complicated breast cyst

Complicated breast cysts are one of the cystic breast lesions that show intracystic debris which may imitate a solid mass appearance. They should be carefully differentiated from a complex cyst and may require alternative management .

Radiographic features

Ultrasound

• thin wall with or without posterior acoustic enhancement
• homogenous hypoechoic content
• low-level internal echoes which may change the shape with the patient position
• sloping fluid-fluid levels

The challenge is to differentiate a complicated from a complex cyst as the low internal echoes of a complicated cyst may appear as a homogeneous hypoechoic mass .

If there is hemorrhagic or inflammatory debris which is adherent to the wall, applying power Doppler and detection of internal vascularity can positively prove it to be a solid mass lesion. On the other hand, Doppler cannot exclude it .

Treatment and prognosis

Complicated breast cysts have less than 2% risk of malignancy and are recommended to be reported as probably benign . Thus, the management is limited to :

• short interval follow up
  • if the size changes over 6 months by >20%, a diagnostic biopsy is indicated
• aspiration
  • indicated in a symptomatic patient to relieve the symptoms, newly detected cyst, and enlarged cysts

In all cases, if aspiration reveals serosanguineous fluid, then cytological analysis should be performed.

Siehe auch:

• einfache Zyste Mamma
• Mammakarzinom in einer Zyste
• zystische Läsionen der Mamma
• ultrasound features of a benign breast lesion
• Neoplasien der Mamma

und weiter:

• Mamma MRT Kontrastmitteldynamik