Mammary fat necrosis following radiotherapy in the conservative management of localized breast cancer: does it matter?
OBJECTIVE
Fat necrosis is a well-described and relatively common complication arising from post-lumpectomy irradiation of the breast, most commonly breast brachytherapy. We wish to assess the clinical significance of fat necrosis resulting from post-lumpectomy breast irradiation.


METHODS
We reviewed the literature to determine the overall incidence and significance of fat necrosis to determine whether or not fat necrosis poses a significant clinical problem.


RESULTS
Fat necrosis occurs in up to one-quarter of patients following post-lumpectomy breast irradiation. Only rarely is invasive intervention required however, it does significantly degrade the quality of all modalities of breast imaging.


CONCLUSIONS
Fat necrosis is a common complication of radiotherapy which rarely requires therapeutic intervention. However, post-therapeutic clinical imaging such as mammography, ultrasound and magnetic resonance imaging are affected which may result in additional diagnostic procedures up to and including biopsy.
Trombetta
Mark
M
Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA 15212, USA. mtrombet@wpahs.org
Valakh
Vladimir
V
Julian
Thomas B
TB
Werts
E Day
ED
Parda
David
D
D001706:Biopsy; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D001940:Breast / Q000528:radiation effects; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005218:Fat Necrosis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D006801:Humans; D015994:Incidence; D015412:Mastectomy, Segmental; D012307:Risk Factors