Breast Cyst

Question 1

Define breast cyst

Answer 1

Fluid-filled sac within the breast

Question 2

What are the causes/risk factors of breast cysts?

Answer 2

• It’s thought that breast cysts develop naturally as the breast changes with age, due to normal changes in hormone levels.
• Breast cysts are caused by blockage of the terminal acini with resultant dilatation of ducts.
• Cysts may be unilateral, although they tend to be bilateral and multifocal.
• May have an underlying malignancy.
• More common closer to ages closer to menopause – 35-60. Post-menopausal rare unless on HRT.
• Single lesions

Question 3

What are the symptoms of breast cysts?

Answer 3

• Most cases are asymptomatic and are picked up on routine investigations.
• Patients may come in because they notice a lump in their breast.
• Breast pain and tenderness may or may not be found in the area of the lump.
• Often rapidly-growing –appear almost overnight and grow quickly.
• No systemic symptoms like fevers.
• No nipple discharge.
• Cyclical change (increase in size before menstruation and a decrease in size after menstruation) is suggestive of a cyst as part of benign cystic change.

Question 4

What are the signs of breast cysts?

Answer 4

• No asymmetry of the breast, unless the cyst is too big.
• Contours of the breast are normal.
• No erythema, ulceration, dimpling, peau d’orange or any other skin changes.
• No changes to the nipple
• No discharge
• Do not move around
• smooth surface
• distinct borders
• firm/lax consistency
• no mobility
• no fixity
• no lymphadenopathy

Question 5

What investigations are carried out for breast cysts?

Answer 5

Triple assessment
• History and examination
• Imaging
- USS <35 years
- Mammography >35 years
   > no internal echoes, smooth walls, well-circumscribed shape
• Biopsy
- FNA (fluid-filled)
- Core biopsy (solid)