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Breast cysts

Overview
  • Definition: Fluid-filled sacs within the breast tissue.
  • Part of the spectrum of fibrocystic breast changes.
  • Most common in women aged 35-50 and tend to resolve after menopause.
Etiology
  • Exact cause unknown but thought to result from the blockage of breast ducts.
  • Hormonal fluctuations: Oestrogen and progesterone can influence the breast ducts and lead to cyst formation.
Symptoms & Signs
  • Palpable lump: Smooth, easily movable round or oval lump.
  • Pain or tenderness in the affected area.
  • Size fluctuation: May increase in size before menstrual period and decrease afterward.
  • Nipple discharge may occur, often clear or yellowish.
Investigations
  • Ultrasound: First-line imaging to distinguish solid from cystic lumps.
  • Fine-needle aspiration: If the cyst is painful, large, or needs further evaluation; cyst fluid can be sent for cytology if bloodstained or if the cyst recurs.
  • Mammography: Typically for women over 35 or if there are any atypical features.
Management
  • Observation: Many cysts are benign and can be left untreated if asymptomatic.
  • Needle aspiration: To relieve symptoms and for diagnosis.
  • Oral contraceptives: May be helpful to reduce recurrence in some women.
  • Pain relief: Over-the-counter analgesics like paracetamol or ibuprofen.
Key Points
  • Breast cysts are benign but should be distinguished from other breast lumps to rule out malignancy.
  • Ultrasound is the primary diagnostic tool for breast cysts.
  • Regular self-breast examinations can help in early detection.

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