Breast Cysts

Diagnosis of Breast Cysts

Breast cyst diagnosis usually involves a combination of breast exam, imaging tests, and possibly fine-needle aspiration or biopsy.

• Breast exam:

  • The doctor examines the breast for lumps or abnormalities.

  • A clinical breast exam alone cannot confirm a cyst, so further testing is needed.

• Imaging tests:

  • Mammography: Detects large cysts or clusters of small cysts, but may miss microcysts.

  • Breast ultrasound: Distinguishes between fluid-filled cysts and solid lumps. Solid lumps may require further testing, including biopsy.

• Fine-needle aspiration (FNA):

  • A thin needle is inserted into the lump to withdraw fluid, often guided by ultrasound.

  • Diagnosis is confirmed if the lump disappears after fluid removal.

  • Straw-colored, non-bloody fluid: No further treatment required.

  • Bloody fluid or persistent lump: Sent for lab testing and further evaluation by a breast specialist.

  • If no fluid is withdrawn, imaging or biopsy may be recommended to rule out solid masses.

Treatment of Breast Cysts

• No treatment needed:

  • Simple, fluid-filled cysts that are asymptomatic usually require no intervention.

  • Many cysts disappear on their own.

• Fine-needle aspiration:

  • Can both diagnose and treat cysts if all fluid is removed.

  • Some cysts may need repeated drainage if they recur.

  • Persistent cysts over 2–3 menstrual cycles or growing cysts should be reevaluated.

• Hormone use:

  • Oral contraceptives may reduce recurrence of breast cysts in some women.

  • Hormone therapy like tamoxifen is usually reserved for severe symptoms.

  • Discontinuing hormone therapy after menopause may help prevent cysts.

• Surgery:

  • Rarely required.

  • Considered if a cyst is painful, recurrent, or contains blood.