Types of cysts
With an ultrasound, the doctor evaluates the contents, walls and internal structure of the cyst. Tactics depend on this. The BI-RADS system is used to describe findings, where simple cysts are classified as benign (category 2).
- A simple cyst is a thin, smooth wall, homogeneous liquid; benign
- Complicated cyst - with internal sediment; often benign, may require monitoring
- Complex (complex) cyst - with a dense component, septa or a thickened wall; need a biopsy
- Microcysts - small clusters of cysts
Reasons
Cysts form from the lobules of the mammary gland when fluid accumulates in dilated ducts. Fluctuations in estrogen and progesterone play a major role, so cysts often appear during the period of active hormonal changes before menopause.
- Age 35–50 years
- Premenopause
- Hormone replacement therapy after menopause
- Fibrocystic changes in the breast
Symptoms
Small cysts are usually not felt and are detected on ultrasound. Large cysts can be felt as a smooth, round, mobile formation. Before menstruation, the cyst may enlarge and become painful, and after it may decrease.
- Round soft elastic movable seal
- Pain or feeling of fullness in the chest
- Increased symptoms before menstruation
- Sometimes - the sudden appearance of a large cyst
Diagnostics
The main method is ultrasound of the mammary glands, which is best performed in the first half of the menstrual cycle. Women over 40 years old also undergo mammography. If the cyst is simple, additional studies are not needed. In case of a complex cyst or a questionable picture, a puncture with examination of the contents or a biopsy of the dense component is performed.
- Examination and palpation of the mammary glands
- Ultrasound of the mammary glands
- Mammography after 40 years
- Fine needle aspiration with cytology as indicated
- Trephine biopsy for a complex cyst
Treatment
Simple asymptomatic cysts do not require treatment - regular preventive examination is enough. If a large cyst causes pain or discomfort, it can be emptied with a thin needle under ultrasound guidance; The procedure is quick and almost painless. If the fluid is bloody, the cyst quickly fills again, or a lump remains after puncture, a biopsy is prescribed. Complex cysts with suspicious signs are removed surgically if necessary. The effectiveness of “absorbable” agents and dietary supplements has not been proven.
- Do a breast self-examination once a month after your period.
- Get a breast ultrasound every year or as recommended by your doctor.
- After 40 years - regular mammography
- Find a comfortable, supportive bra for pain
- Tell your doctor about any new lumps
