Breast cysts - Benign disorders of the breast

Breast cysts

Definition

A common fluid filled epithelial lined space in the breast presenting as a mass.

Incidence

Palpable cysts occur in 7% of women in Western countries and account for 15% ofall discrete breast masses.

Aetiology/pathophysiology

Breast cysts are a very common finding in the years leading up to the menopause and are thought to arise due to an anomaly of breast involution.

Clinical features

Patients present with a solitary or multiple lump(s). These are typically well-demarcated, soft or firm and not fixed to underlying tissue. There should not be any associated lymphadenopathy.

Investigations

Patients require a triple assessment consisting of clinical examination, imaging using ultrasound or mammography  and in the case of a cyst fine needle aspiration.

Management

Patients with a single cyst do not need to be reviewed following an otherwise normal ultrasound and successful fine needle aspiration. Patients with multiple cysts do not need all their cysts aspirated and therefore should remain under regular review. Indications for surgical biopsy include bloody fluid detected on fine needle aspiration, a residual mass following aspiration, or multiple recurrence at the same site.