CYSTS IN THE BREAST( BREAST CYSTS)
These are fluid filled sacs, either single or multiple, seen in one or both breasts.
Breast cysts develop as a result of fluid accumulation inside the glands in the breasts.
These cysts are usually non- cancerous and don’t require treatment unless they are large causing pain or discomfort.
They are more common in women before menopause, i.e; under 50 years of age, but can be found in women of any age.
Breast cysts also occur in postmenopausal women who are on hormone replacement therapy.
CAUSE : Exact cause for breast cysts is not known. They may develop as a result of hormonal changes resulting from monthly menstruation.
SYMPTOMS:
- A smooth, easily movable round or oval lump
- Nipple discharge which may be clear, yellow or straw coloured
- Breast pain or tenderness in the area of the breast lump
- An increase in lump size and breast tenderness just before the period
- A decrease in lump size and tenderness after the period
TYPES:
Depending on the size, Breast cysts may be classified as:
1. Microcysts- seen only during imaging tests, such as mammography or ultrasound, but are too small to be felt.
2. Macrocysts are large enough to be felt by self examination and can grow to about 1 to 2 inches (2.5 to 5 centimeters) in diameter.
DIAGNOSIS:
Diagnostic tests of a breast cyst include
1. A breast examination
2. Imaging tests, such as a breast ultrasound or mammogram and
3. Fine-needle aspiration or a breast biopsy.
Breast examination
Physical examination of the breast by the gynaecologist for a lump and any other breast abnormalities.
Clinical breast exam alone does not tell us whether a breast lump is a cyst and needs further testing- either an imaging test or fine-needle aspiration.
Imaging tests
1. Mammography. Large cysts and groups of small cysts can be seen usually with mammogram. But microcysts are difficult to be seen on a mammogram.
2.Breast ultrasound. This test helps to identify whether a breast lump is fluid filled or solid. A fluid-filled lump usually indicates a breast cyst. A solid-appearing mass most likely is a noncancerous lump, such as a fibroadenoma, but also could be breast cancer.
A biopsy may be advised for further evaluation of a mass that appears solid.
Fine-needle aspiration.
A thin needle is inserted into the breast lump and and the fluid is withdrawn.
At times, fine-needle aspiration is done using ultrasound guidance for accurate placement of the needle. If fluid comes out and the breast lump goes away, breast cyst is diagnosed immediately.
If the fluid is straw-colored in appearance and not bloody and the breast lump disappears, no further testing or treatment is needed.
If the fluid appears bloody or the breast lump doesn’t disappear, a sample of the fluid is sent for lab testing .
If no fluid is withdrawn, an imaging test, such as a mammogram or ultrasound is recommended.
Absence of fluid or a breast lump that doesn’t disappear after aspiration suggests that the breast lump is solid and a sample of the tissue may be collected to check for cancer.
Imaging tests
1. Mammography. Large cysts and groups of small cysts can be seen usually with mammogram. But microcysts are difficult to be seen on a mammogram.
2.Breast ultrasound. This test helps to identify whether a breast lump is fluid filled or solid. A fluid-filled lump usually indicates a breast cyst. A solid-appearing mass most likely is a noncancerous lump, such as a fibroadenoma, but also could be breast cancer.
A biopsy may be advised for further evaluation of a mass that appears solid.
Fine-needle aspiration.
A thin needle is inserted into the breast lump and and the fluid is withdrawn.
At times, fine-needle aspiration is done using ultrasound guidance for accurate placement of the needle. If fluid comes out and the breast lump goes away, breast cyst is diagnosed immediately.
If the fluid is straw-colored in appearance and not bloody and the breast lump disappears, no further testing or treatment is needed.
If the fluid appears bloody or the breast lump doesn’t disappear, a sample of the fluid is sent for lab testing .
If no fluid is withdrawn, an imaging test, such as a mammogram or ultrasound is recommended.
Absence of fluid or a breast lump that doesn’t disappear after aspiration suggests that the breast lump is solid and a sample of the tissue may be collected to check for cancer.
TREATMENT
1.No treatment is necessary for simple breast cysts that are fluid filled and don’t cause any symptoms and that are confirmed on breast ultrasound or with a fine-needle aspiration.
Many cysts will disappear with no treatment.
2.Fine-needle aspiration:
Fine-needle aspiration may be used to diagnose and also to treat a breast cyst if all the fluid can be removed from the cyst during the procedure, and the breast lump disappears thereby relieving the symptoms.
For some breast cysts, fluid may have to be drained more than once. Recurrence or formation of new cysts is common.
3.Hormone therapy:
Birth control pills (oral contraceptives) to regulate menstrual cycles may help to reduce the recurrence of breast cysts. But because of possible side effects, birth control pills or other hormone therapy is recommended only if the women has severe symptoms.
4.Surgery:
Surgery to remove a breast cyst is necessary only if the cyst is large causing discomfort or pain or recurs after aspiration or if a breast cyst contains blood-tinged fluid or shows other worrisome signs.