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Atlas of breast cancer early detection

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Case number:029
Clinical presentation:Premenopausal woman with average risk of developing breast cancer presented with a left breast lump following breast trauma a week ago.


Ultrasound features: Left breast, inner quadrants at 9 o’clock

 ‣ Mass
   • Location:Left breast, inner quadrants at 9 o’clock
   • Number:1
   • Size:2.5 × 0.7 cm
   • Shape:Irregular
   • Orientation:Parallel
   • Margins:Indistinct
   • Echo pattern:Anechoic
   • Posterior features:No posterior features
 ‣ Calcifications:None
 ‣ Associated features:None
 ‣ Special cases:Post-traumatic organized haematoma collection


BI-RADS Category: 2 (benign)

Further assessment:

Further assessment advised: Referral for cytology


Cytology features:

 ‣ Type of sample:FNAC
 ‣ Site of biopsy:
   • Laterality:Left
   • Quadrant:Inner, 9 o’clock
   • Localization technique:Palpation
   • Nature of aspirate:Greasy aspirate
 ‣ Cytological description:Abundant lipid debris with many degenerating adipocytes, foamy macrophages, and a few inflammatory cells
 ‣ Reporting category:Benign
 ‣ Diagnosis:Cytomorphology suggestive of fat necrosis
 ‣ Comments:None

Case summary:

Premenopausal woman presented with left breast lump following recent breast trauma. Diagnosed as post-traumatic collection on imaging and as fat necrosis on cytology.

Learning points:

  • Fat necrosis can simulate carcinoma clinically because of skin retraction and also on imaging studies where it is seen as a mass with irregular margins.

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