0:00

In this case, we have a 68-year-old female presenting

0:03

with a palpable abnormality in the right breast.

0:07

She's had a history of prior lumpectomy, uh,

0:11

in the right breast near by this location,

0:14

and has also had a prior history of benign, uh,

0:17

ultrasound-guided biopsy for which we see clip here.

0:20

Here, looking over where the PAL abnormality

0:23

is underlying, we see a fat-containing

0:25

mass, which has a thin encapsulated margin.

0:29

Both the CC and MLO views.

0:32

Now on both of these views, we see some, uh,

0:34

faint or smaller, sorry, rim calcifications,

0:38

which look like they marginate that area of fat.

0:42

Um, now of course this would be pretty typical

0:44

for fat process, um, with those thin sort of

0:49

rim calcifications. Given her history of cancer,

0:52

however, um, we've elected to have, uh, further

0:55

workup with ultrasound just for confirmation.

1:00

Uh, she subsequently underwent ultrasound,

1:01

which showed this oval, circumscribed

1:04

mass with some heterogeneous internal

1:05

components and posterior acoustic shadow.

1:08

These findings are, uh, compatible

1:10

with evolving fat necrosis.

1:13

Area, which we didn't, uh, completely evaluate here.

1:17

So look at our DBT images.

1:20

It won't be particularly helpful in this case,

1:21

since we've already showed these, uh, rim

1:23

calcifications, which are very stereotypical for fat necrosis.

1:27

But it is always good to confirm that there's no

1:28

additional mass that we're looking at to evaluate.

1:32

So as we scroll through, we can see a very nice, thin,

1:35

encapsulated margin, completely fat-containing mass.

1:39

With no internal components, which would make

1:40

us worry. In addition, deeper in the breast,

1:43

there's no other abnormality which might

1:45

be corresponding to the palp abnormality.

1:47

We always wanna make sure that we look a little

1:49

bit deeper too, just to make sure there's not

1:51

some other finding that might be corresponding

1:53

to the palp abnormality, and you think that it

1:55

might be related to the more benign finding.

1:58

Anyway, we see stereotypical, um, uh,

2:01

findings of fat necrosis, um, likely related

2:04

to her prior surgery at this location.

2:06

Considered benign, recommend.

Fat Necrosis - Post Surgical

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0:00

In this case, we have a 68-year-old female presenting

0:03

with a palpable abnormality in the right breast.

0:07

She's had a history of prior lumpectomy, uh,

0:11

in the right breast near by this location,

0:14

and has also had a prior history of benign, uh,

0:17

ultrasound-guided biopsy for which we see clip here.

0:20

Here, looking over where the PAL abnormality

0:23

is underlying, we see a fat-containing

0:25

mass, which has a thin encapsulated margin.

0:29

Both the CC and MLO views.

0:32

Now on both of these views, we see some, uh,

0:34

faint or smaller, sorry, rim calcifications,

0:38

which look like they marginate that area of fat.

0:42

Um, now of course this would be pretty typical

0:44

for fat process, um, with those thin sort of

0:49

rim calcifications. Given her history of cancer,

0:52

however, um, we've elected to have, uh, further

0:55

workup with ultrasound just for confirmation.

1:00

Uh, she subsequently underwent ultrasound,

1:01

which showed this oval, circumscribed

1:04

mass with some heterogeneous internal

1:05

components and posterior acoustic shadow.

1:08

These findings are, uh, compatible

1:10

with evolving fat necrosis.

1:13

Area, which we didn't, uh, completely evaluate here.

1:17

So look at our DBT images.

1:20

It won't be particularly helpful in this case,

1:21

since we've already showed these, uh, rim

1:23

calcifications, which are very stereotypical for fat necrosis.

1:27

But it is always good to confirm that there's no

1:28

additional mass that we're looking at to evaluate.

1:32

So as we scroll through, we can see a very nice, thin,

1:35

encapsulated margin, completely fat-containing mass.

1:39

With no internal components, which would make

1:40

us worry. In addition, deeper in the breast,

1:43

there's no other abnormality which might

1:45

be corresponding to the palp abnormality.

1:47

We always wanna make sure that we look a little

1:49

bit deeper too, just to make sure there's not

1:51

some other finding that might be corresponding

1:53

to the palp abnormality, and you think that it

1:55

might be related to the more benign finding.

1:58

Anyway, we see stereotypical, um, uh,

2:01

findings of fat necrosis, um, likely related

2:04

to her prior surgery at this location.

2:06

Considered benign, recommend.

Report

Faculty

Ryan W. Woods, MD, MPH

Assistant Professor of Radiology

University of Wisconsin School of Medicine and Public Health

Lesson

Pre-Course Activities

Lesson

Introduction to Tomosynthesis

Lesson

Approach to Interpretation and Lesion Localization

Lesson

Normal Imaging Findings

Lesson

Asymmetries and Masses

Lesson

Gynecomastia

Lesson

Fat-containing Lesions

Lesson

Architectural Distortion

Lesson

Calcifications

Lesson

Associated Findings

Lesson

Postsurgical Findings

Fat Necrosis - Post Surgical