Garsa et al reported a grading system for fat necrosis of the breast following radiation therapy for breast cancer. The authors are from Washington University, Barnes-Jewish Hospital and John Cochran Veterans Hospital.
Patient selection: women with breast cancer following breast-conserving therapy and radiation therapy to the breast
Parameters:
(1) fat necrosis (palpable mass, radiologic findings, or cytologic evidence of fat necrosis)
(2) symptoms, primarily pain
(3) intervention required for symptoms
Necrosis
Symptoms
Intervention Required
Grade
none
none
NA
0
present
none, painless
NA
1
present
present
non-narcotic analgesics
2
present
present
narcotic analgesics for > 2 weeks
3
present
present
surgical intervention
4
where:
• Narcotic analgesics for <= 14 days would be Grade 2.
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