Why do I have Lumps all over my right breast after fat transfer?

My right breast has a lot of lumps some big, some small all over. And my PET SCAN showed abnormalies that could not be differentiated from cancer of fat transfer. I read a lot of good reviews about fat trsnsfer, but none mentioned anything about lumps aftermath that would interfere with the monitoring of cancer. I have left breast radical mastectomy, and during the implant, the right breast, which does not have cancer and had fat teansfer is now lightning up during PET SCAN.

Doctor Answers 4

Lumps

Ideally fat transfer to the breast should not interfere with mammograms and that is why the procedure is done.  Given your history of breast cancer on the other side I think this situation should be evaluated by your oncologist or surgeon with perhaps stereoscopic biopsies to ascertain nothing adverse is going on.

Dr. Corbin


Los Angeles Plastic Surgeon
4.9 out of 5 stars 60 reviews

Fat transfer to the breast

Fat transfer to the breast is very technique dependent.  You have to imaging treating the breast like a piece of Swiss cheese.  The fat needs to placed in small droplets at various depth to allow the fat cells to survive.  If a large piece of fat is transferred all at once and there is not good surrounding vascular tissue the fat will die and end up with a condition called fat necrosis.  This leads to lumpiness of the grafted fat.  Occasionally this can create calcifications in the breast.  This may worry the radiologist as cancer can be associated with calcifications in the breast.  They type of calcification associated with fat necrosis appears to be different compared with the calcifications associated with breast cancer.  When too much fat is transferred at one time fat necrosis may occur.  So you have to monitor what's happening to the fat as some of the fat necrosis will reabsorb over time. 

Benjamin Chu, MD, FACS
Honolulu Plastic Surgeon
4.8 out of 5 stars 84 reviews

Lumpy breasts after fat transfer

Lumpy breasts after fat transfer can be due to large volumes of fat being placed in a single area with subsequent fat necrosis (death of the transferred fat) rather it being placed in small droplets to try to enhance the fat graft's ability to acquire a blood supply and survive.  Fat grafting has been shown to not confuse the detection of breast cancer on mammograms.  Perhaps another type of study such as mammogram or MRI may help address your concerns.  You should discuss this with your plastic surgeon.

Todd C. Case, MD
Tucson Plastic Surgeon
5.0 out of 5 stars 55 reviews

Lumps in breast after fat transfer

Hi Mely,
 Unfortunately, the success of fat transfers cannot always be predicted. The lumpiness can be from calcification of the fat or simply uneven distribution of the fat. While many surgeons have had success with fat transfers, there is still some controversy over its use,
especially with regard to following breast cancers.
The PET scan measures cellular activity of the tissue. Thus, increased activity may be present as your own cells are trying to break down the clumps of fat.
I would advise you strongly to check with your surgeon to be sure everything is OK.
Hope this helps,
Best,
Dr. Rodgers

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