Breast Lumps - Breast Cysts

Breast Cysts are common lumps that usually presents in the perimenopausal age group i.e 35 to 50 years age group. This is also the age group when the incidence of cancerous lumps also go up. They generally disappear after menopause.

Cyst are fluid filed sacs that maybe single or multiple and maybe present in both the breasts. They feel like soft grapes or small water-filled balloon and are often seen on mammograms and if large maybe palpable as distinct soft lumps on self examination.

They are more common in woman on hormone replacement therapy (HRT).

The cause of these cysts is due to degeneration of the fibroglandular tissue of the breast in woman who have crossed their reproductive age - after the age of 35 years. The degeneration causes empty spaces which forms cysts when filled with fluid.

An ‘ultrasound scan’ helps in making the diagnosis and can easily differentiate between a solid or cystic lump. Under its guidance a 23 gauge fine needle can be used to aspirate these cysts and the aspirate can then be sent to the pathologists to look for malignant cells.

The cyst can be considered benign if the following criteria is met -

1. The aspirate is clear or milky, and not bloody
2. The lump disappears after aspiration.
3. The cytology of the aspirate is negative for malignant cells.

If the above criteria are not satisfied, a surgical excision of the cyst is advised to rule out malignancy.

In 20% of the cases the cysts recur and may require a repeat aspiration. If the same cyst is apirated more than 3 to 4 times surgcial excision is advised.