Breast Cyst Aspiration

Abstract

A breast mass is a common presenting symptom in a primary care office setting, at times accompanied by symptoms of pain and tenderness. It is also frequently found on a well woman examination and is a concern to both clinician and patient due to the fear of malignancy. Most breast masses are caused by fibrocystic changes of the breast, but these must be differentiated from breast cancer. Over half of the women in the United States will have fibrocystic changes sometime during their reproductive life; these changes are most common between the ages of 30 and 50. Seven percent of women in the Western world will have palpable breast cysts [1]. Fibrocystic changes consist of two different forms: fibroadenomas, which are solid, and cysts, which are liquid-filled sacs. Most fibrocystic changes fluctuate with hormonal cycles, worsening just prior to menses and improving after the initiation of menses. If a mass is noted by the clinician or the patient, consideration of returning after the patient’s menses for a reevaluation may be appropriate. If the mass is still present, a diagnostic mammogram and sonogram should be ordered. If the breast cyst shows a thickened cyst wall, intramural tumor, multiple septae, or is eccentric on ultrasound, it has a higher likelihood of being malignant [2]. A breast mass must be evaluated even if the mammogram is read as normal, as breast cancer can present in a similar fashion.