Traumatic fat necrosis occurs more frequently in overweight women and in women with pendulous breasts. Haagensen¹ reported a mean age of 52 years with a range from 27 to 80 years. The youngest patient in the Adair and Munger series² was 14 years old, with a median age in the 50s.

Patients typically present with a painless mass located superficially in the breast, accompanied by retraction or dimpling of the overlying skin if the lesion is superficially located. The skin may be thickened clinically and radiologically. Fat necrosis most frequently occurs in the subareolar and periareolar regions, but any part of the breast may be affected. Tumors formed by fat necrosis average 2 cm in diameter. They are firm and relatively circumscribed on palpation. The clinical problem of distinguishing between fat necrosis and recurrent or de novo carcinoma is especially difficult in patients who have undergone breast-conserving surgery and radiation therapy.⁴ Fat necrosis has been reported after various forms of radiation therapy, including external beam, iridium implantation, mammosite, and intraoperative radiation. Massive fat necrosis of the breast has been described as a complication of secondary hyperparathyroidism with mural arterial calcification.⁵