A 52-year-old woman has a firm, mildly tender 2 cm lump in the right breast. Eight months earlier she sustained a significant seatbelt injury across that chest in a road traffic accident. Mammogram shows a spiculated density containing coarse dystrophic calcifications with central lucency. The most likely diagnosis is:

• A Fat necrosis with lipid cyst formation ✓
• B Invasive ductal carcinoma
• C Radial scar
• D Galactocele

Explanation

Trauma followed by a firm lump with coarse, dystrophic calcification and a radiolucent centre (lipid cyst) is the classic picture of fat necrosis, where damaged adipocytes coalesce into an oil cyst surrounded by fibrosis. Carcinoma can look spiculated but does not produce the lucent fatty centre within the lesion. Radial scar lacks the trauma history and lipid cyst, and galactocele occurs in lactation with milk-fat fluid content.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.