Surgery MCQ 199

A 35-year-old female presents with a painless swelling in her left breast that developed following a recent trauma to the area. The swelling is firm and has not been associated with any signs of infection or inflammation. The clinical team is evaluating the most likely cause of the swelling based on the history of trauma and the nature of the lump.

What is the most likely diagnosis for a painless breast swelling following trauma?

A. Breast Abscess  
B. Ductal Carcinoma  
C. Fibroadenoma  
D. Lipoma  
E. Fat Necrosis


The Correct Answer: E. Fat Necrosis

Explanation:

Fat Necrosis (E): Fat necrosis is a common response to trauma in the breast and is characterized by the formation of a painless, firm mass. It occurs due to the death of fat tissue following injury, leading to a localized inflammatory reaction. The mass is typically well-defined and can be mistaken for a malignancy, but it is a benign condition that often resolves on its own.

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Explanation of Incorrect Options:

– Breast Abscess (A): A breast abscess usually presents with pain, swelling, and signs of infection, such as redness and warmth. It is unlikely to be painless and would typically be associated with systemic symptoms or local signs of infection.

– Ductal Carcinoma (B): Ductal carcinoma is a type of breast cancer that can present as a painless lump, but it is not typically associated with recent trauma. Cancerous lumps are often irregular and may have associated lymphadenopathy.

– Fibroadenoma (C): Fibroadenomas are benign tumors that usually present as painless, mobile, and well-circumscribed lumps. They are not typically associated with recent trauma.

– Lipoma (D): A lipoma is a benign tumor of fatty tissue that is generally soft, mobile, and painless. While it could be a consideration, fat necrosis is more commonly associated with trauma.
In summary, fat necrosis is the most likely diagnosis for a painless breast swelling following trauma, making option E the correct answer.