Hello pisces252 and welcome to our forum!

I just wanted to let you know that I have asked our specialist nurses to take a look at your post and they will respond to you very soon. I am sure they will have some useful tips or advice for you.

Best wishes,

Lucie, Cancer Chat Moderator

Hello Pisces252

Thanks for posting a question. I am one of the nurses and as you have not received any replies Lucie our moderator wondered if we might be able to help.

Unfortunately I am not sure that there is much that you can do yourself about the fat necrosis. It may go away without any treatment. All I can really suggest is that you use over the counter pain killers or anti-inflammatory drug like ibuprofen for the pain (check first with your doctor or pharmacist that it is OK for you to take these drugs).

As the pain is troubling you  I think that it is perfectly acceptable for you to discuss things again with the breast care team at the hospital. If you have a breast care nurse you could telephone them and leave a message. If you do have another oil filled cyst draining it may help with the pain. But sometimes there is a hard fatty lump rather than a cyst. Doctors can remove this with surgery if it is very bothersome. But they try to avoid surgery if they can.

As you were looking for tips from people who have had or still have fat necrosis I wonder if you might have more chance of a response on the Breast Cancer Care Forum.

I hope that this reply helps a little. If you have any other questions do get back to us. If you would like to telephone our freephone number is 0808 800 4040. We are here from Monday to Friday between the hours of 9am to 5pm.

Kind regards,

Jean

I was diagnosed with triple negative breast cancer in Oct 2019; I had 7 cycles of chemotherapy, followed by wide local incision surgery and then 5 intensive days of radiotherapy. Whilst I was happy to be told I was cancer free following this treatment, due to the COVID-19 pandemic I was not seen for any follow ups as these were only done by phone. By the summer of 2020 I had developed severe puckering on the side of my left breast where the lump had been removed, and on the inside of the breast a hardening of the skin. I eventually got seen by breast surgeon on September 2020 and was diagnosed with severe fat necrosis and fibrosis. The area becomes infected every few months meaning I was to take antibiotic for up to 2 weeks ata time, I amin severe pain and take painkillers as well. I have lymphatic drainage massage when I can, although due to lockdowns this has been sporadic.  I am now faced with having to have a mastectomy of my left breast and since there isn't enough viable skin and tissue undamaged in my breast a need a bi-pedicel diet flap surgery to reconstruct the breast using skin, fat and blood vessels from my tummy. I will then have a breast lift of the right breast to give me back some symmetry and a third procedure of tattooing a pile onto the reconstructed left breast.
 

My first surgery is not due to take place until the end of June, since I had to wait for a year after my least radiotherapy session and timings due to high volume of work my breast surgeon and plastic surgeon are having to undertake due to cases missed during the pandemic.  I'm having this done privately as alternative under NHS is to wait another 18 months and I don't think I can live with the pain that long.  This has meant that my cancer journey feels somewhat protracted and I cannot put it behind my until after these surgeries.

I currently take 400mg ibuprofen and paracetamol for the pain during the day, also using volterol gel and take Amitripyline 10-20mg at night.  Any other suggestions of how to deal with pain for the next 7 weeks? Has anyone else suffered like this fro such dramatic effects from the radiotherapy?

I’d be really grateful to know how things are for you both now pls, as I realise these posts are now old. 
I’ve had a similar journey to severe fat necrosis and fibrosis. After a bilateral mammoplasty/ quadrantectomy to remove the cancer, I rapidly developed a large dent in the ‘fault line’, where the tissue was re-folded together. I then begun to develop fat necrosis and hardening of my breast on the cancer side.  Following radiotherapy, it intensified significantly, with the large dent and hard tissue pushing on the nerves in my armpit and leading to lymphodema & constant pain. My nipple and areola became distorted, pulling up and in towards my armpit. Two months after completing radiotherapy, I had lipofilling privately, with the surgeon advising that the fat would fill the large dent. None of the fat survived and after two mths of recurrent infections, I had further lipofilling and the nipple/areola moved lower on my breast. The blood supply failed and after 6 weeks, my dead nipple and much of the areola was excised & this is slowly healing from the base up. Again, all the fat died and this time my breast became significantly fibrosed and shrunken. Once healed and recovered, physically and emotionally, I’ll need more reconstruction surgery and a nipple forming. I’ve been advised by a plastic surgeon to wait at least six mths after fully healing and then have repeated fat injections every 3 mths, potentially 5 times. I’m wondering if anyone has found massage or any other minimally invasive treatment has helped with the necrosis, as I feel I need to try and do something positive whilst waiting for yet more surgery.  If anyone can give me some hope, I’d be truly grateful.