge of both benign and malignant-appearing features of fat necrosis on conventional modalities such as mammography and ultrasound, as well as newer applications including digital breast tomosynthesis, PET/CT, and MRI, should help the radiologist minimize the number of unnecessary biopsies.
AB - Fat necrosis of the breast is a well-described benign entity that can result in unnecessary biopsy of breast lesions. The pathogenesis of fat necrosis is a non-suppurative inflammatory process of adipose tissue, which may be seen after trauma, surgery, biopsy, post-breast reconstruction, post-fat grafting, post-radiotherapy, infection, and duct ectasia, among other conditions. Clinically, these patients may be asymptomatic or may present with a palpable lump, skin tethering, induration, and occasionally axillary lymphadenopathy. Depending on the time at which diagnostic imaging is performed, fat necrosis can have highly variable appearances on different modalities as it evolves. This is directly related to whether inflammation or fibrosis is predominating within the lesion, and correlation with clinical history is paramount in evaluating these patients. This review aims to analyze benign and suspicious imaging features of fat necrosis confirmed by tissue sampling. Knowledge of both benign and malignant-appearing features of fat necrosis on conventional modalities such as mammography and ultrasound, as well as newer applications including digital breast tomosynthesis, PET/CT, and MRI, should help the radiologist minimize the number of unnecessary biopsies.
UR - http://www.scopus.com/inward/record.url?scp=85056960985&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056960985&partnerID=8YFLogxK
U2 - 10.1259/bjr.20180213
DO - 10.1259/bjr.20180213
M3 - Review article
C2 - 29987981
AN - SCOPUS:85056960985
SN - 0007-1285
VL - 91
JO - British Journal of Radiology
JF - British Journal of Radiology
IS - 1092
M1 - 20180213
ER -