breast cysts
Simple breast cysts are a common benign cause of a breast lump in women.
Clinical presentation
Patients may be asymptomatic or present with a breast lump. Some patients may have associated pain or tenderness.
Pathology
Breast cysts are caused by blockage of the terminal acini with resultant dilatation of ducts. Cysts may be unilateral, although they tend to be bilateral and multifocal.
Cyst epithelium is cuboidal to columnar with flattening, or even atrophic change in larger cysts. Epithelial proliferation may lead to piled up masses. Epithelial overgrowth and papillary projections are not a rare finding in the cysts covered with apocrine epithelium. The stroma around the cysts represents the compressed fibrous tissue.
They can be classified according to size:
- microcyst: <3 mm
- macrocyst: >3 mm
Microcysts are found commonly in fibrocystic change.
Radiographic features
Ultrasound
The diagnostic sonographic features are the following:
- oval or round shape
- anechoic (no internal echoes)
- circumscribed margins
- posterior acoustic enhancement
Other findings may include the following:
- reverberation artifact
- smooth walls
- peripheral calcifications
Mammography
Cysts appear as a breast mass with the following features:
- oval or round shape
- circumscribed margins
Multiple round masses in both breasts is suggestive.
Treatment and prognosis
Simple cysts are benign (BI-RADS 2). When typical features of a simple breast is seen, no further workup is required.
Symptomatic large cysts may warrant aspiration. If such a situation, cytological analysis is usually not required, unless it contains bloody material . Simple cyst aspiration showing straw colored fluid can be discarded.
Postaspiration ultrasound confirms the cyst has disappeared completely with no residual mass and will confirm hemostasis. Complications from aspiration are virtually unknown but include bleeding and theoretically infection. Aspiration of cysts can be safely performed without stopping aspirin therapy.
They should not increase in size in post-menopausal women.
Differential diagnosis
- complicated cyst, which has internal low level echoes
- complex cyst, which has both anechoic (cystic) and echogenic (solid) components
- clustered microcysts, which are small and multiple
Siehe auch:
- breast lumps
- epidermale Inklusionszyste der Mamma
- fibrocystic changes
- komplizierte Zyste Mamma
- ultrasound evaluation of breast cysts
- intracystic papillary carcinoma of the breast
- BI-RADS II
- Mammakarzinom in einer Zyste
- papilläres Mammakarzinom
- fibrocystic change
- zystische Läsionen der Mamma
- invasives muzinöses Mammakarzinom
- Neoplasien der Mamma
und weiter:
Assoziationen und Differentialdiagnosen zu einfache Zyste Mamma:
