Breast Cyst

What is a Breast Cyst?

Breast cysts are inflamed benign lesion where fluid accumulates within the breast and results in the formation of a lump. These cysts can also be on the outer part of the breast. They mostly form during the period of ovulation and menstruation. These cysts can be hard or soft in touch and can range in any size.

Women before menopause, between the ages of 35 to 50 are most prone to breast cyst but it can develop in women of any age. Women who take hormonal therapy are also likely to have this cyst.

When can Cyst be Cancerous?

Sometimes breast cysts are harmful and turn out to be breast cancer. The signs and symptoms of breast cyst being breast cancer are:

  • Sensation of immovable lump or knot inside the breast or area under the arm
  • Visibility of swelling, redness or darkness & shrinking of the skin
  • Change in shape & size
  • Causes itchiness or rashes
  • Occurrence of pain in new parts of the breast
  • Liquid discharge from the nipples
  • Feeling of inside pull in the breast & in the nipples

Epidemiology

Around 7% of the women in the western world have palpable breast cysts. Women, especially at young age, have a high chance of developing breast cancer. Breast cyst in men is a very rare case, but if present it may be malignant.

Causes of Breast Cyst

Causes of breast cysts are still a mystery for the experts. But it is assumed that it can be a cause of monthly menstruation cycle due to hormonal changes or excessive estrogen in the body can stimulate breast tissue which can lead to breast cyst.

Breast is made up of lobes of glandular tissue which is arranged like petals of a daisy flower. During pregnancy and breastfeeding these lobes get divided into smaller lobules. The breast is given a shape by the supporting tissue which is made up of fibrous connective tissues which contain fat. Due to the accumulation of fluid inside these glands, breast cyst develops.

Types of Breast Cyst

Breast cyst can be classified into two types-

  • Micro cysts: Small in size and hardly felt, these are visible during imaging tests like mammography or ultrasound. Usually, clustered micro cysts are most common in premenopausal and perimenopausal women. It can be identified by diagnosis and can be easily removed when they are small, new or deep.
  • Macrocysts: Varying in size from 1 -2 inches in diameter, these cysts can be felt. It can cause pain and harm to the adjacent breast tissues.

Complicated Cyst: Cyst with Debris

Complicated cysts are masses that are similar to simple cyst but they are not anechoic, i.e., they partially appear like hypoechoic internally.

Symptoms of breast cyst

Signs and symptoms of breast cyst are:

  • Formation of oval lump which is smooth, round, easily movable & has distinct edges
  • Nipple discharge might be yellowish, straw or dark brown in color
  • Feel of breast pain or tenderness & variation in size of the lump
  • Increased breast lump size & tenderness before the period
  • Decreased size of the lump & resolution after the period

Diagnosis of Breast Cyst

Most of the breast cyst are benign in nature but to confirm whether it is cancerous or not, following diagnosis is done:

  • Mammogram: Low dose x-rays that examine the breast in a small amount through ionizing radiation.
  • Breast ultrasound: Soundwave which determines the nature of the cyst (solid or fluid). It is a better process than mammography.
  • Breast MRI: Procedure that gives better results than mammogram and breast ultrasound. It detects the cyst and gives a detailed picture of the breast inside.

If doctors are not satisfied with these results then further tests are prescribed:

  • Ultrasound biopsy
  • Stereotactic (X-Ray) biopsy
  • MRI-guided biopsy

Diagnosis depends on certain conditions like:

  • When the fluid contains blood and the lump is still present, then the doctors send it for lab testing and further imaging tests should be followed-up.
  • If the fluid does not contain blood and the bump disappears, then no further test is needed.
  • In case no fluid comes out, then doctors go for imaging test to check if it is a solid mass which increases the rate of breast cancer.

If bilateral complicated, multiple or simple cyst is there, then BI-RADS 2, gives a better result.

Treatment of breast cyst

The cyst which is fluid filled and doesn’t have any symptoms, do not need any treatment. But if the cyst varies in size or show changes, the following treatment should be done:

  • Fine Needle Aspiration: In this process ingestion of a needle can remove the fluid from the cyst and the lump disappears, however, re-occurrence is expected. It usually takes place during an ultrasound to determine the exact placement of the needle. Immediately after the removal of the fluid and disappearance of the lump, diagnosis is done.
  • Birth control pills: Usage of birth control pills can reduce the re-growth of breast cyst because it helps in the continuation of the menstrual cycle.
  • Surgery: If a cyst shows any kind of reaction after its removal, then surgery is necessary. This re-occurrence can be a result of blood-tinged fluid.
  • Pain medications: Sometimes doctors may recommend pain relievers like acetaminophen (Tylenol, others) or ibuprofen (non-steroidal inflammatory drug).

Alternative Method

Some studies suggest that use of evening primrose oil which is a fatty acid (linoleic acid) can reduce the menstrual cycle breast pain. But it is still not stated whether it is effective or not because lack of linoleic acid in women affects the hormonal fluctuation during menstruation which results in breast pain.

Prevention of Breast Cyst

The cyst is common amongst the women who are in the stage of premenopausal or have undergone estrogen replacement. Although it can be avoided by taking some natural precautions, which includes:

  • Consumption of toxins like caffeine should be avoided
  • Regular aerobic exercise or yoga is quite helpful
  • Nutrition-rich diet should be maintained
  • Wear supportive, well-fitted bra
  • Massaging breast with lubricating oil can offer some relief
  • Reduction of salt in diet
  • Application of warm or cool compress

References

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