Breast: Breast Cysts

Breast Cysts

Basics

  • Definition: Benign Fluid-Filled Round Mass from the Terminal Duct Lobular Unit (TDLU)
  • About 25% of Benign Breast Lesions
  • Risk of Malignancy:
    • Simple/Complicated: < 1%
    • Complex: 1-23%

Classification

  • Simple: Well Circumscribed Anechoic Lesions
    • BI-RADS 2
  • Complicated: Homogenous with Low-Level Internal Echoes without Solid Components, Thick Walls, Thick Septa or Vascular Flow
    • BI-RADS 2-3
  • Complex: Solid Components, Thick Walls, Thick Septa or Vascular Flow
    • BI-RADS 4-5

Presentation

  • Palpable Mass
  • Pain/Discomfort

Diagnosis

  • Primary Diagnostic Evaluation: US
    • Mammogram or MRI Showing Cyst Should Be Followed Up with US
  • Fine Needle Aspiration (FNA) May Be Considered for Simple/Complicated Cysts
    • Shows Varying Color (Not Blood)
    • Collapses with Aspiration
  • Core Needle Biopsy is Required for Complex Cysts (BI-RADS 4-5)

Treatment

  • Simple/Complicated Cysts: No Intervention Required
    • Consider Fine Needle Aspiration (FNA) if Symptomatic, Inflamed or Infected
    • Follow BI-RADS Recommendations as Appropriate
  • Complex Cysts: Core Needle Biopsy to Evaluate for Malignancy

Simple Breast Cyst 1

Complicated Breast Cyst 2

Complex Breast Cyst 3

References

  1. Shah G, Jankharia B. Pictorial essay: Breast USG. Indian J Radiol Imaging. 2010 May;20(2):98-104. (License: CC BY-2.0)
  2. Dialani V, James DF, Slanetz PJ. A practical approach to imaging the axilla. Insights Imaging. 2015 Apr;6(2):217-29. (License: CC Not Specified)
  3. Siddiqui B, Faridi SH, Arif SH, Aslam M. Primary hydatid disease of the breast clinically masquerading as a galactocele: A case report. J Transl Int Med. 2015 Apr-Jun;3(2):82-84.(License: CC BY-NC-ND-3.0)