Answer 1: C. Fat necrosis.
Answer 2: B. Suture material.
A 22-year-old female collegiate soccer player complains of a painful palpable area in her right breast accompanied by a straw-colored nipple discharge. Because she is extremely anxious and has had previous excisional biopsies, you decide to perform a lumpectomy. Comment: Fat necrosis is not a common lesion found in the breast, although it is of clinical importance since a mass is often produced. The most common cause is trauma, although some patients do not recall an injury. The skin can appear retracted and the nipple can exhibit a bloody or straw-colored discharge. The tissue injury results from release of triglycerides and lipases from the adipocytes. With time, saponification of the lipid can occur and there is deposition of a white chalky residue which often becomes infiltrated with calcium.
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Reference:
López JA, Saez F, Alejandro Larena J, et al. MRI diagnosis and follow-up of subcutaneous fat necrosis. J Magn Reson Imaging. 1997;7:929-932.
Yanina IY, Orlova TG, Tuchin VV, Altshuler GB. The morphology of apoptosis and necrosis of fat cells after photodynamic treatment at a constant temperature in vitro. In: Hamblin MR, Waynant RW, Anders J, eds. Mechanisms for Low-Light Therapy VI. Edited by Proceedings of the SPIE, Volume 7887. San Francisco, California; 2011:78870X-78870X-7.
