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A breast cyst is a benign, liquid-filled pouch in the breast. It occurs when fluid accumulates in an empty milk gland. Some cysts are too small in size, whereas the size of others grows up to several inches, which is large enough to make the patients uncomfortable. A bunch of cysts can form in one breast or both.
Breast cysts are quite common, especially for women who are in their later years of labour. These can be easily mistaken for a cancerous lump. About a quarter of breast masses approximately turn out to be cysts.
Although breast cysts occur in women of any age group, they're more commonly seen in women before the menopause period, typically under the age group of 50. But in some cases, they are found in women of any age group as well. Breast cysts also occur in postmenopausal women who take hormone therapy.
Breast Cysts Types
Breast cysts can be defined based on their size:
- Microcysts are observed during certain imaging tests, like mammography or ultrasound. These are too small in size to feel.
- Macrocysts are relatively large enough to be felt and grow in size to about 2.5 to 5 centimetres in diameter.
There are three types of breast cysts:
- Simple breast cysts: These are always noncancerous and solely filled with fluid.
- Complicated breast cysts: These consist of some solid fragments floating in the fluid. The doctor recommends performing a breast cyst aspiration or needle biopsy.
- Complex breast cyst: This kind of cyst is troublesome as it appears to have some amount of cancerous tissue present. Needle biopsy is recommended for those patients having this type of cyst.
Breast Cysts Symptoms
Breast cysts may be found in either one or both breasts. Signs and symptoms of a breast cyst comprise of:
- A smooth, easily movable round or oval-shaped lump that seems to have smooth edges, typically indicating it to be benign
- Discharge from the nipples can be clear, yellow, or dark brown in appearance
- Pain in the breast or tenderness in the area of the breast lump
- A gradual increase in the size of the breast lump and breast tenderness just before the period
- A decrease in breast lump size and subsiding of other symptoms after the period
Breast Cysts Causes
Experts don't know exactly the cause behind breast cysts; however, it is believed that they may occur due to hormonal changes resulting from regular menstruation cycles.
Breast Cysts Diagnosis
Diagnosis of a breast cyst usually consists of a breast examination followed by certain imaging tests, like a breast ultrasound or mammogram, and lastly, a fine-needle aspiration biopsy for the breast.
Breast examination
After discussing the symptoms and health history, the doctor will physically examine the breast lump and assess for any other associated breast abnormalities. Since the doctor can't predict from a clinical breast examination alone whether a breast lump is a cyst or not, so further investigations are recommended, like an imaging test or fine-needle aspiration biopsy.
Imaging tests
These generally consist of the following:
- Mammography. Large cysts and bundles of small cysts can usually be observed with mammography, whereas micro cysts are difficult or near impossible to notice through a mammogram.
- Breast ultrasound. This test can help the doctor to determine whether a breast lump is filled with fluid or a solid substance. A fluid-filled area usually indicates the presence of a breast cyst. A solid-looking mass is most likely a noncancerous lump, like a fibroadenoma, but at times, solid lumps could also turn out to be breast cancer, as seen in a few cases.
The doctor may further recommend a biopsy procedure to evaluate a mass that seems solid. If the doctor can easily palpate the breast lump, imaging tests are skipped, and a fine-needle aspiration biopsy is performed to discharge the accumulated fluid and crumble the cyst.
Fine-needle aspiration
During this procedure, the doctor injects a thin needle into the breast lump area and attempts to withdraw some amount of fluid. Often, fine-needle aspiration biopsy is carried out using ultrasound to guide the correct execution of the needle. If the fluid is withdrawn and the breast lump settles down, then the doctor can confirm the diagnosis of a breast cyst.
- If the appearance of the fluid is not bloody and has a straw-coloured display and the breast lump subsides, patients don't need any further testing beyond that.
- If the appearance of the fluid is bloody and the breast lump doesn't settle down, the doctor may send a sample of the extracted fluid for further lab testing.
- If no fluid is withdrawn, then the doctor will most probably suggest an imaging test, like a diagnostic mammogram or ultrasound. The lack of fluid on extraction or a breast lump that doesn't disappear after aspiration suggests that the breast lump, or at least a portion of its solid. A biopsy sample of the tissue may be collected to assess for cancer.
Breast Cysts Treatment
In most cases, patients don't require treatment as such. Simple breast cysts don't cause any issues and, at times, even disappear on their own.
If the cyst is uncomfortable, the doctor can aspirate the fluid from it with the help of a needle biopsy. However, the fluid can collect back. If it accumulates and continues to be painful, the patient may need surgery to remove it.
Surgery
Surgical intervention to remove a breast cyst is necessary only in unusual circumstances. Surgery may be considered if an uncomfortable breast cyst recurs month after month or if a breast cyst contains blood-tinged fluid or shows other worrisome signs.
Breast Cysts Risk Factors
Some women tend to be more susceptible than others to developing breast cysts and lumps in the breasts. There is not a lot of evidence regarding the factors that seem to escalate the risk of breast cysts. In general, certain benign breast conditions, including breast cysts, tend to occur in families. If few women in the family have dense or cystic breast tissue, then others may be more likely to have the same issues as well.
Breast Cysts Complications
Simple cysts usually do not have any long-term complications. They do not increase a woman's possibility of having breast cancer by themselves. However, the presence of multiple cysts and fibrous changes in the breast tissue makes it more difficult to diagnose cancer on a mammogram. If there is the presence of fibrocystic changes or dense breasts, the doctor recommends supplemental screening exams. This includes undergoing 3D mammograms or breast ultrasound, or MRI scans as compared to a standard mammogram.
Complex cysts can be more troublesome in the later part of life. It is possible for them to incorporate cancerous cells or even put the individuals at risk for evolving cancer further in the future. The biopsy results will give the doctor information about this likelihood.
Outlook
Breast cysts don't increase the risk of breast cancer. But the patients should have any new lump checked out by the doctor. Breast cysts usually disappear after menopause.
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