Filed under: Women's Health
Breast cysts are fluid-filled sacs within your breast, which are usually not cancer (benign). You can have one or many breast cysts. They're often described as round or oval lumps with distinct edges. In texture, a breast cyst usually feels like a grape or a water-filled balloon, but sometimes a breast cyst feels firm.
Breast cysts don't require treatment unless a cyst is large and painful or otherwise uncomfortable. In that case, draining the fluid from a breast cyst can ease your symptoms.
Breast cysts are common in women before menopause, between ages 35 and 50, but can be found in women of any age. If you have breast cysts, they usually disappear after menopause, unless you're taking hormone therapy.
Signs and symptoms of breast cysts include:
Having one or many simple breast cysts doesn't increase your risk of breast cancer. But having cysts may interfere with your ability to detect new breast lumps or other abnormal changes that might need to be evaluated by your doctor. It's important to become familiar with how your breasts normally feel so that you'll know when something is new or changing or just doesn't feel right.
When to see a doctor
Normal breast tissue in healthy women often feels lumpy or nodular. But if you detect the presence of any new breast lumps that don't go away after a menstrual period, or if a previously evaluated breast lump seems to have grown or otherwise changed, make an appointment with your doctor to get it checked out right away.
Each of your breasts contains lobes of glandular tissue, arranged like petals of a daisy. The lobes are further divided into smaller lobules that produce milk during pregnancy and breast-feeding. Small ducts move the milk to your nipple. The supporting tissue that gives the breast its shape is made up of fatty tissue and fibrous connective tissue. Breast cysts develop when an overgrowth of glands and connective tissue (fibrocystic changes) block milk ducts, causing them to widen (dilate) and fill with fluid.
The cause of breast cysts remains unknown. Some evidence suggests that excess estrogen in your body, which can stimulate the breast tissue, may play a role in breast cyst development.
For evaluation of a new breast lump or changes on your breast exam, you'll likely start by seeing your primary care provider. In some cases, based on a clinical breast exam or findings on an imaging test, you may be referred to a breast-health specialist.
What you can do
The initial evaluation focuses on your medical history. You'll discuss your symptoms, their relation to your menstrual cycle and any other relevant information. To prepare for this discussion, make lists that include:
Basic questions to ask your doctor include:
Don't hesitate to ask questions anytime you don't understand something.
What to expect from your doctor
Be prepared to answer questions that your doctor may ask, such as:
Screening and diagnosis of a breast cyst usually begins after you or your doctor identify a breast lump. In addition to discussing your symptoms and health history, your doctor will do a breast exam and may do a breast ultrasound or fine-needle aspiration, depending on your needs.
Your doctor will physically examine the breast lump and check for any other problem areas in your breasts. Because your doctor can't tell from a clinical breast exam alone whether a breast lump is a cyst, you'll need another test, either an imaging test or fine-needle aspiration.
Breast ultrasound can help your doctor determine whether a breast lump is fluid-filled or solid. A fluid-filled area usually indicates a breast cyst. A solid-appearing mass most likely is a noncancerous lump, such as a fibroadenoma, but solid lumps also could be breast cancer.
Based on what the doctor sees on the ultrasound, he or she might recommend a biopsy to further evaluate a solid-appearing mass. If your doctor can easily feel a breast lump, he or she may skip breast ultrasound and perform fine-needle aspiration instead.
During a fine-needle aspiration, your doctor inserts a thin needle into the breast lump and attempts to withdraw (aspirate) fluid. Often, fine-needle aspiration is done using ultrasound to guide accurate placement of the needle. If fluid comes out and the breast lump goes away, your doctor can make a breast cyst diagnosis immediately.
No treatment is necessary for fluid-filled (simple) breast cysts. If you haven't reached menopause, your doctor may recommend closely monitoring a breast cyst to see if it resolves on its own.
Fine-needle aspiration, the procedure used to diagnose a breast cyst, also may serve as treatment if your doctor removes all the fluid from the cyst at the time of diagnosis, your breast lump disappears and your symptoms resolve.
If you have a breast cyst, you may need to have fluid drained more than once. Recurrent or new cysts are common. However, if the cyst is persistent through two to three menstrual cycles and increasing in size, you should see your doctor for evaluation with an ultrasound.
Using birth control pills (oral contraceptives) to regulate your menstrual cycles may help reduce the recurrence of breast cysts. But because of possible serious side effects, birth control pills or other hormone therapy, such as tamoxifen, is usually only recommended in women with severe symptoms. Discontinuing hormone replacement therapy during the postmenopausal years may reduce the formation of cysts as well.
Surgical removal of a cyst is necessary only in unusual circumstances. Surgery may be considered if an uncomfortable breast cyst recurs month after month or if a breast cyst contains blood-tinged fluid or shows other worrisome signs.
To minimize discomfort associated with breast cysts, you might try these measures:
Evening primrose oil is a fatty acid (linoleic acid) supplement that's available over-the-counter. A few small studies suggest that evening primrose oil may help minimize menstrual cycle breast pain, sometimes associated with breast cysts. But evidence isn't conclusive, and more research is needed. Although the exact mechanism isn't clear, some experts believe that women deficient in linoleic acid are more sensitive to hormonal fluctuations during the menstrual cycle, resulting in breast pain.
Your cyst or lump needs medical evaluation to be sure it's not cancer, so follow your doctor's recommendations. Let your doctor know if you're taking any vitamins, herbal remedies or other dietary supplements.