Lipogranuloma of the breast

Lipogranuloma of the mammary gland is a fat necrosis, that is, a benign formation.

Let's consider the features of this pathology, symptoms, diagnostic methods, treatment and prevention methods, as well as the prognosis for recovery.

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Causes mammary lipogranulomas

Lipogranuloma is a benign neoplasm characterized by the formation of aseptic inflammatory processes, cysts and foci of lipocyte necrosis. Lipogranulomas are distinguished by the type of structure, there are diffuse and nodular. The cause of the pathology can be trauma, sudden weight loss, radiation exposure, etc.

The causes of lipogranuloma of the mammary gland are varied, but most often the neoplasm appears due to breast trauma. When traumatized, normal blood circulation is disrupted and adipose tissue is damaged. An inflammatory focus is formed inside the gland, from which infiltrate discharge with transformation into granulation tissue with a hard capsule is possible. Pathology can appear due to blockage of the sebaceous gland ducts, due to a sharp decrease in weight and exposure to radiation.

The disease accounts for 0.6% of all cases of nodular lesions of the breast. More often, this pathology appears in women with macromastia than in those with small breasts. Traumatic factors include bruises, medical manipulations, sports injuries, etc. In some cases, radiation therapy leads to the formation of lipogranuloma.

Reconstructive mammoplasty with own tissues after mastectomy is another cause of benign tumor. Due to damage to capillaries, blood circulation is lost. As soon as the inflammatory process subsides, fibrosis of tissue begins in the mammary gland. In some cases, scar tissue appears at the site of necrosis. Later, calcium salts are deposited on such areas of the breast, which leads to petrification of the necrosis focus or ossification processes.

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Symptoms mammary lipogranulomas

Most often, the disease occurs in women with large breasts. The tumor is characterized by a long-term formation, which at first does not manifest itself. The first symptom of the pathology is post-traumatic formations with hematomas and hemorrhages. If the fat elements in the mammary gland die, then a cyst with liquid forms in the lipogranuloma. In some cases, the contents of the capsule become infected, which leads to suppuration. If the lipogranuloma progresses over a long period of time without proper treatment, this leads to its calcification.

Women diagnosed with this pathology feel discomfort and pain in certain areas of the mammary glands. When attempting palpation, a painful, dense and lumpy formation is clearly defined. If the neoplasm is pronounced, it leads to nipple retraction and deformation of the mammary gland. But in some cases, the disease is asymptomatic. Quite often, the tumor resembles a malignant process in its course, so correct diagnostics of lipogranuloma and differential methods of study are very important.

Symptoms of lipogranuloma of the mammary gland largely depend on the causes that caused the pathology. Microscopically, the pathology is nodular proliferation of granulation tissue from epithelial cells, xanthomous and lipophages with giant nuclei around fatty tissue. Diffuse lipogranuloma is surrounded by fatty tissue of the mammary gland, and nodular by capsules. Thin-walled cavities filled with serous or oily fluid are one of the components of lipogranuloma.

If fat necrosis occurs as a result of trauma, then a painful tumor of a round shape with a dense consistency and fused with the skin appears at the site of the lesion. As the disease progresses, the mammary gland may lose its sensitivity.

• Red or cyanotic color of the gland skin is another symptom of lipogranuloma. If the neoplasm occurs in the areola area, it leads to nipple retraction and breast deformation. Lipogranuloma is not accompanied by high body temperature, as is the case with mastitis.
• Symptoms of lipogranuloma are similar in appearance to breast cancer. Dimples appear on the skin, breast deformation occurs, dense infiltrate and enlarged lymph nodes.

Lipogranuloma is characterized by painful sensations that increase with palpation of the mammary gland. Pain occurs even with palpation, enlargement of the lymph nodes and the appearance of small pits on the skin are possible. Please note that lipogranuloma does not degenerate into a malignant tumor, but can simulate it. Therefore, it is very important to use differential diagnostics. If fat necrosis is recognized using ultrasound or mammography, then the tumor can be determined as a malignant neoplasm.

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Diagnostics mammary lipogranulomas

Diagnosis of lipogranuloma of the mammary gland is a very important process. The final diagnosis (nature of the tumor) and the choice of treatment method depend on the results of the studies. When diagnosing fat necrosis, recent injuries to the gland are important, as they can be the cause of the pathology. Initially, the mammologist examines the breast and palpates it. During palpation, fluctuations and painful seals with unclear contours can be detected.

In addition to the initial examination and palpation, the woman undergoes a general mammography, CT and MRI of the mammary glands. In this case, the lipogranuloma looks like a nodular compaction with uneven contours and a heterogeneous structure. In X-ray, tomography and echography, fat necrosis has a picture similar to breast cancer. At later stages, when calcification of the tumor occurs, the focus of pathology looks like a spherical calcification (like an eggshell), which allows us to exclude the malignant nature of the tumor.

Differential diagnostics of lipogranuloma is mandatory. The woman undergoes a biopsy, cytological and histological examination of the obtained samples. The biopsy is performed under X-ray or ultrasound control. Sometimes sonography is used for more accurate diagnostics.

Let us consider in more detail the complex of diagnostic procedures carried out to recognize lipogranuloma:

• Mammography – low-level radiation is used for diagnostics to obtain an image of the mammary gland on paper. The method allows to determine the nature of the neoplasm (benign, malignant). Mammography makes it possible to detect lipogranuloma before it is determined by palpation.
• Aspiration is a diagnostic method that allows you to find out about the contents of a tumor (liquid, dense). The procedure is carried out in a clinic and does not require anesthesia. A needle is inserted into the tumor; if it is a cyst, the fluid is extracted until the tumor subsides. If the tumor contains dense masses, the doctor obtains a small number of cells, which are examined in the laboratory using a microscope.
• Biopsy is one of the final studies, allowing to make a final diagnosis. The procedure is carried out under local or general anesthesia, in a clinic. If the neoplasm is small, the surgeon removes it completely, if it is large, only part is removed. The obtained tissues are sent for further microscopic examination.
• Ultrasound examination – high-frequency waves are used to identify tumors. Using electronics, the waves are converted into a visual image of the condition of the mammary glands.
• Transillumination – rays of light are passed through the mammary glands. Thus, different types of tissue transmit and retain light differently.
• Thermography – temperature readings are recorded on different areas of the chest. A temperature difference indicates the presence of pathology.

In the diagnostic process, none of the last three methods is used to make a final diagnosis. These methods are more often used to clarify the diagnosis, since sometimes lumps in the mammary glands indicate hormonal changes in the body. For timely detection of pathological processes in the chest, it is recommended to be examined by a doctor twice a year.

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Treatment mammary lipogranulomas

Treatment of lipogranuloma of the mammary gland depends on the results of the diagnostics, the woman's age and other characteristics of the patient's body. Benign seals, which include lipogranuloma, are treated with medication, aspiration or surgery. With the help of a puncture, fluid is sucked out of the tumor, which leads to the collapse of its walls. If after aspiration and puncture the neoplasm does not disappear, then surgical removal is performed.

Considering focal changes in fatty tissue of irreversible nature and difficulties of differential diagnostics, often with lipogranuloma, women undergo organ-preserving sectoral resection (removal of a sector or part of the breast). After such treatment, the woman is given a course of vitamin therapy and hormonal drugs to restore normal functioning of the body.

After the operation, tissue samples are sent for further examination. Postoperative histological examination makes it possible to exclude oncology. During the treatment period, a woman should maximally protect herself from possible injury to the mammary glands, hormonal imbalances and other causes that can lead to relapse of the neoplasm.

Prevention

Prevention of lipogranuloma of the mammary gland is aimed at regular examinations by a mammologist and avoiding trauma to the mammary glands. After the treatment, the woman is recommended to wear a special bandage top that maintains the normal position of the breast and prevents trauma during sports.

Since fat necrosis does not turn into a malignant tumor, but can simulate it, the woman's task is to exclude all possible causes of lipogranuloma formation. This will save from surgical intervention and further drug therapy.

Special attention in the prevention of benign breast tumors should be paid to the level of hormones. To maintain the normal functioning of the body, you should have regular sex with a regular partner, as this has a positive effect on emotional and physical health. Do not forget about nutrition, the food should be healthy and natural. You should also refrain from topless sunbathing, exercise and strengthen the immune system.

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Forecast

The prognosis for breast lipogranuloma is positive. This is due to the fact that the tumor is benign, and surgical treatment completely removes the affected tissue, which prevents possible relapses of the tumor.

Lipogranuloma of the mammary gland occurs very rarely, but despite this, it has every chance of complete recovery. The task of a woman is to regularly undergo examinations by a gynecologist and mammologist, independently examine the mammary glands and promptly seek medical help.

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