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Case Reports
. 2025 Jun 13;17(6):e85934.
doi: 10.7759/cureus.85934. eCollection 2025 Jun.

From Aesthetic to Alarming: Ductal Carcinoma In Situ Following Breast Fat Grafting

Laila Ashkar  1 , Bashair M Abufarea  2 , Fai F Alkaeid  1 , Raghad O Alruwaithi  1 , Raghad W Nadhra  1
Affiliations
Case Reports

From Aesthetic to Alarming: Ductal Carcinoma In Situ Following Breast Fat Grafting

Laila Ashkar et al. Cureus. .

Abstract

This case presents a rare occurrence of ductal carcinoma in situ (DCIS) in a patient with a history of bilateral iatrogenic fat injections, aiming to contribute to the ongoing discussion on potential associations between fat grafting and breast pathology. A 43-year-old Saudi woman presented with bilateral palpable masses at the sites of previous fat grafting performed two years earlier. Despite having no significant risk factors or family history of breast cancer, imaging revealed a suspicious asymmetry adjacent to the palpable area in the left breast. Biopsy of this region confirmed fat necrosis with foci of atypical ductal hyperplasia and low-grade DCIS. This case underscores the importance of vigilant follow-up in patients undergoing autologous fat grafting to the breast.

Keywords: atypical ductal hyperplasia; case report; dcis; fat grafting; mammography.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Timeline of case presentation
Timeline illustrating the patient’s clinical progression following bilateral breast fat injections, including the development and evaluation of palpable breast masses. DCIS, ductal carcinoma in situ
Figure 2
Figure 2. Pre-lumpectomy craniocaudal (a, b) and mediolateral oblique (c, d) mammograms
Mammograms showing bilateral, well-circumscribed, fat-containing masses. In the left breast (b, d), an irregular focal asymmetry with architectural distortion is observed adjacent to the area of fat necrosis (see arrow).
Figure 3
Figure 3. Pre-lumpectomy ultrasound
Ultrasound images showing bilateral complex cystic and solid masses at the 12:00 position (a, b), with features suggestive of oil cysts or fat necrosis. In the left breast (c), an irregular mass with architectural distortion is observed adjacent to the area of fat necrosis (see arrow).
Figure 4
Figure 4. Pre-lumpectomy MRI
T1 non-fat-saturated (a), T1 fat-saturated (b), axial (c), and coronal (d) subtraction MRI sequences showing bilateral oval, fat-containing masses. The left-sided lesion demonstrates a thick, enhancing wall. The red arrow indicates a suspicious, irregular, enhancing mass at the inferior margin of the fat necrosis in the left breast.
Figure 5
Figure 5. Post-lumpectomy mammogram
(a) The right breast demonstrates increased rim and intrinsic calcifications within the oil cyst/fat necrosis, categorized as BI-RADS 2. (b) The left breast shows postsurgical architectural distortion following removal of the oil cyst/fat necrosis.
See this image and copyright information in PMC

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