Fat necrosis in the Breast: A systematic review of clinical.
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ABSTRACT:
SUBMITTER: Vasei N
PROVIDER: S-EPMC6560815 | biostudies-literature | 2019 Jun
REPOSITORIES: biostudies-literature
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Fat necrosis in the Breast: A systematic review of clinical.
Vasei Narges N Shishegar Azita A Ghalkhani Forouzan F Darvishi Mohammad M
Lipids in health and disease 20190611 1
Breast fat necrosis (FN) originates from aseptic fat saponification, which is a typical lipid cyst or a spiculated lesion called mammographic presentation which mimics malignancy. In order to avoid biopsy, it would be necessary to identify the spectrum of fat necrosis appearances. A systematic research was conducted in October 2018 by using PubMed, MEDLINE, Embase, Google Scholar databases and Google to search for science literature published after 2004. Therefore, the aim of this systematic rev ...[more]
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Project description:Case Report: We report here on a 58-year-old patient with abnormal findings in the left breast on screening mammography (October 2012). In May 2008 the patient was diagnosed with rectal cancer, subsequently treated by surgical resection followed by radiochemotherapy. In September 2011 the patient was diagnosed with peritoneal cancer. Extravasation of folinic acid occurred during palliative chemotherapy, which was delivered through a surgically implanted port, placed prepectorally on the left side. The patient had not previously undergone breast surgery. The abnormal finding in the left breast was located at the 1-2 o'clock position. The mammogram showed extensive hyperdense nodules with predominantly round, fine granular calcifications. On sonography, the findings presented as a hypoechogenic, inhomogenous, partially diffuse, partly solid, partly cystic mass with individual calcifications and reduced echogenicity in the dorsal aspect. Strong densification of the left breast was found at the corresponding position on palpation. On computed tomography (CT) done during follow-up for rectal cancer, new streaky/pitted densifications were noted in the left breast. Based on the patient's previous history and the results of the breast diagnostics a diagnosis of extensive fat necrosis after folinic acid extravasation was made. No further measures were taken. The patient will continue to be screened using mammography. Conclusion: A good knowledge of the mammographic and sonographic features of fat necrosis can reduce the number of unnecessary biopsies. Careful consideration of the patient's prior medical history is very important in breast diagnostics and may often be decisive for the correct diagnosis.
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Project description:BackgroundSubcutaneous fat necrosis of the newborn (SCFN) is a rare disease occurring in the first days of life. Characteristically, the infants show hard nodules in subcutaneous tissue, purple or erythematous in color and appear on the upper back, cheeks, buttocks and limbs. In most cases, SCFN is a self-limiting disease, as the nodules disappear in up to 6 months. A severe complication associated with SCFN is hypercalcaemia. Pathophysiological mechanisms causing SCFN or associated hypercalcaemia are not fully understood yet.MethodsA systematic literature research including the six biggest databases for medical research has been used to identify all published case reports of SCFN. N = 206 publications has been identified containing n = 320 case reports. All cases have been classified into four subgroups (depending on reported serum-calcium-level): hypercalcaemia, normocalcaemia, hypocalcaemia or no information given. Reported maternal factors, birth characteristics, details about SCFN, diagnostics, therapy and long-term observations have been extracted from publications.ResultsThis is the first systematic literature research that summed up all published cases of SCFN from 1948 up to 2018. Information about serum calcium level was given in 64.3% of the cases. From those, the majority showed hypercalcaemia (70.5%) (normocalcaemia 25.1%, hypocalcemia 4.3%). 89.3% of newborns with hypercalcaemia showed suppressed levels of the parathormone. Maternal gestational diabetes, maternal hypertensive diseases during pregnancy, macrosomia (> 4000g), asphyxia and therapeutic hypothermia are risk factors for SCFN. Histological findings showed a granulomatous inflammation in 98% of cases.ConclusionWe identified that maternal, birth characteristics and therapeutic measures are probably risk factors for SCFN. These risk factors should be taken into account within the care of neonates.
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Project description:BackgroundAlthough fat necrosis is a minor postoperative complication after breast reconstruction, occasionally it mimics to tumor recurrence in patients with breast cancer. Therefore, the surgeon should distinguish between benign fat necrosis and true local recurrence. The authors evaluated the clinical characteristics of fat necrosis after breast reconstruction and investigated the natural course of fat necrosis.MethodsBetween 2007 and 2013, a total of 362 patients underwent breast reconstruction after partial or total mastectomy for breast cancer in Kyungpook National University Hospital. Clinicopathologic characteristics and the occurrence of fat necrosis were assessed during surveillance for 10 years of mean follow-up period.ResultsThere were 42 cases (11.6%) of fat necrosis after breast reconstruction with partial or total mastectomy which were confirmed by needle or excision biopsy. The fat necrosis was resolved after a mean period of 45.9 months (SD, ± 42.1) and 26 cases (61.9%) of fat necrosis were almost completely resolved (less than 5 mm) during 10-year follow-up period.ConclusionBased on the natural course of fat necrosis, the fat necrosis after breast reconstruction can be only monitored, if pathologic confirmation was done. More than half of the cases will be resolved within 2-3 years.
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