Fat necrosis after radiation

I am an 11-year survivor of invasive ductal carcinoma. I had chemol then a lumpectomy, then an irridium boost, then external beam radiation. I went for my annual check at my high-risk cancer clinic this past week, and they found something odd on my mammogram(s), then on the sono, so a core needle biopsy was ordered. The radiologist took one look at the sono screen prior to administering lidocaine and announced that I had fat necrosis, but that he would biposy it anyway to be sure. My question: does fat necrosis take care of itself? Does its presence mean that I need to have scans more frequently? I don't get the path results for 5 more days.

[Fernando Roque, MD]

Hi.  Fat necrosis is a common finding in breast mammograms after lumpectomy and radiation therapy.  It occurs as a result of either direct injury by the radiation to the fat tissue or injury by the surgery/ radiation to the blood vessels supplying the fat tissue.  This causes the fat tissue to literally "die" or undergo necrosis, leaving behind either calcifications or areas of lucency (dark areas) on mammography.  Fat necrosis is basically a "scar" left behind after the treatment and should not lead to any problems.  Your doctor wants to perform a biopsy just to make sure that what he's seeing in the mammogram is actually fat necrosis and nothing else.  If the biopsy confirms the finding of fat necrosis, you probably wouldn't need to do scans more frequently, unless a new abnormal finding is observed.

[Leathm60]

A related discussion, Information on postradiation fat necrosis in my leg was started.