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Topic: Fat necrosis...

Forum: Not Diagnosed But Worried —

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Posted on: Apr 16, 2012 02:06PM

Sommer43 wrote:

Has anybody had fat necrosis diagnosed, just with ultrasound?  Without biopsy? 

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Apr 16, 2012 02:08PM marie5890 wrote:

Sommer,

For all the time I have been here I have never seen any woman Dx with fat necrosis based on imaging alone. If anything, it can mimic cancer in how it looks, that is why a biopsy is needed has been what I have observed with ladies who in the end had fat necrosis.

Hope that helps.

Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.
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Apr 16, 2012 02:29PM Sommer43 wrote:

Hi Marie,

With 1,580 posts, then you've been here sometime, so that does help thank you.  A lady I was talking to today, was sent home being told without a biopsy that it was fat necrosis...  And not to worry.  I have suspected fat necrosis in one mass, after surgery, which was biopsied. 

I am so shocked at this. 

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Apr 16, 2012 03:54PM Sommer43 wrote:

http://www.hkmacme.org/course/2010BW01-03-00/OGCS_Jan10.pdf

 Paper on fat necrosis. 

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Apr 17, 2012 03:13PM J9W wrote:

Hi Sommer43,  I was told I have fat necrosis, so far based only upon physical exam.  I have a small lump in the front of my shoulder, close to the arm pit, and my BS said fat necrosis. However, next month I'm having an excisional biopsy.  I'm leaning towards it being a result of trauma....I fell last September while running through the woods and still have a bruise on my knee and my elbow is sore as heck still  - so my fingers are crossed that this is just a result of landing harding on tree roots.

DCIS, grade 3, 2009. Right mastectomy, tamoxifen for only 11 months.
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Apr 17, 2012 03:22PM Sommer43 wrote:

HI J9W

I think I am about read up on fat necrosis, including the above paper.  Mine was biopsied, which I am relieved about.  Can I ask, why you are having an excisional for it?  Sounds like the trauma has caused it, and I am surprised at my trauma to the breast, since my excisional of a fibroadenoma, which I was not consulted about when I opted for a removal.  I now have quite a large mass that the radiologist stated he could feel under the probe.  I am confident it is fat necrosis, given the fact that it was the clinical director of breast screening who performed the ultra sound and he is clearly very experienced in imaging, recommending an FNA to ensure this was the case. 

 It is painful, excision will be likely if this pain comes along as it is currently, alas will that set me up for more problems? 

 Is yours painful? 

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Apr 17, 2012 04:00PM J9W wrote:

Hi again,  no mine isn't painful.  I had actually thought it was a swollen gland (so freaked out) but my BS said there aren't any glands where I have the lump. Instead of calling her right when I discovered the lump, I consulted Dr. Google and via a search for 'lymph glands near the shoulder' I could see my lump is located where there are deltopectorial and infraclavicular nodes (why I freaked out)....but my BS told me that this lump was too close to the surface for it to be a node - so most likely it's a fat necrosis. However she did state that sometime she's wrong so for peace of mind we should take it out and she said she could do it as outpatient in her office, a little numbing stuff and cut away. Also, it's very little so it will probably be only one stitch - two at most, and a needle biopsy might not get it.  I had been dxd with DCIS in 2009, grade 3, right mastectomy, so she doesn't mess around. Plus, I have an MRI every six months and the one I had in February ended up with a grade 3 Birads of the left breast.  Better safe than sorry, I guess. 

DCIS, grade 3, 2009. Right mastectomy, tamoxifen for only 11 months.
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Apr 17, 2012 04:16PM Sommer43 wrote:

Thanks for that, J9W. 

I have quite a large area, not a lump, more of a molehill.  I see now, why you are having this removed, to be on the safe side. 

I am interested in how fat necrosis has come so largely and so soon after my excisional.  I seem to be running into another problem now and mine is quite painful, clearly my breast didn't like the excisional and the FNA and the biopsy... 

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Apr 17, 2012 04:58PM J9W wrote:

I keep finding there is more and more to learn about this journey. For instance, although lymphadema was mentioned to me, I had NO idea that it really is a problem. After reading here what some people go through with that, I'd be very reluctant to let anyone take more than one or two glands from me. And FAT necrosis - really??? Couldn't they even come up with a better name - when my doc said that to me I was thinking 'great, now my fat is bubbling to the surface!'

DCIS, grade 3, 2009. Right mastectomy, tamoxifen for only 11 months.
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Apr 17, 2012 05:08PM Sommer43 wrote:

Hi there, oh that made me laugh, J9W, it is a horrid name... 

I read last night, that fat necrosis happens more in women who have pendulous breasts and corpulent. 

I am 64 kilograms and have a 34 b bust. 

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Apr 17, 2012 07:56PM nandksmom wrote:

My biopsy was what determined what was seen on the ultrasound was fat necrosis (I mistyped in an earlier post).   My doctor told me that it can present very similar to cancerous lump because the edges and shape are not always clearly defined.  During the biopsy the lump "disappeared" from the screen (I had an ultrasound guided biopsy), and at that point the doctor performing the biopsy said he no longer though it very suspicious.  I did, of course, worry until I got the results back confirming.  I will go back in 6 months for a new baseline, this time not just before I leave for vacation LOL.   I hate the name too. Wink
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Apr 17, 2012 08:16PM marie5890 wrote:

Well we can look at it in a funny manner since breast tissue is made up of fat....

 Fat necrosis = dead fat cells... (necrosis/necrotic means dead. )

so----ya got dead fat!!!!  

better than ..ummm.."living" fat??!!!!  Cool 

Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.
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Apr 18, 2012 06:07AM Sommer43 wrote:

It's a strange thing, I think. 

nandkmom, yes, I too have read that it can mimic cancerous progress, with the edges being so irregular, this lady that I was talking to, stated that the radiologist was very skilled in that he could see clearly from the US that it was not a fibroadenoma, or a cyst and there was no need for further biopsy. 

 Marie, dead fat?  Makes me think of a frying pan, with old fat in it, not terribly attractive. 

 Still, funny or not, it is certainly better to hear the term than malignant.  Does anybody have experience of simply allowing the body to absorb the dead fat and it go away?  I am tempted to leave well alone and just see what happens, even though I don't like the fact it is there, but weighing up the risk of having another surgery, more trauma, recurrence of the damn stuff, I am thinking to leave it, and hope it goes away.  As I am on a three month follow up... 

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Apr 20, 2012 01:20PM Sommer43 wrote:

So, received results today, and in the report it stated:

"Unequivocally benign, with highly unusual edges...  This was from my GP who read the report to me..  In keeping with fat necrosis... This was from the radiologist to my GP and the breast consultant.

Now, while benign is good, what does "highly unusual mean? 

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Apr 20, 2012 01:56PM marie5890 wrote:

Just that the edges were highly unusal for a  B9 result. But definitely B9!!!! Cool

Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.
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Apr 20, 2012 02:04PM Sommer43 wrote:

Hi Marie

Thank you, I feel like am going mad...  Am on a follow up now, for six months, which I am pleased about...  Or September anyway, so five months.  I was told to massage the fat necrosis, but my GP said today, to not massage it, as it can irritate the breast.  While it is nothing, and I am pleased it is benign, I cannot shake the worry. 

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Apr 20, 2012 02:11PM marie5890 wrote:

I hear you about having difficulty shaking the worry, the anxiety. 

Many times when we are in a state of anxiety, even clear cut hard facts and data just dont seem to make a difference for a while.

An option you may want to consider until the anxiety/worry diminishes. Stay off these boards and any thing else related to BC for a while. SOmetimes that just keeps the anxiety and the "what ifs" going by adding fuel.

Just a thought. Smile 

Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.
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Apr 20, 2012 05:33PM Sommer43 wrote:

Thank you Marie, for taking the time to respond.  I am much calmer now, which has helped and for the little time I am here, then it has been a good experience. 

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Apr 20, 2012 10:59PM - edited Apr 20, 2012 11:05PM by Matzwd

My BS pretty much diagnosed me on physical exam. I had already had the mammogram and us that didn't show anything really. Well, the ultrasound showed dense tissue in that area and a dilated duct. Interestingly, though, the radiologist and us tech were discussing things in front of me while pointing at the monitor. The radiologist was saying something about "this area"and pointing on the screen. The tech said, "I think that is a duct, I think it's a duct." I was sent then for the mammo where they saw nothing at all. Interestingly, when I picked up the reports to take to the bs, I noticed that the us report mentioned a dilated duct, but I could tell when we were all in the room together that the radiologist really had no idea what it was, so I guess the tech diagnosed me at that point, and I'm not sure I'm comfortable with that. Anyhow, when the bs saw the reports and the films and examined me, she told me she was sure it was fat necrosis and did a fine needle biopsy for my peace of mind. I got a call 2 days later starting that everything was fine. I didn't however, actually ask for the pathology results. I'm going to have to get a copy just for curiosity's sake.

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May 7, 2012 11:48AM Sommer43 wrote:

This stuff, is doing my bloody head in.  Painful, I have taken everything, I have cold compressed it, warm compressed it, massaged it, which just makes it worse.  The affected breast, has now very prominent veins showing, the necrosis, is now a long pencil line, stemming from the mass under my incision.  I have a pain under my arm, which seems to be worse, it is the most bizarre feeling, as though something is wriggling around in there.  In my breast, there are stinging sensations, and the my doctor sent me back to clinic.  No ultra sound, (I know I cannot have a mammogram as I had one in February)

My surgeon stated "Price you have to pay, for being a woman"  Nice.  I have left everything alone also, not touched it, ignored it.  Talk about pissed off! 

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May 7, 2012 12:36PM Paula1231 wrote:

Sommer,

Thanks so much for the paper on fat necrosis.  I have a major lump PCM said it is about 1 cm  smooth and hard.  I had a LB MX Sept 2010 and now this lump next to the implant.  I am scared shitless.  I have ultrasound this afternoon at 3:30, and I am so praying that is what this is.  OMG.  Could I be that lucky?  My gut says no.  I am praying anyway.  Sure wish I had remembered to bring the ativan. 

Miles to go before I sleep. LBMX on 8/17/10.TE with Alloderm. OncoDX score 18. 4 AC + 4 Taxol DD. Chemo done 2-3-11 Start Tamox 2/24/11. Implant & Maxopexy 3/29/11. Nipp recon & fat trans 7/12/11. Nip Tat 10/6/11 DONE!! Started Femara on 3/28/13. Dx 6/26/2010, IDC, Left, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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May 7, 2012 01:08PM Sommer43 wrote:

Hi Paula

I bet you are scared shitless, I feel for you.  I was scared when I went back, six weeks after an excisional with a massive lump, to be told it was necrosis. 

I suppose in the great scheme of things, I simply have to live with it.  I felt better just ranting it out on here.  I am not worried that it is anything else, just so hacked off with living with pain... 

 It should get easier am sure.  Good luck Paula.  Come back and let us know. 

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May 16, 2012 12:29PM Sommer43 wrote:

So as not to hijack Sparky's thread, as she needs her support much more than I do, interestingly, I have just been told, that fat necrosis, is not absorbed by the body. 

With my ongoing issues, I have now grabbed the attention of the first consultant and the second one I saw. 

Will hear back tomorrow, what it is to be done with me. 

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May 24, 2012 05:14PM Paula1231 wrote:

It's B-9!!!  I am sooo relieved! The surgeon says its a fat necrosis.  They recommend leaving it alone or getting it "lipoed" out. 

Miles to go before I sleep. LBMX on 8/17/10.TE with Alloderm. OncoDX score 18. 4 AC + 4 Taxol DD. Chemo done 2-3-11 Start Tamox 2/24/11. Implant & Maxopexy 3/29/11. Nipp recon & fat trans 7/12/11. Nip Tat 10/6/11 DONE!! Started Femara on 3/28/13. Dx 6/26/2010, IDC, Left, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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May 24, 2012 06:44PM Matzwd wrote:

Great Paula!!  Glad to hear your good news.  This fat necrosis stuff is sure weird, isn't it?  I actually have several, I suppose as a result of my reduction almost 13 years ago.  Thing is, I keep growing more of them.  It's odd that after that long things are still forming as a result of the trauma from the surgery.  Congratulations to you!!

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Jan 6, 2015 12:21PM MrsG57 wrote:

I was told from mammography alone that the lump I am feeling is not cancerous and that with the mammogram I had numerous fatty deposits and that it is just fat necrosis.  I am still seeing a breast surgeon because the alarming part is I show symptoms for diabetes insipidus and am being tested for it. But is it possible for a radiologist not a tech can give that diagnosis. ..because im currently excited with my current diagnosis and after googling fat necrosis im hesitant... ive seen stories of women being tild its fat necrosis and biopsy said cancer. ..should I worry still?

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Jan 6, 2015 12:50PM JO-5 wrote:

MrsG5

From one that is currently recovering from a biopsy, that came back radiation fibrosis and fat necrosis...my dr says the only way to know for sure is a biopsy. He said by mammogram and physical exam he did not think it was anything else but quote: "I'm not God and I can't see in there."

JO-5

Org dx 04 lumpectomy rads arimidex stage 1 grade 3 no nodes er+pr+her- 2014 rads induced angiosarcoma, wide excision 2015 angio recurrence, rt mast. Lat flap, 1/3 flap went necrotic, skin graft leg to chest Seeing dr every 3 to 6 months.
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Jan 6, 2015 01:46PM MrsG57 wrote:

So should I be relieved?  I just cant shake the feeling something is wrong and the last time I didnt listen to myself I walked on a broken knee for 6 years. It would have never been found had it not been for a second opinion.  I dont understand how she knew it was fat necrosis within minutes of looking at it.. my only hang up was the lump they marked was not the lump my ob and I found it was many inches to the left.. thank u for replying I guess I have to wait for thursday to see the breast surgeon and see.

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Jan 6, 2015 08:43PM JO-5 wrote:

If I were you I would see what the surgeon says. A needle or punch biopsy is a procedure my surgeon does in the office.

I've had 8 punch and/or core biopsies in the last 10+ years. My fibrosis and necrosis is from surgeries, radiation treatments, and multiple biopsies.

It is not pleasant and it hurts most of the time, but better than cancer. You can ask for a biopsy if that is the only way you can have peace about it.

I've been on this journey over 10 yrs and I've never had a radiation tech give a dx.

If you go to a breast center the radiologist are pretty good at reading the mammos.

It probably is fat necrosis especially if they have past mammos to compare it to.

Good luck. Let us know what the surgeon says.

JO-5

Org dx 04 lumpectomy rads arimidex stage 1 grade 3 no nodes er+pr+her- 2014 rads induced angiosarcoma, wide excision 2015 angio recurrence, rt mast. Lat flap, 1/3 flap went necrotic, skin graft leg to chest Seeing dr every 3 to 6 months.
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May 9, 2016 03:06PM Frustratedfriend wrote:

good advice. Do not let a radiologist diagnose fat necrosis. Only way to diagnose for sure is to rule out malignancy. Better safe than sorry. My friend was diagnosed by ultrasound with fat necrosis..it was an aggressive tumor. Went 1 year later for mammography and is a minimum of stage 3c...still staging I know biopsies are scary, but not doing one is not worth the risk.

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May 9, 2016 10:46PM marie5890 wrote:

Hi Frustrated and welcome.

This is an older thread so if you have questions or concerns I recommend starting a new one. :)

Welcome to BCO!

Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.

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