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.