title: Drug injection-related fat necrosis of the breast with FDG PET-CT uptake.
abstract: A 52-year-old woman was found to have a lung mass and bilateral breast lesions on computed tomography (CT). Subsequent positron emission tomography/CT demonstrated marked uptake in the lung mass and mild uptake within the breast lesions. A diagnostic mammogram and targeted ultrasound were performed to exclude primary breast malignancy or metastases from presumed pulmonary malignancy. A pertinent history of recent intravenous drug use with heroin injection into bilateral breasts, together with imaging features, facilitated diagnosis of fat necrosis. Fat necrosis is a common diagnosis in breast imaging and may be an incidental finding on positron emission tomography/CT in the oncologic setting. The presence of fat along with suggestive clinical history can lead to the diagnosis and appropriate assignment of either benign, breast imaging-reporting and data system (BI-RADS) 2, or probably benign, BI-RADS 3, category with short interval follow-up. Appropriate work-up of incidental fluorodeoxyglucose-avid breast masses with diagnostic mammogram ± ultrasound is warranted to avoid incorrect interpretation as neoplastic processes.
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, University of Washington School of Medicine, Box 357115, Seattle, WA, 98195-7115, USA.
authors.forename: Lauren Kay
authors.initials: LK
authors.lastname: Toney
authors.affiliation: Division of Breast Imaging, Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Lam
authors.affiliation: Division of Breast Imaging, Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Habib
authors.initials: H
authors.lastname: Rahbar
keywords: Breast; Breast lump; FDG PET-CT; Fat necrosis; Intravenous drug use