This page is dedicated to organizing various examples of standardized exam questions whose answer is fat necrosis of the breast. While this may seem a odd practice, it is useful to see multiple examples of how fat necrosis of the breast will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 33 year old woman is being evaluated for a mass found in her breast during a self exam a few days ago. The patient has a past history of a bilateral breast reduction about 2 years ago. She currently takes no medications and her paternal grandmother died at age 67 from breast cancer. In the clinic her breast exam shows a firm and fixed mass in the upper region of the left breast. A mammogram shows a 2 X 4 cm spiculated was with coarse calcifications in the upper region of the left breast. An ultrasound of the breast shows a hyperechoic mass. A core biopsy is taken, and the pathologist notes the presence of foamy macrophages and fat globules when analyzing the biopsy. Later the mass is excised and further pathological findings are concordant with the biopsy. What is the likely diagnosis in this patient?
Explanation: calcifications on imaging + foamy macrophages/fat globules on biopsy.
Page Updated: 10.05.2016