Lipogranuloma of the breast

Lipogranuloma of the breast is a fatty necrosis, that is a benign formation.

Let's consider features of the given pathology, signs, methods of diagnostics, ways of treatment and preventive maintenance, and also the forecast on convalescence.

[1], [2], [3], [4], [5]

Causes of the breast lipogranulomas

Lipogranulema is a benign neoplasm, which is characterized by the formation of aseptic inflammatory processes, cysts and foci of lipocyte necrosis. Lipogranulems are distinguished by the type of structure, diffuse and nodular. The cause of the pathology can be trauma, a sharp decrease in body weight, radiation exposure and other.

The causes of lipogranuloma mammary gland are varied, but most often the growth appears due to chest injuries. In case of trauma, normal blood circulation is disrupted and fatty tissue is damaged. Inside the gland an inflammatory focus is formed, from which it is possible to isolate the infiltrate with transformation into a granulation tissue with a solid capsule. Pathology can appear due to blockage of the ducts of the sebaceous gland, due to a sharp decrease in weight and exposure to radiation.

The disease is 0.6% of all cases of nodal lesions of the breast. Most often this pathology appears in women with macromastia, than in women with small breasts. Traumatic factors include bruises, medical manipulations, sports injuries, and more. In some cases, radiation therapy leads to the formation of lipogranuloma.

Reconstructive mammoplasty with one's own tissues after mastectomy is another reason for a benign tumor. Due to damage to the capillaries, blood circulation is lost. Once the inflammatory process has died out, the fibrous tissue begins to develop in the mammary gland. In some cases scar tissue appears on the site of necrosis. Later on such areas of the breast are deposited calcium salts, which leads to petrification of the foci of necrosis or ossification processes.

[6], [7], [8], [9], [10]

Symptoms of the breast lipogranulomas

Most often, the disease occurs in women with large breasts. The tumor is characterized by a prolonged formation, which at first does not manifest itself. The first symptom of pathology is posttraumatic formations with hematomas and hemorrhages. If the mammary gland is necrosis of fat cells, a fluid cyst is formed in the lipogranulem. In some cases, the contents of the capsule are infected, which leads to suppuration. If the lipogranuloma progresses over a long period of time without proper treatment, then it leads to its calcification.

Women who have been diagnosed with this pathology experience discomfort and pain in certain areas of the mammary glands. At attempts of a palpation the morbid, dense and hummock formation is accurately defined. If the neoplasm has a pronounced character, this leads to the retraction of the nipple and the deformation of the mammary gland. But in some cases, the disease is asymptomatic. Quite often the tumor in its current resembles a malignant process, so it is very important to properly diagnose lipogranuloma and differential methods of study.

Symptoms of lipogranuloma of the breast depend largely on the causes that caused the pathology. Microscopically, pathology is a nodular proliferation of granulation tissue from epithelial cells, xanthomatous and lipophagous with giant-sized nuclei around the adipose tissue. The diffuse lipogranuloma is surrounded by a fatty tissue of the mammary gland, and the nodal capsule. Thin-walled cavities filled with serous or oily liquid are one of the components of the lipogranuloma.

If fat necrosis occurs as a result of trauma, a painful tumor of round shape with a dense consistency and welded to the skin appears on the lesion site. With the progression of the disease, the mammary gland may lose its sensitivity.

• Red or cyanotic skin color of the gland is another symptom of lipogranuloma. If the neoplasm arises in the areola region, this leads to the entrainment of the nipple and deformation of the breast. Lipogranulema is not accompanied by high body temperature, as it happens with mastitis.
• Symptoms of lipogranuloma are externally similar to breast cancer. On the skin appear dimples, there is a deformation of the breast, a dense infiltrate and an increase in lymph nodes.

Lipogranuloma is characterized by painful sensations, which are enhanced by palpation of the breast. The pain arises even at palpation, probably an increase in lymph nodes and the appearance of small dimples on the skin. Note that the lipogranuloma does not degenerate into a malignant tumor, but can simulate it. Therefore, it is very important to use differential diagnostics. If the fat necrosis is detected by ultrasound or mammography, the tumor can be defined as a malignant tumor.

[11], [12], [13]

Diagnostics of the breast lipogranulomas

Diagnosis of breast lipogranuloma is a very important process. The final diagnosis (the nature of the tumor) and the choice of the method of treatment depend on the results of the studies performed. In the diagnosis of fat necrosis, recent lesions of the gland are important, since they can be the cause of pathology. Initially, the mammologist examines the chest and palpation. In the process of palpation, fluctuations and painful seals with indistinct contours can be detected.

In addition to the initial examination and palpation, a woman is given an overview mammogram, a computer and magnetic resonance imaging of the mammary glands. In this case, the lipogranuloma appears as a nodal seal with uneven contours and a heterogeneous structure. At a roentgenography, a tomography and an ultrasound, fatty necrosis has a picture similar to a cancer of a mammary gland. At later stages, when calcification of the tumor occurs, the focus of the pathology looks like a spherical calcinate (as an egg shell), which allows to exclude the malignant nature of the tumor.

Differential diagnosis of lipogranuloma is mandatory. A woman undergoes biopsy, cytological and histological examination of the samples. A biopsy is performed under x-ray or ultrasound. Sometimes sonography is used for more accurate diagnosis.

Let's consider in detail the complex of diagnostic procedures conducted for the recognition of lipogranuloma:

• Mammography - for the diagnosis use low radiation to get a picture of the breast on paper. The method allows to determine the nature of the neoplasm (benign, malignant). Mammography provides an opportunity to identify the lipogranuloma before it is determined by the method of palpation.
• Aspiration is a diagnostic method that allows you to learn about the contents of a tumor (fluid, dense). The procedure is carried out in a polyclinic, and it does not require anesthesia. In the new formation of a needle, if it's a cyst, the fluid is extracted until the tumor is gone. If the neoplasm contains dense masses, the doctor receives a small number of cells, which he examines in the laboratory using a microscope.
• Biopsy - one of the final studies, allows you to make a final diagnosis. The procedure is performed with local or general anesthesia, in a clinic. If the tumor is small, the surgeon removes it completely, if large, then only a part is removed. The resulting tissue is sent for further microscopic examination.
• Ultrasound - high frequency waves are used to detect tumors. With the help of electronics, the waves are transformed into a visual image of the state of the mammary glands.
• Translumination - rays pass through the mammary glands. So, different types of fabrics differently pass and delay light.
• Thermography - on different parts of the chest record temperature. The temperature difference indicates the presence of pathology.

During the diagnosis, none of the last three methods are used to establish a final diagnosis. These techniques are often used to clarify the diagnosis, because sometimes seals in the mammary glands indicate hormonal changes in the body. For the timely detection of pathological processes in the chest, it is recommended that the doctor be examined twice a year.

[14], [15], [16], [17]

Treatment of the breast lipogranulomas

Treatment of lipogranuloma of the breast depends on the results of the diagnosis, the age of the woman and other characteristics of the patient's body. Benign seals, which include lipogranulema, are treated with medication, aspiration or surgical intervention. With the help of a puncture, a liquid is sucked from the tumor, which leads to a drop in its walls. If, after aspiration and puncture, the neoplasm has not disappeared, then surgical removal is performed.

Given focal changes in fatty tissue irreversible and the difficulty of differential diagnosis, often with lipogranuloma, women are performing organ-preserving sectoral resection (removal of the sector or part of the breast). After such treatment, a woman will receive a course of vitamin therapy and hormonal drugs to restore normal functioning of the body.

After the operation, tissue samples are sent for further research. Postoperative histological examination makes it possible to exclude oncology. During the treatment the woman should protect herself as much as possible from possible traumatization of mammary glands, hormonal failures and other reasons that can lead to relapse of the neoplasm.

Prevention

Prophylaxis of lipogranuloma of the breast is directed to regular examinations at the mammalogist and avoidance of traumatism of the mammary glands. After the treatment, a woman is recommended to wear a special bandage top that maintains the normal position of the breast and prevents traumatization in 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 the formation of lipogranuloma. This will save you from surgery and further medication.

Particular attention in the prevention of benign breast formations should be addressed to the level of hormones. To maintain the normal functioning of the body should be a regular sex life with a regular partner, as this positively affects emotional and physical health. Do not forget about food, the food should be healthy and natural. You should also refrain from sunbathing topless, play sports and strengthen the immune system.

[18], [19], [20]

Forecast

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

Lipogranuloma of the breast occurs very rarely, but, despite this, it has all the chances for a full recovery. The task of a woman to regularly undergo examinations with a gynecologist and mammologist, independently conduct an examination of the mammary glands and promptly seek medical help.

[21], [22]