Why even a benign lump must always be checked

A woman may have a single cyst or many cysts, which feel like a soft grape or a water-filled balloon. These cysts normally disappear after menopause, except in cases where the women are taking hormone therapy.

Symptoms of breast cysts include a smooth, easily movable round breast lump with distinct edges, pain in the area of the breast lump and an increase in breast lump size and tenderness just before a period.

It’s important to be aware that a simple cyst does not increase the risk of developing breast cancer. However, if you detect the presence of any new breast lumps or if an already identified breast lump seems to have grown, you should always consult a doctor and have it checked out.

Each of the breasts contains 15-20 lobes of glandular tissue. The lobes are further divided into smaller lobules that produce milk. Ducts then carry the produced milk. Breast cysts develop when an overgrowth of glands and connective tissue blocks the milk ducts, causing them to widen and fill with fluid.

Microcysts are too small to feel, but will be seen during imaging tests such as mammography or ultrasound.

Macrocysts, on the other hand, are large enough to be felt, often measuring 2.5 centimetres. These large cysts can put pressure on nearby breast tissue, causing breast pain.

The cause of breast cysts remains unknown but may be caused by excess oestrogen in the body. 

The doctor will begin by physically examining the breast though this in itself cannot identify whether a breast lump is fluid-filled or solid and other tests will be needed. 

A breast ultrasound can help the doctor determine whether a breast lump is fluid-filled or solid.

Fine-needle aspiration is performed is then performed. This consists of the doctor inserting a needle into the breast lump and withdrawing fluid. If the fluid is not bloody, no further testing is needed. If the fluid appears bloody, the doctor will send a sample of the fluid for lab testing. If no fluid is withdrawn or the breast lump does not disappear, it suggests that the breast lump or a portion of it is solid and a sample of cells will be sent for analysis to check for cancer.

No treatment is necessary for simple breast cysts. The doctor may recommend closely monitoring a breast cyst to see if its size changes. In persistent cases, he may use the fine-needle aspiration procedure to remove all the fluid from the cyst and an ultrasound will be used to guide the accurate placement of the needle. After the fluid has been withdrawn from a breast cyst, a recurrence or new cysts are very common.

Using birth control pills to regulate the menstrual cycles may help reduce the recurrence of breast cysts. Discontinuing hormone replacement therapy during the postmenopausal years may also reduce the formation of cysts as well.

In some cases, the surgical removal of cyst is necessary. Surgery may be considered for an uncomfortable breast cyst or if a breast cyst contains blood-tinged fluid or shows other worrisome signs of cancer.

For prevention of breast cysts, you should wear a well-fitted and supportive bra to help relieve some discomfort. While there is no scientific proof that coffee consumption is linked to breast cysts, some women report finding relief from their symptoms after stopping coffee consumption. Salt in the diet should also be reduced because sodium increases the congestion of excess fluid retained by the body.

Breast self-examination should be done at least once each month. In any abnormality is found, seek immediate medical attention.

 

 

Dr Duangmani Thanapprapasr can be contacted at Samitivej Sukhumvit Hospital’s Women’s Health Centre. Call (02) 711 8555-6.