Teaching Case 27
52 y/o F with recalled from screening for a left asymmetry. What is the most likely diagnosis?
- Saponification of local fat – benign inflammatory process
- Related to direct trauma or surgery
- Middle-aged women with pendulous breasts are more prone
- Can evolve into an oil cyst (fine curvilinear calcification of the wall)
- Mammo: Fat density [focal] asymmetry
- US: Variable
- Acute – hyperechoic due to edema
- Subacute – ill-defined cystic lesion (anechoic) surrounded by edema (hyperechoic)
- Late – round/oval mass with shadowing calcified walls
Related Radiology Article: Taboada JL, Stephens TW, Krishnamurthy S, Brandt KR, Whitman GJ. The many faces of fat necrosis in the breast. AJR Am J Roentgenol. 2009 Mar 1;192(3):815-25.