What are breast cysts?
Breast cysts are non-cancerous fluid-filled sacs of varying size. They range from small cysts you cannot feel but are detectable via ultrasound (microcysts) to larger ones that are palpable, often measuring 1-2 inches (macrocysts). It is possible to have multiple breast cysts at the same time. However, breast cysts do not increase the risk of breast cancer and rarely develop into more severe conditions.
Breast cysts are common in women aged 35-50, whether they are menstruating or undergoing hormone replacement therapy post-menopause.
What are the types of breast cysts?
- Simple Breast Cyst: A benign cyst in the breast characterized by a smooth wall and no solid components inside. Approximately 90% of breast cysts are simple breast cysts.
- Complex Breast Cyst: This type of cyst contains fluid and solid components inside. There is a risk of around 20% that a complex breast cyst could potentially develop into breast cancer. Doctors may recommend removing a tissue sample for further examination.
- Complicated Breast Cyst: This type of breast cyst has an irregular border and contains cloudy fluid. Doctors may insert a needle to drain the fluid and recheck the cyst at six months. There is less than a 2% chance that complicated breast cysts may develop into cancer.
What causes breast cysts?
Breasts consist of lobes of glandular tissue, organized like the petals of a daisy, with each lobe containing smaller lobules responsible for milk production during pregnancy or breastfeeding. Surrounding these lobes are fatty and fibrous tissues, contributing to the varied consistencies and sizes of breasts.
Breast cysts arise from the fluid buildup in the breast ducts, typically triggered by hormonal fluctuations during the menstrual cycle. Increased levels of estrogen before menstruation can stimulate the production of fluid in the breast ducts, leading to the formation of cysts. Additionally, breast cysts may develop during menopause or periods of hormonal fluctuations, such as during pregnancy or hormone therapy.
What are the symptoms of a breast cyst?
- A soft or firm palpable lump in the breast that is movable when pressed or touched.
- Pain or tenderness in the breast before menstruation.
- Cysts may increase in size before menstruation and become smaller after the period ends.
- Clear or yellowish discharge from the nipple in some cases.
When should I see a doctor?
If you have a breast lump that persists for longer than 1-2 months, the lump size increases, or there are skin changes over the breast area, seek medical attention.
What are the complications of breast cysts?
Breast cysts are not life-threatening, but they can potentially grow, cause discomfort, become infected, or require aspiration for further evaluation.
What are the diagnostic methods for breast cysts?
History taking and physical examination
Your doctor will inquire about your symptoms and conduct a physical examination to check for breast abnormalities. If a breast lump is palpable, needle aspiration is possible without ultrasound or mammogram guidance.
Imaging tests
- Mammograms can detect larger cysts or clusters of smaller cysts but may not identify the microcysts.
- Ultrasound can determine whether there is a fluid-filled sac or a solid mass in the breast. Areas with fluid suggest a breast cyst, while dense tissue areas may indicate a benign mass, such as a fibroadenoma. Solid lumps may suggest malignant tumors, prompting a doctor to recommend a biopsy.
Needle aspiration
Your doctor will insert a needle guided by ultrasound into the breast lump to drain the fluid. If the lump collapses after aspiration, this indicates it is a cyst or fluid-filled sac.
- If the breast cyst fluid contains no blood and has a straw, light brown color and disappears after draining, no additional tests or treatments are required.
- If the fluid in the breast cyst contains blood and the lump does not disappear, the doctor will recommend a biopsy and send the tissue sample to a laboratory for analysis.
- If no fluid is obtainable from the lump, the lump is solid, not a breast cyst. The doctor will recommend imaging to determine whether the lump is cancerous.
What are the treatment modalities for breast cysts?
Most benign breast cysts resolve on their own. Doctors may remove fluid to alleviate the discomfort. Surgical removal may be advisable if a recurring breast cyst causes pain.
- Needle aspiration (FNA)
This procedure serves both as a diagnostic and therapeutic method. For larger cysts, your doctor may need to aspirate the fluid multiple times. Breast cysts can recur, or new ones can form, often due to hormonal fluctuations. If the cyst enlarges or persists longer than 2-3 menstrual cycles, doctors will recommend further diagnostic evaluations. - Hormone therapy
Taking birth control pills can reduce the occurrence of breast cysts, but doctors usually recommend this only for patients with severe symptoms due to potential side effects. Additionally, discontinuing hormone replacement therapy after menopause can help prevent the formation of breast cysts. - Surgery
Surgery is typically a treatment of last resort and is recommended for patients who frequently develop breast cysts, have blood in their cysts, or exhibit worrisome signs that may indicate a more severe condition.
How can I prevent breast cysts?
Breast cysts are not preventable, but regularly performing self-examinations and undergoing annual mammograms can help detect abnormalities early.
What are home remedies for breast cysts?
- Wear a supportive bra.
- Apply warm or cold compresses to alleviate pain and tenderness in the breast.
- Avoid foods and beverages containing caffeine, such as coffee or chocolate, and observe if symptoms improve.
- Take pain relievers as recommended by your doctor, such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium.
What should I do before my doctor’s appointment?
- Record your symptoms, the date of your last menstrual period, and any medications or supplements you are taking, and prepare questions to ask your doctor:
- What causes breast cysts?
- Can a breast cyst turn into cancer?
- Do I need any additional tests?
- What is the appropriate treatment?
- Prepare answers to the questions that your doctor may ask:
- When did you first notice the lump or cyst in your breast?
- Has the size of the lump or cyst changed?
- What symptoms are you experiencing?
- Are one or both breasts affected?
- Do you feel any pain in your breasts?
- Is there any discharge from your nipple?
- When was your last mammogram?
- Does anyone in your family have a history of breast lumps or cysts?
- Have you previously had cysts or lumps in your breast, a history of breast cancer, or any biopsies?
FAQ
- Are breast cysts dangerous? Can they resolve on their own?
Breast cysts are common and often clear up on their own. It is advisable to do regular breast self-examinations and have annual mammograms. - Do breast cysts require treatment?
If a breast cyst is small and not causing pain, your doctor may recommend no further action, as it may resolve without treatment. If the cyst enlarges or causes breast pain, doctors may suggest needle aspiration. - Do breast cysts increase the risk of cancer?
The chance of a breast cyst developing into cancer is low. Simple cysts are benign, and 90% of breast cysts fall into this category. Complicated cysts have less than a 2% chance of becoming cancerous, and only 14% - 23% of complex cysts have a chance of turning into cancer. - Can breast cysts turn into tumors?
This belief is a common misconception. Typically, breast cysts do not turn into tumors.
A note from MedPark’s doctors
Breast cysts are common in women around the age of 40 and are usually not serious. If you discover a new breast lump, consult a doctor for proper diagnosis and evaluation.