What is breast lipogranuloma and how to treat a benign process with the formation of foci of fat necrosis. Fatty necrosis of the mammary gland, treatment and prevention Treatment of fatty necrosis of the mammary gland with folk remedies

Fatty necrosis of the mammary gland is characterized by gradual necrosis of the tissue of the same name, followed by scarring of the problem area. This process develops in foci. By outward signs and it is difficult to feel to differentiate between fat necrosis and cancer. In both cases, pain occurs and the shape of the breast changes in both women and men.

general information

Fat necrosis is diagnosed in 0.6% of cases of breast growths. In men, this process in this zone is extremely rare. conditioned given fact lack of sufficient amount of adipose tissue. However, more often Fat necrosis is diagnosed in overweight men.

The pathological process is most typical for women with large breasts. The risk zone includes patients of reproductive age (25-35 years).

Causes

The main reason for the development of necrosis of adipose tissue of the breast is trauma to the mammary glands resulting from:

• injury;
• surgical intervention;
• sampling during a biopsy.

appearance fat necrosis promotes rapid weight loss. Weight loss occurs against the background of severe systemic pathologies or while following a strict diet.

Among the factors provoking necrosis of adipose tissue of the breast include:

• tuberculosis;
• malignant tumors;
• endocrine disorders;
• severe stress;
• body intoxication.

It is also possible that necrosis develops after radiotherapy and against the background of cardiovascular pathologies.

Tissue death occurs due to impaired blood circulation in the mammary glands. Because of this, the cells receive insufficient nutrients, which triggers the necrotic process.

When blood vessels are damaged, the body strives to repair tissue. Because of this, in problem area there are foci of inflammation, separated from healthy areas. As the process progresses, tissue necrosis starts. But due to the activity of the body, the affected cells are removed naturally. And the necrotic focus is tightened by fibrous tissue.

Symptoms

Due to the fact that necrosis develops after injuries, signs of damage become noticeable before the onset of tissue death. The problem is indicated by:

• the appearance of seals in the chest;
• retraction of the nipple;
• pain, aggravated by contact;
• worsening general condition organism.

The tumor, which is formed against the background of the inflammatory process, has an oval (rounded) shape. On palpation, an elastic structure is noted. The tumor is characterized by low mobility due to cohesion with neighboring tissues.

As the necrotic process progresses, the intensity of pain may decrease due to skin numbness. Covers over the focus of inflammation acquire a red or cyanotic hue.

The deterioration of the general condition is associated with the fact that the decay products that occur in the process of necrosis spread throughout the body, provoking intoxication. Because of this, a decrease in appetite, poor sleep, and lethargy are possible. Body temperature remains within the normal range in most patients.

Diagnostic methods

If breast necrosis is suspected, information about the patient's condition is first collected, and then the problem area is palpated. To make an accurate diagnosis, the following studies will be required:

• x-ray;
• tomosynthesis, which creates a two-dimensional image of the gland;
• optical mammography.

To exclude a malignant tumor, material is taken (biopsy) followed by histological and cytological studies fabrics. Additionally assigned general analysis blood to rule out bacterial contamination.

Possible Complications

Necrosis of adipose tissue provokes the formation of fistulas in the problem area. The course of the pathological process contributes to the attachment bacterial microflora and suppuration of tissues, which can cause the development of sepsis.

In advanced cases, gangrene occurs in patients with adipose tissue necrosis.

Methods of treatment

Elimination of necrosis of adipose tissue of the mammary glands is carried out through surgical intervention. Conservative therapy and treatment folk remedies are not applicable in this case. Medications recommended to eliminate the consequences of the operation, as well as to suppress bacterial microflora. For this apply:

1. Antibiotics a wide range actions. Drugs not only suppress infections, but also prevent infection.
2. Vitamin complexes. Stimulates the repair of damaged tissues.

Surgical intervention for necrosis is used due to the difficulty in differentiating such a lesion from cancerous tumor. Besides, tissue does not regenerate after death.

The type of operation is selected depending on the localization of the necrotic process. Sectoral is mainly used, in which only part of the mammary gland is removed. Tissues after excision are sent for histological examination in order to exclude malignant tumor.

Forecast and prevention

The prognosis for adipose tissue necrosis is ambiguous. In most cases, there are no complications after the operation, except for the fact that the woman is missing part of her breast. Tissue plastic surgery is used to restore the mammary gland.

The prognosis is poor in cases of late presentation when necrosis has caused systemic complications.

In order to prevent inflammation with subsequent death of breast tissue, it is recommended to avoid breast injuries. To do this, you should wear comfortable underwear, give up contact sports, and avoid strict diets. Women (especially of reproductive age) need timely treatment of breast diseases and endocrine pathologies. In addition, it is important to regularly (once every six months) be examined by a mammologist and immediately consult a doctor if palpation reveals seals in the chest.

Everyone knows that female breast is a very delicate gland, the tissues of which should not succumb physical influences(injuries, bruises). Girls should be aware that their breasts should be protected from being squeezed by a bra, cover their breasts with their hands during a massive crowd of people, and in every possible way avoid even the most minimal chest injuries. This is because the mammary gland consists of extremely sensitive tissues, which, at the slightest impact, can change their structure. The mammary glands are very susceptible to such pathological processes like mastopathy, fibroadenoma, mastitis, papillomas. There may also be fat necrosis of the breast.

Fatty necrosis of the mammary gland. Causes of lipogranuloma

Fatty necrosis of the mammary gland is an aseptic focal necrosis of fatty tissue. In this case, adipose tissue is replaced by scar tissue. Fat necrosis is also called oleogranuloma, lipogranuloma and steatogranuloma. Fat necrosis refers to non-enzymatic necrosis. The main cause of oleogranuloma is chest trauma. Fat necrosis of the mammary glands is more susceptible to patients with large breasts than with small ones.

Traumatic factors that can provoke fatty necrosis of the mammary glands: accidental bumps and bruises, for example, in transport, sports training, medical manipulations. Sometimes the cause of oleonecrosis is rapid weight loss or radiation therapy. Sometimes necrosis occurs after breast augmentation or mastectomy.

What happens in breast tissue during fat necrosis?

With injuries to the breast tissue, small capillaries of the fatty tissue area are damaged. Further, breast tissues react to this process by the appearance of an inflammatory reaction. A demarcation zone is formed, which limits the dead tissue. After finishing inflammatory response the process of fibrosis begins, in which necrotic masses are replaced by connective tissue cells. This is how scar tissue is formed. In the future, calcium salts are deposited in such areas of necrosis of the adipose tissue of the mammary gland, and petrification of the foci occurs. In rare cases, ossification processes are observed.

Symptoms of fatty necrosis of the breast

After a chest injury, a painful swelling appears, which is soldered to the skin. It has a dense texture and a rounded shape. Later, the affected area of ​​adipose tissue begins to lose sensitivity. Outwardly, the gland may change in color - the skin of the gland may acquire a bluish or red tint, the nipple may be somewhat retracted. Such a picture often resembles mastitis and misleads women, but it is very easy to distinguish fatty necrosis from mastitis - with mastitis, there will be an increase in body temperature to febrile numbers.

With all this, fat necrosis can be clinically similar to breast cancer. Deformation of the mammary gland, the density of the infiltrate, the appearance of retracted areas on the skin of the gland and an increase in regional lymph nodes may resemble breast cancer. In neglected states, fat necrosis can occur in the form of sequestration and tissue melting.

Diagnosis of fatty necrosis of the breast

In the diagnosis of fatty necrosis, it is of great importance to indicate the patient's history of a chest injury that has occurred recently. On palpation, a mammologist determines a painful induration that does not have clear contours and can fluctuate.

When conducting ultrasound of the mammary glands, CT or MRI, a heterogeneous formation of a nodular nature is detected, which has stringy uneven contours. With these tests, the results are often very similar to breast cancer. But, after some time, when the focus of necrosis begins to calcify, on mammography, the focus of fat necrosis looks like a spherical calcification of the type " eggshell". This allows you to exclude the malignancy of the process.

For differential diagnosis it is advisable to conduct a biopsy of the gland tissues with subsequent histological examination. Breast biopsy is performed under ultrasound guidance.

Treatment and prevention of fatty necrosis of the breast

In the presence of fat necrosis, only surgery– organ-preserving sectoral resection of the mammary gland. After that, the material is checked histologically. Microscopically, this material is represented by nodular growths of granulation tissue from epithelioid cells, large lipophages, and xanthoma cells around fatty inclusions. The main components of lipogranulomas are fatty cysts- cavities with thin walls that are filled with a serous and oily fluid.

If the gland is injured, it is necessary to give it an elevated position with a bandage and immediately consult a doctor.

Fat necrosis of the mammary gland is the process of focal necrosis of the adipose tissue of the breast and its subsequent replacement with scar tissue. There is fatty necrosis of the mammary gland after various injuries (accidental bruises and blows in transport or at home, during training or medical manipulations). Rarely, breast fat necrosis is caused by radiation therapy or rapid weight loss. In some cases, fat necrosis of the mammary gland can form in a patient who has undergone reconstructive mammoplasty.

In all these cases, the integrity of small vessels may be disrupted, and the blood supply to this area may be interrupted. All this leads to the development of fatty necrosis of the mammary gland. The most common fat necrosis of the mammary gland occurs in women with large breasts.

Symptoms of fatty necrosis of the breast

Most often, fat necrosis of the mammary gland is preceded by some kind of trauma to the mammary gland. At the site of injury, a painless tumor of a dense consistency and rounded shape is formed. Sometimes with fatty necrosis of the mammary gland, patients complain of discomfort and pain in some areas of the mammary gland. But most often, fat necrosis of the mammary gland has unexpressed symptoms, and tumors are detected only by palpation.

At further development fat necrosis of the mammary gland in this area of ​​\u200b\u200bthe mammary gland, sensitivity may be lost. With the formation of fatty necrosis of the gland, the skin, as it were, is soldered to the tumor and acquires a red or cyanotic color. In addition, with fatty necrosis of the mammary gland in the areal area, nipple retraction may occur, which makes the patient think about the development of a tumor. External similarity with cancer to fatty necrosis of the mammary gland gives an increase in lymph nodes and the appearance of irregularities and dimples on the skin. In fact, fat necrosis of the mammary gland is a benign formation, it can only mimic a malignant tumor in the diagnosis.

After inflammatory process subsides in the mammary gland, the process of replacing necrotic masses begins connective tissue. As a result, at the site of fatty necrosis of the mammary gland, scar tissue is formed. With the unfavorable development of fatty necrosis of the mammary gland, septic fusion of the focus and rejection of the damaged area from the surrounding tissues can be observed.

Diagnosis of fatty necrosis of the breast

When diagnosing fat necrosis of the breast, it is very important that the patient report breast trauma. During an external examination of the glands, the doctor may note redness or blueness of the skin, as well as the presence of bumps and retractions on the skin. On palpation of the mammary gland, the doctor can easily determine the compaction, sometimes painful. The contours of such a seal in fatty necrosis will be fuzzy. But ultrasound of the breast will not reveal characteristics fatty necrosis of the breast. Plain mammography or MRI of the breast during diagnosis can reveal a nodular formation with uneven edges and heterogeneous structure. Since the picture in breast fat necrosis resembles that in breast cancer, this will require additional research. In the future, when calcium salts are deposited on the site, and calcification of the focus occurs, fatty necrosis of the mammary gland on mammograms will look like a spherical calcification resembling an eggshell. This will allow the diagnosis to exclude the malignancy of the ongoing process in the mammary gland.

Until this happens, fat necrosis of the mammary glands requires a biopsy. A breast biopsy is performed under X-ray or ultrasound control. After that, the obtained samples must be sent for cytological and histological examination. This allows you to differentiate fat necrosis of the breast and exclude the development of cancer.

Treatment and prevention of fatty necrosis of the breast

Since fat necrosis of the mammary gland is characterized by irreversible changes in adipose tissue, then drug treatment in this case will lead to nothing. In addition, it is very difficult to completely differentiate breast fat necrosis even when performing a biopsy. Therefore, sectoral resection is used as a treatment for fatty necrosis of the mammary gland. It allows you to remove only part (sector) of the breast.

Further postoperative examination of the macropreparation will completely exclude the oncological process in the breast. Microscopically, fat necrosis is a nodular growth of granulation tissue. One of the components of fatty necrosis will be fatty cysts. Under a microscope, they are thin-walled formations that are filled with an oily liquid.

Fatty necrosis of the mammary glands is a disease that is easier to prevent than to treat later. In order to prevent fat necrosis, trauma to the mammary glands should be avoided. If the injury nevertheless occurred, it is necessary to give the mammary gland an elevated position with a bandage and contact a mammologist.

You should periodically contact a specialist not only in case of injury, but also for prevention in order to avoid fatty necrosis of the mammary glands. Such examinations should become mandatory for every woman, this will allow timely detection of diseases of the mammary glands, diagnostics and elimination of oncological processes in the breast. And, of course, every woman should make an independent examination of the glands at least once a month.

Fat necrosis of the mammary gland is a focal necrosis of adipose tissue that occurs after various injuries. This pathology- These are benign changes in the tissues of the breast. With various damaging factors, as a result of a violation of the integrity of small vessels, the blood supply to the tissue site stops, after which necrosis develops. Injuries can be very different, for example, an elbow strike during sports training or a bruise on a door frame.

Often, necrosis can be observed due to radiation therapy and with sharp decline weight. Usually pain symptoms fat necrosis or absent, and changes in adipose tissue are detected only when medical examination by traditional palpation or manifest painful sensations, and a visual examination of the chest shows enlarged lymph nodes and irregularities in the form of dimples on the skin.

Fat necrosis does not degenerate into a malignant tumor, but can only simulate it. With a mammogram or ultrasound examination fat necrosis is defined as a malignant tumor, which requires the use of a biopsy, and in some cases, performing sectoral resection. Fat necrosis of the mammary gland, also called oleogranuloma, lipogranuloma and steatogranuloma, refers to non-enzymatic necrosis.

Changes in the tissue structure are characterized by the development reactive inflammation with the formation of a demarcation zone that separates dead tissue. The subsidence of inflammation is accompanied by the process of fibrosis, i.e., the replacement of necrotic masses with connective tissue. In places of necrosis, scar tissue is formed. Possible deposits in the area of ​​fat necrosis of calcium salts, calcification of the focus of necrosis.

Symptoms and diagnosis of fatty necrosis of the breast

The development of fat necrosis is preceded by a traumatic effect on any part of the mammary gland. If the blow is strong, then a painful swelling quickly forms at the site of the injury, cyanotic or red in color, round in shape and dense in consistency. It is soldered to the skin, sensitivity is lost.

Fat necrosis entails retraction of the nipple, proceeds without an increase in body temperature. With an unfavorable development of the disease, septic fusion of the focus and the process of rejection of the necrotic site (sequestrum) from the surrounding living tissues can occur. Diagnosis of fatty necrosis of the mammary gland necessarily begins with a survey of the patient, the doctor must know the nature of the traumatic effect, the timing of the development of necrosis.

Mammologist in progress contact definition reveals the degree of density, the clarity of the contours of fat necrosis, symptoms of the presence of fluid (pus, blood). Panoramic mammography and MRI of the mammary glands help to detect heterogeneity of the structure, stranded uneven contours.

X-ray, tomographic and echographic studies of fat necrosis often show symptoms of breast cancer. After calcification occurs, the focus of fatty necrosis of the mammary gland resembles a spherical calcification of the “eggshell” type, this circumstance completely excludes the presence of a malignant tumor. Differential diagnosis involves a biopsy of the mammary gland, i.e., a fine-needle puncture or trephine biopsy, which makes it possible for subsequent cytological and histological examination of the obtained fragments.

The biopsy is always performed under ultrasound or X-ray guidance. Treatment and prevention of fatty necrosis of the mammary gland has its own specifics and some difficulties. It is good when patients go to the doctor at the beginning of discomfort. Since focal changes in adipose tissue are irreversible, and there are also difficulties in differential diagnosis, an organ-preserving operation with the removal of a part of the mammary gland is indicated.

Repeated histological studies after surgery, they can completely exclude or confirm the process of oncological damage. Under the microscope, fat necrosis presents as nodular growths of granulation tissue from epithelioid cells, multinucleated giant phagocytic fats and lipoids, and cholesterol ester-laden macrophages around fat inclusions.

Lipogranulomas contain fatty cysts in the form of thin-walled cavities filled with oily and serous fluid. The best prevention necrosis of the mammary gland is caution and respect for their body parts. If, nevertheless, it was not possible to avoid injury, it is recommended to take measures on your own first medical care, namely, lift the injured chest with a bandage and immediately consult a specialist.

Expert editor: Mochalov Pavel Alexandrovich| MD general practitioner

Education: Moscow medical institute them. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".

Fat necrosis of the mammary gland is a focal necrosis of adipose tissue that occurs after various injuries. This pathology is a benign change in the tissues of the mammary gland. With various damaging factors, as a result of a violation of the integrity of small vessels, the blood supply to the tissue site stops, after which necrosis develops. Injuries can be very different, for example, an elbow during sports training or a bruise on a door frame.

Often, necrosis can occur as a result of radiation therapy and with a sharp decrease in weight. Usually, pain symptoms of fat necrosis are either absent, and changes in adipose tissue are detected only during a medical examination by traditional palpation or are painful, and a visual examination of the chest shows enlarged lymph nodes and irregularities in the form of dimples on the skin.

Fat necrosis does not degenerate into a malignant tumor, but can only simulate it. On mammography or ultrasound, fat necrosis is defined as a malignant tumor, which requires the use of a biopsy, and in some cases, a sectoral resection. Fat necrosis of the mammary gland, also called oleogranuloma, lipogranuloma and steatogranuloma, refers to non-enzymatic necrosis.

Changes in the tissue structure are characterized by the development of reactive inflammation with the formation of a demarcation zone that separates dead tissue. The subsidence of inflammation is accompanied by the process of fibrosis, i.e., the replacement of necrotic masses with connective tissue. In places of necrosis, scar tissue is formed. Possible deposits in the area of ​​fat necrosis of calcium salts, calcification of the focus of necrosis.

Symptoms and diagnosis of fatty necrosis of the breast

The development of fat necrosis is preceded by a traumatic effect on any part of the mammary gland. If the blow is strong, then a painful swelling quickly forms at the site of the injury, cyanotic or red in color, round in shape and dense in consistency. It is soldered to the skin, sensitivity is lost.

Fat necrosis entails retraction of the nipple, proceeds without an increase in body temperature. With an unfavorable development of the disease, septic fusion of the focus and the process of rejection of the necrotic site (sequestrum) from the surrounding living tissues can occur. Diagnosis of fatty necrosis of the mammary gland necessarily begins with a survey of the patient, the doctor must know the nature of the traumatic effect, the timing of the development of necrosis.

The doctor-mammologist in the process of contact determination reveals the degree of density, the clarity of the contours of fat necrosis, the symptoms of the presence of fluid (pus, blood). Panoramic mammography and MRI of the mammary glands help to detect heterogeneity of the structure, stranded uneven contours.

X-ray, tomographic and echographic studies of fat necrosis often show symptoms of breast cancer. After calcification occurs, the focus of fatty necrosis of the mammary gland resembles a spherical calcification of the “eggshell” type, this circumstance completely excludes the presence of a malignant tumor. Differential diagnosis involves a biopsy of the mammary gland, i.e., a fine-needle puncture or trephine biopsy, which makes it possible for subsequent cytological and histological examination of the obtained fragments.

The biopsy is always performed under ultrasound or X-ray guidance. Treatment and prevention of fatty necrosis of the mammary gland has its own specifics and some difficulties. It is good when patients go to the doctor at the beginning of discomfort. Since focal changes in adipose tissue are irreversible, and there are also difficulties in differential diagnosis, an organ-preserving operation with the removal of a part of the mammary gland is indicated.

Repeated histological studies after surgery can completely exclude or confirm the process of cancer. Under the microscope, fat necrosis presents as nodular growths of granulation tissue from epithelioid cells, multinucleated giant phagocytic fats and lipoids, and cholesterol ester-laden macrophages around fat inclusions.

Lipogranulomas contain fatty cysts in the form of thin-walled cavities filled with oily and serous fluid. The best prevention of breast necrosis is to be careful and respectful of your body parts. If, nevertheless, it was not possible to avoid injury, it is recommended to take independent first aid measures, namely, to lift the injured chest with a bandage and urgently contact a specialist.