TRAUMATIC FAT NECROSIS

**TRAUMATIC FAT NECROSIS **

Definition Traumatic fat necrosis is a rare form of fat necrosis caused by trauma to the breast tissue.

Types

1. Traumatic fat necrosis can occur after minor injuries such as bruising or after major surgery like mastectomy.

Causes

1. Trauma → direct injury to the breast tissue → severe bruising → mastectomy or other surgical procedures
2. Idiopathic - some cases may not have any known cause.

Clinical Features

1. The breast may appear swollen, red, or bruised
2. The patient may feel pain or tenderness in the affected area
3. In some cases, the fatty tissue may become calcified and appear as a mass on imaging studies.

Investigations

1. Mammography → mammograms may show a mass or calcification in the affected area → the mass may appear as a spiculated mass with surrounding skin thickening
2. Ultrasound → ultrasound may show a hypoechoic mass with a posterior acoustic enhancement → the mass may be well-defined with a lobulated border.

Imaging Features on Mammogram

1. The mass may appear as a spiculated mass → the mass may be surrounded by skin thickening → calcification may be present within the mass.

Imaging Features on Ultrasound

1. The mass may appear hypoechoic → the mass may have a posterior acoustic enhancement → the mass may be well-defined with a lobulated border.

Differential Diagnosis from Malignancy

1. Carcinoma → ductal carcinoma in situ (DCIS) → invasive ductal carcinoma (IDC) → inflammatory breast cancer (IBC)
2. Other conditions such as fibroadenoma or cysts.

Complications

1. Infection → cellulitis → abscess formation
2. Hematoma → collection of blood in the affected area.

Management

1. Conservative management → observation with regular follow-up → pain management
2. Surgical management → excisional biopsy → wide local excision.

Surgical Management

1. Excisional biopsy → a small incision is made to remove the affected tissue → the tissue is sent for histopathological examination
2. Wide local excision → a larger incision is made to remove the affected tissue and a margin of normal tissue → the tissue is sent for histopathological examination.

Homeopathic Support

1. Arnica montana → for pain and swelling
2. Calendula officinalis → for wound healing
3. Hypericum perforatum → for nerve pain
4. Graphites → for skin conditions.