Breast cyst, also called mammary cyst, breast cyst or cyst in the breast, is the most common benign lesion of the breast, and can be found in women of any age, although its peak incidence is between 35 and 50years old.
A woman may have one or multiple cysts in the breast, which in turn can affect only one or both breasts.
Cysts are round or oval lesions, which are often described by patients as a grape or a small balloon filled with water that can be palpated in the breast.
In this article we will explain what is the breast cyst, how it appears, what are its symptoms and what are its treatment options. Let's also explain what is the risk of a breast cyst turning into breast cancer.
What is the
breast cyst? In medicine, we call a cyst any liquid or semi-liquid collection that is surrounded by a membrane, forming a kind of bag or bag. The mammary cyst, therefore, is a small net collection, which is located inside the breast.
We talk about other types of cysts present in our body in the following articles:
- BAKER CISTO - Popliteal cyst.
- CISTO NO OVÁRIO - Symptoms and Treatment.
- SIMPLE RENAL CISTO.
- PILONIDAL CISTO - Causes, Symptoms and Surgery.
- CISTO SINOVIAL - Causes, Symptoms and Treatment.
To understand how the cyst of the breast is formed, it is necessary to know a little of the anatomy of the breasts. Follow the illustration to make the text easier to understand.
In females, each of the breasts contains about 15 to 25 mammary lobes, which have the glands responsible for milk production. These lobes of the breast distribute themselves as petals of a flower and are surrounded by a supporting tissue composed of fat and fibrous tissue. Each breast wolf drains into a canal, called a lactic acid duct, which extends to the nipple.
Breast cysts usually arise from an obstruction in the terminal lobular ducts, which are the portion of the lactating duct closest to the lobes. Ductal obstruction causes fluid accumulation and formation of the cyst.
Contrary to common sense may suggest, breast cysts are not composed of milk. Its liquid is a mixture of water of mineral salts and its coloration is yellow-brown, produced by the very wall of the cyst. The probable cause of the cysts is linked to hormonal fluctuations along the menstrual cycle and the life of the patient, but the exact mechanism that leads to their formation is not yet clear.
Breast cysts can be classified according to their size:
- microcysts - they are very small mammary cysts that can be detected during imaging, such as mammography or ultrasound, but they are too small for us to achievepalpate it. Cysts are usually smaller than 0.4 cm in diameter.
- macrocysts - are large enough to be palpated and can grow up to about 5 centimeters in diameter. Macrocysts may compress the adjacent breast tissue and cause pain or discomfort.
Symptoms of breast cyst
Breast cyst can appear at any age, but it is most common between the ages of 35 and 50.In this age group, it is present in about 40% of women. As most cysts are small and asymptomatic, this estimate is likely to be underestimated. After menopause, cysts become less common.
Microcysts are too small to cause any symptoms and often go undetected, being identified accidentally in some imaging examination.
Already cysts with diameters greater than 0.5 cm can be identified on palpation of the breast, having a nodular aspect with a smooth, soft, rounded surface and with well defined borders. The texture of the cyst is variable and is often described as similar to that of a grape or a water balloon. In some cases, however, the cyst may resemble a hard mass.
Pain on palpation of the cyst is also common, especially if it is large( greater than 2.0 cm).In some women, the cysts may ache spontaneously.
The patient may also have a cluster of multiple small cysts( usually 0.3 cm), which may have, on palpation, the appearance of an ill-defined mass.
Therefore, palpation of the cyst( s) alone is not able to 100% securely distinguish a benign cyst, a cluster of cysts, a benign solid mass or a malignant tumor. This requires imaging tests, such as ultrasound or mammography.
Diagnosis of breast cyst
Ultrasonography is usually the imaging exam used to identify mammary cysts, since this method easily allows the identification of structures filled by fluid( i.e., cysts).
Ultrasound, cysts can have the following characteristics:
- Simple breast cyst: A simple cyst is well circumscribed, has thin walls and purely liquid content inside.
- Complex cyst: complex cysts are defined as thick-walled masses with septa in their interior and a heterogenic aspect with mixed liquid and solid lesion characteristics. The complex cyst is uncommon, only 5% of cysts identified on ultrasound have this characteristic.
When the cyst is large enough to be palpated, the doctor may perform fine-needle aspiration of the lesion before requesting any imaging examination.
- In cases of simple cysts, aspiration of its net contents causes the lesion to disappear. In these cases, no other measures are necessary.
- If the aspiration detects bloody contents or the cyst does not disappear completely, the aspirated material should be sent for analysis and an imaging examination should be performed to better characterize the lesion.
- If the aspiration comes dry, suggesting a predominantly solid lesion, an imaging examination, such as mammography or magnetic resonance imaging, should be the next step.
Can cyst in the breast become cancer?
Breast cysts are by definition benign lesions. A simple mammary cyst is not cancer, it is not at risk of becoming cancer nor increases the risk of the patient having cancer in the future.
Malignant tumors are usually solid lesions. Eventually, some tumors may present as a complex cyst, but this is uncommon. In most cases, the complex cyst is composed only of pus, clots and cell debris.
Large cysts have not seen cancer, but their presence may make the detection of malignant lesions more difficult through imaging tests.
Treatment of the cyst in the breast
Cysts in the breast that are simple and asymptomatic do not require any type of treatment.
If the cyst is palpable and patient is unsafe with the lesion, fine needle aspiration can be performed. Recurrence of the cyst, however, is common, a fact that should be clarified to the patient.
Painful cysts or large cysts, which interfere with visualization of breast tissue on imaging tests, may also be drained by fine needle.