Breast cysts are one of the most common lesions in the breast and are also known as fibrocystic disease.
Cysts are fluid-filled sacs formed by the enlargement of breast ducts. They can occur as single or multiple entities and may be widespread. Breast cysts can present themselves as painful masses in the breast or may exist without any symptoms. Cysts without symptoms are often detected during routine ultrasound screenings.
Cysts are generally lesions that do not require intervention and can be managed through monitoring. However, intervention may be necessary if symptoms such as bleeding into the cyst, growth (typically over 3 cm),or severe pain occur. Surgical intervention is not a highly preferred method for cyst management. Instead, cyst aspiration (draining the cyst fluid) is performed using a syringe. The collected fluid is sent for pathological examination and the cyst is monitored. Surgical intervention may be required if the cyst recurs, contains a solid component, or does not shrink after aspiration.
Cysts can grow and shrink in relation to the menstrual cycle and may be noticed as painful masses during these periods. If cysts show smooth boundaries on ultrasound controls and the fluid inside is homogeneous, they are called simple cysts. Some of these may completely disappear, and they do not exhibit a risk of transformation into cancer. Cysts that go unnoticed during examination and do not cause complaints do not require follow-up.
All complex cysts identified in the fluid content, along with solid components, in the last controls need to be monitored. In cases where necessary, a biopsy for pathological diagnosis should be considered, and surgery should be planned in appropriate cases.
The majority of cysts in the breast do not require treatment. While monitoring is sufficient for simple cysts, complex cysts require more frequent and regular follow-up.
Cysts, which are quite common lesions occurring in 30-40% of women before menopause, result from the blockage of breast ducts and the filling of these ducts with fluid.
Due to the absence of a risk of transformation into cancer, this condition is also referred to as fibrocystic disease. Environmental factors, dietary habits, psychological irregularities, and hormonal fluctuations are believed to play a role in the formation of breast cysts.
A breast cyst is most commonly identified as a painful or painless mass felt in the breast. The growth of the cyst or bleeding into the cyst can cause pain. In addition, often without any apparent symptoms, ultrasonography during routine check-ups may reveal cysts of millimetric size, either singular or multiple.
Although breast cysts are the most common lesions in the breast, the majority of them are painless and are incidentally detected during ultrasound examinations. However, cysts can cause pain when they reach large sizes, experience bleeding into the cyst, or become infected (due to trauma).
In the breast, cysts are seen as simple and complex cysts. Simple cysts are known for having a smooth wall, and the fluid filling them appears homogeneous on ultrasound. Monitoring is sufficient for these cysts, and they generally do not require treatment.
Complex cysts, on the other hand, have a thick wall structure known as a solid component in part of the cyst. Intensely dense cystic fluid may be observed inside. Regular follow-up is necessary for these types of cysts. When deemed appropriate, pathological examination through biopsy and, if necessary, surgical intervention should be planned.
Any type of lesion detected in the breast is referred to as a mass. To distinguish whether this mass is benign or malignant, methods such as examination, ultrasound, and mammography are employed. Breast cysts are also referred to as breast masses. Breast cancer is also a type of breast mass. However, since cysts are generally benign, follow-up without the need for surgery is usually sufficient.
Due to the significant role of hormonal factors in cyst formation, cysts are often detected as more painful lesions approaching menstruation and during menstruation. With the end of the menstrual period, cysts can undergo changes and transformations, leading to a decrease in symptoms. Therefore, simple cysts can grow, multiply, disappear, and reappear. However, none of these situations are associated with cancer.
Breast cysts generally only require monitoring and do not necessitate treatment. However, in cases where complex cysts (with thickening of the wall forming the cyst),bleeding into the cyst, lack of rapid growth causing pain, or infection of the cyst occur, aspiration of the cyst (emptying its contents) may be necessary. If suspicious findings are detected during follow-ups, a biopsy may be performed, and surgical intervention may be carried out as needed.
Breast cysts, particularly simple breast cysts, are benign lesions in the breast. They do not transform into breast cancer; monitoring is sufficient.
Breast cysts can manifest as localized or widespread breast pain. Sometimes, patients may describe their symptoms as sensitivity, a feeling of fullness, or heaviness. However, breast cysts do not cause arm pain.
The size of breast cysts is not related to the formation of cancer; they can reach large sizes. The crucial factor here is not the size but irregularities in the cyst wall structure, the presence of solid components, and the non-homogeneous appearance of the fluid in the cyst, which may warrant a biopsy. Based on the biopsy results, surgical intervention may be planned.
A breast lump refers to any lesion found in the breast, ranging in size from millimeters to centimeters, and can be either painful or painless. The majority of breast lumps are noticed by patients who then seek medical attention. A smaller portion is detected during doctor examinations or through breast-related investigations.
Regardless of whether these lesions in the breast are benign or malignant, they are all classified as breast lumps.
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Prof. Dr. Sezai AydınGeneral Surgery Turkey
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