A Review on Fat Necrosis of the Breast: The Dilemma of Differential Diagnosis with Cancer

Fat necrosis is a benign inflammatory process which can involve adipose tissueanywhere in the body.Aprevious history of trauma or surgery may or may not bepresent. Information about the clinical and radiological appearance of this lesion isvery important because it can mimic breast cancer.In this article, we review the features of fat necrosis in different imagingmodalities including mammography, ultrasound, and magnetic resonance imaging(MRI), and compare them with histopathologic findings; then, we try to provide alogical approach for fat necrosis management.The appearance of fat necrosis at imaging is variable from definitely benigntype to highly suspicious for malignancy. The specificity of mammography ishigher than that of ultrasonography; therefore, for a definite diagnosis of fatnecrosis, emphasis should be mainly based on mammography rather thanultrasonography.Finally, fat necrosis is not a common disease; however, regarding unusual andatypical findings in different imaging modalities, differentiation from a cancermay be difficult, especially in patients with a previous history of malignancy.Therefore, a multimodality approach is required for a definite diagnosis.