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Case Report

Massive breast fat necrosis with invasive breast cancer: A case report

  • Authors:
    • Anjie Zhang
    • Linfeng Song
    • Xiyao Yang
    • Xu Chen
    • Binlin Tian
    • Yongzhe Li
    • Guoyuan Jiang
    • Lin Jiang
  • View Affiliations / Copyright

    Affiliations: Department of Radiology, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi), Zunyi, Guizhou 563000, P.R. China, Department of Breast and Thyroid Surgery, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi), Zunyi, Guizhou 563000, P.R. China
  • Article Number: 45
    |
    Published online on: November 25, 2025
       https://doi.org/10.3892/ol.2025.15398
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Abstract

Breast fat necrosis is a relatively uncommon benign breast condition, while invasive breast cancer is one of the most common types of breast cancer. Coexistence of massive breast fat necrosis with invasive breast cancer is relatively uncommon. The present study reported the case of a 74‑year‑old female patient who was diagnosed with breast cancer based on mammography findings; breast MRI indicated fat necrosis; subsequent surgical resection confirmed the coexistence of breast fat necrosis with invasive breast cancer using histopathological and immunohistochemical analysis. The relatively uncommon combination of these two conditions poses notable diagnostic challenges for radiologists. The present study reported relevant imaging findings to improve the understanding of radiologists on this disease, highlighting the clinical and radiological features.
View Figures

Figure 1

(A) The mammographic mediolateral
oblique view reveals an irregular high-density mass in the upper
outer quadrant of the left breast, with indistinct, spiculated
margins. (B) Axial T1-weighted MRI exhibits an irregular mass in
the upper outer quadrant of the left breast with indistinct,
spiculated margins. The lesion exhibits low signal intensity with
small focal areas of high signal intensity within. (C) Axial
fat-suppressed T2-weighted MRI demonstrates slightly high signal
intensity within the mass, with small focal areas of low signal
intensity. These areas are lower in signal intensity than the
surrounding fat, displaying the characteristic ‘black hole sign’.
(D) Axial post-contrast MRI exhibits heterogeneous enhancement of
the mass with patchy non-enhancing areas. (E) Maximum intensity
projection reveals slightly increased vascularization of the mass.
(F) The time-signal intensity curve demonstrates a washout
pattern.

Figure 2

(A) The gross specimen exhibits
extensive gray-yellow necrotic fat with white spot-like cancer foci
(indicated by the black arrow). (B) Fat necrosis and invasive
breast cancer (H&E stain): The area indicated by the blue arrow
displays ruptured or disrupted adipocytes, with their normal round
structure destroyed. Macrophages are visible. The area indicated by
the black arrow displays highly heterogeneous cancer cell
morphology and size, with an increased nucleus-to-cytoplasm ratio.
The cancer cell cytoplasm stains light pink, and the cancer cells
infiltrate the surrounding fibrous stroma in a cord-like pattern
(magnification, ×5). (C) Invasive breast cancer (Ki-67):
Ki-67+ cells have brownish-yellow-stained nuclei. The
positive staining is confined to the cell nucleus, with no staining
in the cytoplasm. (D) Invasive breast cancer (E-cadherin):
E-cadherin(+) displays brownish-yellow positive staining on the
cancer cell membranes, with staining primarily localized to the
cell membrane, suggesting that the cancer cells still retain some
adhesive function. (E) Invasive breast cancer (ER): ER+
cells have brownish-yellow-stained nuclei. (F) Invasive breast
cancer (PR): PR+ cells have brownish-yellow-stained
nuclei (magnification, ×10). ER, estrogen receptor; PR,
progesterone receptor.

Figure 3

(A) Invasive breast cancer (c-erbB-2):
c-erbB-2+ with brownish-yellow staining observed on
tumor cell membranes. (B) Invasive breast cancer (p120):
p120+ with brownish-yellow staining in tumor cells. (C)
Invasive breast cancer (nm23): nm23+ with
brownish-yellow cytoplasmic staining in tumor cells. (D) Invasive
breast cancer (EGFR): EGFR− with no staining observed in
tumor cells. (E) Invasive breast cancer (CK5/6): CK5/6−
with no staining in tumor cells. (F) Invasive breast cancer (p63):
p63− with no staining detected in tumor cells
(magnification, ×10). c-erbB-2, erythroblastic oncogene B-2
receptor; nm23, non-metastatic protein 23.
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Copy and paste a formatted citation
Spandidos Publications style
Zhang A, Song L, Yang X, Chen X, Tian B, Li Y, Jiang G and Jiang L: Massive breast fat necrosis with invasive breast cancer: A case report. Oncol Lett 31: 45, 2026.
APA
Zhang, A., Song, L., Yang, X., Chen, X., Tian, B., Li, Y. ... Jiang, L. (2026). Massive breast fat necrosis with invasive breast cancer: A case report. Oncology Letters, 31, 45. https://doi.org/10.3892/ol.2025.15398
MLA
Zhang, A., Song, L., Yang, X., Chen, X., Tian, B., Li, Y., Jiang, G., Jiang, L."Massive breast fat necrosis with invasive breast cancer: A case report". Oncology Letters 31.2 (2026): 45.
Chicago
Zhang, A., Song, L., Yang, X., Chen, X., Tian, B., Li, Y., Jiang, G., Jiang, L."Massive breast fat necrosis with invasive breast cancer: A case report". Oncology Letters 31, no. 2 (2026): 45. https://doi.org/10.3892/ol.2025.15398
Copy and paste a formatted citation
x
Spandidos Publications style
Zhang A, Song L, Yang X, Chen X, Tian B, Li Y, Jiang G and Jiang L: Massive breast fat necrosis with invasive breast cancer: A case report. Oncol Lett 31: 45, 2026.
APA
Zhang, A., Song, L., Yang, X., Chen, X., Tian, B., Li, Y. ... Jiang, L. (2026). Massive breast fat necrosis with invasive breast cancer: A case report. Oncology Letters, 31, 45. https://doi.org/10.3892/ol.2025.15398
MLA
Zhang, A., Song, L., Yang, X., Chen, X., Tian, B., Li, Y., Jiang, G., Jiang, L."Massive breast fat necrosis with invasive breast cancer: A case report". Oncology Letters 31.2 (2026): 45.
Chicago
Zhang, A., Song, L., Yang, X., Chen, X., Tian, B., Li, Y., Jiang, G., Jiang, L."Massive breast fat necrosis with invasive breast cancer: A case report". Oncology Letters 31, no. 2 (2026): 45. https://doi.org/10.3892/ol.2025.15398
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